一起小学食源性诺如病毒胃肠炎聚集性疫情调查

An Investigation on a Case of Foodborne Clustering Norovirus Gastroenteritis in a Primary School

目的调查成都市一起小学急性胃肠炎聚集性疫情,查找感染来源、传播途径和危险因素。方法应用现场流行病学调查方法进行调查,采集患者及厨师肛拭子、食物留样等标本进行检测分析。结果 2015-03-12/16,该校共发生急性胃肠炎搜索病例255例,总罹患率15.00%,主要症状为恶心、呕吐、腹痛,轻症为主;4年级罹患率明显高于1、2年级(P<0.05),学生罹患率明显高于教职工罹患率,差异有统计学意义(P<0.05);病例对照结果显示12日午餐可增加发病风险(OR=1.088,95%CI:1.035~1.144);7份病例肛拭子、3份厨师肛拭子、1份食品留样检出诺如病毒核酸阳性。结论此次疫情为诺如病毒感染引起的急性胃肠炎聚集性疫情,主要系食物被诺如病毒污染所致。加强食品安全管理,是有效杜绝类似食源性肠道传染病的关键。疫情发生后快速准确判断,是有效控制疫情的关键。

Objective To investigate the occurrence of a primary school in Chengdu, and find the source of infection cases, transmission and risk factors. Methods Field epidemiological survey method was used to investigate, the anal swabs of patients and chefs, food retention samples and other specimens were collected for testing analysis. Results From March 12 to 16, 2015 , there were 255 cases acuting gastroenteritis search cases in the school. The total attack rate was 15.00% , the main symptoms were vomiting, abdominal pain, nausea, mainly mild. The attack rate of grade 4 was significantly higher than grade 1 and grade 2 （P 〈 0. 05 ）. The attack rate of students was significantly higher than teachers, the difference was statistically significant （P 〈 0. 05 ）. Results from the case - control showed that the lunch of 12th can increase the risk of pathogenesis （ OR = 1. 088, 95% CI： 1. 035 - 1. 144） ; anal swabs from 7 cases and 3 chefs, one part food to stay kind were norovirus nucleic acid positivt. Conclusion The outbreak of norovirus infection causes acute gastroenteritis clusters of disease, mainly due to food contaminated with norovirus. Strengthening food safety management is the key to effectively prevent similar＇foodbome intestinal infectious diseases. Quickly and accurately determining cause of outbreak is the key to effectively control of the epidemic.