摘要
目的调查分析天津市宁河区某中学1起诺如病毒(NV)引起的急性胃肠炎暴发疫情流行病学特征,为今后类似疫情处置提供科学依据和经验借鉴。方法依据《感染性腹泻诊断标准》及《诺如病毒感染暴发调查和预防控制技术指南》进行现场调查,采用描述性流行病学方法进行数据分析,并采集相关标本,采用实时荧光定量PCR方法进行NV核酸检测。结果2019年11月12日至17日,此次疫情累计41例NA确诊病例,其中学生38例,罹患率为3.02%(38/1260);教职工3例,罹患率为1.22%(3/245),差异无统计学意义(χ^(2)=2.484,P=0.115)。各年级学生均为420人,病例罹患率分别为高一4.76%(20/420)、高二2.62%(11/420)、高三1.67%(7/420),差异有统计学意义(χ^(2)=7.218,P=0.027)。走读生和住校生罹患率分别为0.68%(3/439)、4.26%(35/821),差异有统计学意义(χ^(2)=12.532,P<0.001)。采集粪便、呕吐物、肛拭样本95份,进行NV核酸检测,其中59份检出NV-GⅡ型,阳性率为62.10%(59/95);粪便、肛拭、呕吐物样本阳性检出率分别为80.00%、46.67%、72.00%,差异有统计学意义(χ^(2)=10.138,P=0.006)。结论本次疫情由NV-GⅡ型引起,存在年级聚集性,粪便标本诺如病毒阳性检出率高于其他标本;在采取病例隔离诊治、卫生消毒等措施后,疫情得到有效控制。因此,处理疫情时应加强传播途径、传染源调查以及病毒核酸检测,以便及时识别、妥善处理,控制疫情传播。
Objective To investigate and analyze the epidemiological characteristics of an outbreak of acute gastroenteritis caused by norovirus(NV)in a middle school in Ninghe District,Tianjin City,in order to provide scientific evidence and experience for the treatment of similar epidemics in the future.Methods According to the“Diagnostic Criteria for Infectious Diarrhea”and the“Technical Guidelines for Norovirus Infection Outbreak,Prevention and Control”,the on-site investigation was carried out,the descriptive epidemiological method was used for data analysis,and relevant specimens were collected,and the NV nucleic acid detection was performed by real-time fluorescent quantitative PCR.Results From November 12 to 17,2019,there were a total of 41 confirmed cases of NA infection,including 38 students with a prevalence rate of 3.02%(38/1260)and 3 faculty and staff with a prevalence rate of 1.22%(3/245),with no significant difference(χ^(2)=2.484,P=0.115).There were 420 students in all grades,and the case incidence rates were 4.76%(20/420)in grade 1,2.62%(11/420)in grade 2,and 1.67%(7/420)in grade 3,respectively,with a statistically significant difference(χ^(2)=7.218,P=0.027).The prevalence rates of day students and residential students were 0.68%(3/439)and 4.26%(35/821),respectively,and the difference was statistically significant(χ^(2)=12.532,P<0.001).A total of 95 samples of feces,vomit and swabs were collected for NV nucleic acid testing,of which 59 were detected with NV-GII,with a positive rate of 62.10%(59/95).The positive detection rates of feces,swabs and vomit samples were 80.00%,46.67%,and 72.00%,respectively,and the difference was statistically significant(χ^(2)=10.138,P=0.006).Conclusions The outbreak was caused by NV-GII,which was clustered by grade,and the positive detection rate of norovirus in fecal specimens was higher than that of other specimens.After taking measures such as case isolation,diagnosis and treatment,sanitation and disinfection,the epidemic situation has been effectively controlled.Therefore,when dealing with the epidemic,it is necessary to strengthen the investigation of transmission route and the source of infection,and the nucleic acid testing of the virus,so as to identify and properly handle the epidemic in a timely manner and control the spread of the epidemic.
作者
刘杰
丛龙学
LIU Jie;CONG Longxue(Ninghe District Center for Disease Control and Prevention,Tianjin 301500,China)
出处
《中国校医》
2023年第12期905-907,共3页
Chinese Journal of School Doctor
