摘要
目的调查自贡市Y幼托机构出现以呕吐为主要症状的聚集性事件的发生原因,为类似事件的防控及处理提供参考。方法对Y幼托机构开展流行病学调查,对所采集的病例、食品及环境样本进行诺如病毒核酸、消化道病原菌检测。结果调查共发现病例25人,均为在园儿童,分布于3个班级,A班17人,罹患率40.5%(17/42),B班5人,罹患率10.9%(5/46),C班3人,罹患率9.7%(3/31)。2份粪便样品检出诺如病毒阳性(GⅡ型),食品留样中检出金黄色葡萄球菌和蜡样芽孢杆菌,从2份呕吐物,1份粪便中检出金黄色葡萄球菌,肠毒素未检出。从2份呕吐物样本中检出蜡样芽胞杆菌。咽拭子流感病毒检测均阴性。流行曲线提示为点源暴发,该幼托机构对餐具未进行物理消毒。结论本次是一起幼托机构诺如暴发疫情,餐具清洗过程中的交叉污染可能是形成暴发的主要原因。食品监督部门应加强对于幼托机构餐具消毒的管理,要求清洗后必须进行物理消毒。
Objective Investigate a vomiting outbreak that took place in Y kindergarten of Zigong city, provide reference of prevention and management for similar event. Methods We made epidemical investigation in Y kindergarten and collected patients, food and environment samples for the test of norovirus nucleic acid and gastrointestinal pathogenic bacteria. Results We found 25 patients, all of them were students of Y kindergarten, distributed in 3 classes, class A found 17 patients, attack rate were 40.5% （17/42）, class B had 5 patients, attack rate were 10. 9% （5/46）, class C had 3 patients, attack rate were 9.7% （3/31）. 2 stool samples were identified norovirus type G Ⅱ positive, food samples were identified staphylococcus aureus and bacillus cereus positive, 2 vomitting and 1 stoll samples were identified enterotoxin free staphylococcus aureus positive, 2 vomitting samples were identified bacillus cereus positive. Throat swabs were all influenza virus negative. The epidemic curve showed the outbreak were point - sourced pattern, the tableware didn＇ t implement physically sterilization. Conclusion This event was a norovirus outbreak in kindergarten, the cross contamination during tableware washing might be the main cause. The Food Supervision Administration should enforce the tableware disinfection in kindergarten, requiring physical sterilization after cleaning.
作者
张正东
陈曦
周世熙
邓建平
范正轩
周敏
ZHANG Zhengdong CHEN Xi ZHOU Shixi DENG Jianping FAN Zhengxuan ZHOU Min(Zigong Municipal Center for Disease Control and Prevention, Zigong 643000, Sichuan Province, Chin)
出处
《职业卫生与病伤》
2017年第2期70-73,共4页
Occupational Health and Damage
关键词
诺如病毒
暴发
幼托机构
norovirus, outbreak, kindergarten
