金山区2014年诺如病毒聚集性胃肠炎疫情流行病学分析

Epidemiological analysis on the clusters of norvirus gastroenteritis in Jinshan District,2014

目的了解金山区诺如病毒聚集性胃肠炎疫情的流行病学特征。方法对2014年金山区诺如病毒胃肠炎疫情和病原学检测结果进行统计分析,运用Excel2007和SPSS17.0处理数据。结果共处理7起疫情,累计病例187例,罹患率介于16.67%~72.97%之间,平均罹患率48.32%;疫情发生在小学(占57.14%)、中学、养老院、托幼机构(各占14.29%);7起疫情均发生在冬季;病例临床表现以呕吐(89.30%)、腹痛或腹部不适(53.48%)为主;诺如病毒聚集性胃肠炎疫情的持续时间与疫情非及时处理(首例病例发病时间-首次介入调查时间间隔)之间呈正相关(rs=0.96,P=0.0005);5起疫情由GⅡ诺如病毒感染引起,2起由GⅠ诺如病毒感染引起;1起疫情由食品污染所致,其余6起以人-人密切接触的途径传播。结论 GⅡ型诺如病毒为金山区聚集性胃肠炎疫情的主要病原体,冬季是好发季节,学校、托幼机构和养老院是诺如病毒防治重点场所。

Objective To analyze the epidemiological characteristics of norovirus gastroenteritis clusters in Jinshan District. Methods Epidemiological features and pathogen distribution of clusters of norvirus gastroenteritis in Jinshan District in 2014 were statistically analyzed. All statistics were conducted by software Microsoft Excel 2007 and SPSS17.0. Results Totally 7 clusters of norovirus gastroenteritis were reported in Jinshan District in 2014, involving 187 patients. The attack rates ranged from 16.67% to 72.97%, with an average attack rate of 48.32%.The cases occurred in primary schools （57.14%）, middle schools（14.29%）, nursing homes （14.29%） and kindergartens （14.29%）.The 7 clusters all occurred in winter, and the main clinical manifestations were vomiting（89.30%）, abdominal pain or vague abdominal discomfort（53.48%）. The duration of each clustered event was positively correlated with non-prompt case handling （the gap between the onset of the first case and the first investigation time） （rs=0.96,P=0.0005）. Five clusters were caused by GⅡ norovirus and 1 cluster was caused by GⅠ norovirus. 1 cluster was induced by food contamination, and the other 6 clusters were mainly transmitted through person-to-person close contact. Conclusions GⅡ norovirus is the main pathogen for the clusters of nonbacterial gastroenteritis in Jinshan District.Winter is the peak season. Schools, kindergartens and nursing homes are key places for norovirus gastroenteritis prevention and control.