浙江省诺如病毒引起急性胃肠炎暴发的流行病学研究

Epidemiology of norovirus gastroenteritis outbreaks in Zhejiang province

目的研究浙江省诺如病毒胃肠炎暴发疫情流行特征。方法采用荧光PCR检测诺如病毒核酸,应用现场流行病学调查方法分析诺如病毒胃肠炎暴发疫情。结果 2004-2010年,浙江省共报告10起诺如病毒肠炎暴发疫情,发病848例,总罹患率为5.31%,10起暴发疫情分布在学校、看守所、农村,冬、春季节高发,发病高峰明显,多出现在疫情的第2～3天。主要临床症状以腹泻、呕吐、腹痛或腹部不适为主,腹泻比例较高,大部分病例病程较短(1～3 d)。67份送检样本经荧光PCR法检出诺如病毒核酸阳性。疫情主要由饮用了被污染的桶装水引起。结论诺如病毒是浙江省爆发性非细菌性胃肠炎的重要病原体之一,浙江省多起诺如病毒胃肠炎暴发疫情与饮用了被污染的桶装水有关;发生疫情可及时采取隔离治疗、消毒、加强饮水和食品卫生的管理为主的综合控制措施避免疫情扩散。

Objective To analyze the epidemiological characteristics of norovirus gastroenterits outbreaks in Zhejiang province.Methods Field epidemiological surveys were conducted and fluorescence PCR assays were performed to detect the nucleotide of norovirus.Results Ten norovirus gastroenterits outbreaks with 848 cases were reported from 2004 to 2010 in Zhejiang.The attack rate was 5.31%.The outbreaks occurred in schools,detention houses and in rural areas.The outbreaks were mainly reported in winter and spring and the cases mainly occurred during 2nd-3rd days of an outbreak.The main symptoms of norovirus gastroenterits included diarrhea,vomit,bellyache and abdominal discomfort.The disease courses were short for most cases（1-3 days）.Sixty seven specimens were detected to be norovirus positive by fluorescence PCR.The barrelled water contaminated by norovirus was the major infectious source of the disease.Conclusion Norovirus was the one of major pathogens of the nonbacterial gastroenterits outbreaks in Zhejiang.Some outbreaks were related with the drinking of the barrelled water contaminated by norovirus.The spread of the disease may be prevented by taking comprehensive control measures including isolated treatment of patients,disinfection and strengthened water/food management.