成都市2017年诺如病毒聚集性疫情及影响因素分析

Distribution of norovirus outbreaks and associated factors in Chengdu during 2017

目的分析2017年成都市学校、托幼机构诺如病毒感染聚集性疫情及其疫情规模和持续时间的影响因素,为开展诺如防控工作提供科学依据。方法 2017年成都市共监测处置75起学校、托幼机构诺如聚集性疫情,采用方差分析比较不同组间差异,采用二元Logistic分析诺如疫情规模和持续时间的影响因素。结果共发生病例710例,平均每起疫情涉及9.47例,持续27.52 h,分别较2016年下降1.06例和10.56 h。发病高峰在1—3月,经济圈层中的一圈层地区的疫情数最多,托幼机构是疫情发生主要场所,以GII型为主。影响因素的二元Logistic回归分析显示,相较于首发呕吐在家的疫情,在学校公共区域的疫情规模更大(OR=11.76,95%CI=1.63～84.69);相对于学校/社区主动报告,被动监测的疫情规模更大(OR=4.09,95%CI=1.04～16.03)。结论建议学校和托幼机构针对学校公共区域、教室等不同场所进行呕吐腹泻物处置开发和培训,在落实诺如防控措施中尤其要重视对疫情的主动监测和报告。

Objective To analyze the features of Norovirus outbreaks in schools and kindergartens and the associated factors in Chengdu,2017,and to provide the scientific basis for Norovious outbreaks prevention and control.Methods A total of 75 schools and kindergartens in Chengdu of 2017 participated in the study about Norovirus outbreaks.ANOVA and binary Logistic regression models were used to analyze the influencing factors and duration of Norovirus outbreaks.Results OveraⅡ 710 cases were included.There was an average of 9.47 cases and 27.52 hours for each outbreak,decreasing by 1.06 cases and 10.56 hours compared with those of 2016.Most outbreaks happened inkindergartens and in the first-level economy regions from January to March, with GⅡ type as the main outbreak.Compared with the first case of vomiting at home,vomiting in public area (OR=11.76,95%CI=1.63-84.69)was much more serious,and compared with the active report of school/community,being informed of the outbreak passively (OR =4.09,95 %CI=1.04-16.03)was positively associated with outbreak severity.Conclusion To prevent Norovirus infection,specific development and training of dealing with vomiting and feces should be introduced,and measures to increase the a- bility to surveil and report Norovirus outbreaks should be enhanced.