北京市东城区2013-2015年诺如病毒感染聚集性疫情流行病学特征分析

Epidemiology features of norovirus outbreak in Dongcheng District of Beijing, 2013-2015

目的 对2013-2015年北京市东城区诺如病毒感染聚集性疫情的流行病学特征和病原学特征进行分析.方法 采取面对面问卷调查的方式,对2013年1月至2015年12月北京市东城区报告的诺如病毒感染聚集性疫情开展流行病学调查,描述性分析疫情流行病学特征;采集病例及环境标本进行诺如病毒实时荧光PCR检测和基因序列分析,掌握疫情病原学特征.结果 2013-2015年共报告20起聚集性疫情,每起疫情发病人数在8-78例之间,罹患率在6.3-61.5％之间.三年报告起数呈逐年递增趋势,34月和10-12月报告17起,占总起数的85.0％.疫情主要发生在小学、幼儿园、集体单位和医院病房.采集患者便标本、密接便标本和环境涂抹标本260份,检出诺如病毒GⅡ型核酸阳性122份,阳性率为46.9％.对14起疫情的阳性标本基因序列分析结果：GⅡ.17型6起,GⅡ.6型3起,GⅡ.4Sydney-2012型2起,GⅡ.2、GⅡ.3、GⅡ.7型各1起.结论 2013-2015年北京市东城区诺如病毒聚集性疫情春季和秋冬季高发,应加强学校和托幼机构疫情的监测,加强集体单位食堂员工以及医院护理人员的监测与管理.

Objective To understand the epidemiologic and etiological characteristics of norovirus outbreaks in Dongcheng District of Beijing,2013-2015.Methods The norovirus outbreaks in Dongcheng District of Beijing from January 2013 to December 2015 were investigated by face to face investigation,and were analyzed by descriptive study.Specimens of patients and environmental swabs were collected and tested by real-time PCR and nucleotide sequence analysis.The etiology of outbreaks was studied.Results A total of 20 norovirus outbreaks were reported during 2013-2015,involving 8-78 cases and the attack rate was 6.3%-61.5%.The norovirus outbreaks in Dongcheng District of Beijing,2013-2015 were increase every year.There were 17 outbreaks occurred during March-April and October-December,accounting for 85.0% of all outbreaks.The outbreaks occurred in primary school,pre-school,collective unit and hospitalized patients.A total of 260 specimens were collected and tested,including stools of patients and close contacts as well as environmental swabs.One-hundred and twenty-two samples were positive for norovirus GⅡ（46.9%）.The results of virus nucleotide sequence analysis were norovirus GⅡ.17（6 outbreaks）,GⅡ.6（3 outbreaks）,GⅡ.4 Sydney_2012（2 outbreaks）,GⅡ.2 （1 outbreaks）,GⅡ.3 （1 outbreaks） and GⅡ.7 （1 outbreaks）.Conclusions Norovirus outbreaks in Dongcheng District were frequent during spring and autumn-winter time from 2013 to 2015.The surveillance for norovirus infection should be strengthened in primary school and pre-school.as.The health monitoring of the canteen staff or care worker should also be enhanced.