目的 分析一起幼儿园暴发疫情特征,针对暴发疫情中感染诺如病毒GⅡ型的教职工开展排毒期调查,为采取针对性控制措施提供参考。方法 采用描述性流行病学方法分析疫情特征,采集部分儿童病例和全体教职工肛拭子、粪便或呕吐物标本进行诺如病毒检测;针对感染诺如病毒GⅡ型的教职工开展排毒时间调查,每间隔1～7 d采集教职工感染者肛拭子或粪便标本进行检测,直至阴性。结果 该园共350名儿童,146 人发病,罹患率为41.71%,所有班级均有病例;主要症状为呕吐。教职工共计49人,其中确诊病例24人,主要症状为腹泻;隐性感染者13人;教职工感染率75.51%。教职工GⅡ型感染者排毒期最短为发病后7 d,最长20 d,中位数为12 d;其中确诊病例排毒期中位数13 d明显高于隐性感染者的9 d。幼儿病例的呕吐物样本 11份、肛拭子样本 2份,检测8份GⅡ型;49名教职工肛拭子或粪便标本检出36人感染GⅡ型,1人感染GⅠ型。结论 该起疫情是由诺如病毒感染引起的感染性腹泻暴发疫情,感染GⅡ型诺如病毒的确诊病例排毒时间长于隐性感染者。
Abstract
Objective To analyze the characteristics of an outbreak in a kindergarten,and to investigate the detoxification period of faculty members infected with norovirus GⅡ in the outbreak,so as to provide reference for taking targeted control measures. Methods Descriptive epidemiological methods were used to analyze the epidemic characteristics.Anal swabs,feces or vomit samples of some children and all teaching staff were collected for norovirus detection.In addition,the detoxification time of faculty members infected with norovirus GⅡ was investigated,and their anal swabs or fecal samples were collected every 1 ~ 7 days for detection until they were negative. Results There were 350 children in the kindergarten,146 of whom were ill,and the incidence rate was 41.71%.Their main symptom was vomiting.There are 49 faculty members in total,including 24 confirmed cases whose main symptom was diarrhea and 13 recessive infections.Therefore,the infection rate of faculty members was 75.51%.The shortest detoxification period of GⅡ infection in faculty members was 7 days after onset,the longest was 20 days,and the median was 12 days.Among them,the median of 13 days in the detox period of confirmed cases was significantly higher than the 9 days of recessive infections.There were 11 vomit samples,2 anal swab samples and 8 GⅡ samples from children's cases.Anal swabs or fecal samples of 49 faculty members were tested,36 people were infected with type GⅡ and one was infected with type GⅠ. Conclusion This is an outbreak of infectious diarrhea caused by norovirus infection.And the detoxification time of confirmed cases infected with G Ⅱ norovirus is longer than that of recessive infections.
关键词
诺如病毒 /
感染性腹泻 /
暴发疫情 /
排毒时间
Key words
Norovirus /
Infectious Diarrhea /
Outbreak /
Detoxification time
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 廖巧红,冉陆,靳淼,等.诺如病毒感染暴发调查和预防控制技术指南( 2015 版) [J]中国病毒病志,2015,5(6):448 -458.
[2] 连怡遥,骆洪梅,冉陆,等.中国2014—2018年学校和托幼机构诺如病毒疫情流行病学分析[J].中国学校卫生,2019,40(3):406-410.
[3] 余建兴,赖圣杰,王鑫,等.中国 27 省(市、自治区)2009—2013 年门诊腹泻病例诺如病毒流行特征分析[J].中华流行病学杂志,2015,36(3):199-204.
[4] 刘白薇,高志勇,王全意,等.北京市 2013 - 2014年肠道门诊腹泻患者中诺如病毒感染的流行病学及临床特征分析[J].中华流行病学杂志,2015,36(4):383 - 386.
[5] 吴琳,田卫东,李宏,等.一起幼儿园诺如病毒感染聚集性疫情调查分析[J].安徽预防医学杂志,2021,27(2):141-143.
[6] 王雅新,沈小婷,汪晨夕,等.一起托幼机构诺如病毒聚集性疫情病例排毒时间分析[J].中国学校卫生,2021,41(5):762-764.
[7] 连怡遥,骆洪梅,冉陆,等.中国2014—2018年学校和托幼机构诺如病毒疫情流行病学分析[J].中国学校卫生,2019,40(3) :406-410.
[8] 鲁琴宝,丁哲渊,吴昊澄,等.2019年浙江省学校诺如病毒胃肠炎暴发疫情分析[J].疾病监测.https://kns.cnki.net/kcms/detail/11.2928.R.20210514.1030.002.html.
[9] Götz H,Ekdahl K,Lindäbck J,et al..Clinical spectrum and transmission characteristics of infectionwith Norwalk-like virus:findinges from a large community outbreak in Sweden[J].Clin Infect Dis,2001,33 (5):622-628.
[10] Rockx B,De Wit M,Vennema H,et al.Natural history of human calicivirus infection:a prospective cohort study [J].Cin Infeet Dis,2002,35 (3):246-253.
[11] 唐小清,朱玲,吴小花,等.重庆市南岸区2018年14起诺如病毒疫情流行病特征分析[J].中国学校卫生,2021,42(6):914-916.
[12] Graham DY,Jiang X,Tanaka T,et al.Norwal virus infection of volunteers:new insights based on improved assays.J Infect Dis.1994,170(1):34-43.
[13] 钱程,陈聪,顾敏华,等.诺如病毒Ⅱ型感染儿童的肠道排毒时间及其相关因素的研究[J].现代预防医学,2017,44(20):3081-3084.
PDF(977 KB)
