株州市学校一起因生活用水污染引起的诺如病毒胃肠炎暴发

An outbreak of norovirus gastroenteritis caused by water pollution in school in Zhuzhou City

目的了解株洲市2013年某学校一起感染性腹泻暴发的特点和流行原因，探讨暴发疫情处理的经验并为制定防止对策提供依据。方法采用现场流行病学调查分析和实验室检测方法。结果2013年8月30日—9月15日，该校发生感染性腹泻病例97例，罹患率为9．8％，发病教师年龄35岁，发病学生年龄范围15～17岁，男女性别比为0．03：1。病例的临床表现基本相同，以腹泻、腹痛、乏力等症状为主，病程1—3d。回顾性队列研究显示，大食堂就餐为主要危险因素，从患者肛拭子标本中和管网末梢水中检测到诺如病毒抗原，采取改造供水管道、隔离治疗患者和健康教育等综合措施后，疫情得到控制。结论该次疫情为一起诺如病毒感染性腹泻暴发，暴发原因是该校供水管道被污染。供水系统安全存在诸多薄弱环节，建议尽快改用市政自来水供水。

[ Objective] To analyze the epidemiological features and causes of an infectious diarrhea outbreak in a school of Zhuzhou City in 2013, explore the experience of the outbreak treatment, and provide the basis for making the prevention and control meas- ures. [ Methods] The filed epidemiological survey and laboratory testing were adopted in this study. [ Results] From August 30 to September 15 in 2013, 97 cases of infectious diarrhea were found in this school, and the attack rate was 9.8%. The age of teacher patients was 35 years old, and the student patients were aged 15-17 years old. The ratio of male-to-female was 0.03： 1. The main clinical symptoms were diarrhea, bellyache and weakness, with 1-3 days of the disease course. The historical cohort study showed that eating in large canteen was the main risk factor. Norovirus antigen was detected from anal swabs of patients and the tap water. The outbreak was controlled rapidly through implementing the comprehensive measures which included reconstruction of water sup- ply pipeline, isolation and treatment of patients, and health education. [ Conclusion ] This is an outbreak of infectious diarrhea caused by norovirus, which is resulted from the population of water supply pipeline in the school. There are many weak links in wa- ter supply system, so it is urgent to switch to municipal water supply.