昌江县某电厂一起诺如病毒暴发疫情的调查

Investigation of an outbreak of Norovirus infection in a power plant in Changjiang County

目的了解诺如病毒感染引起腹泻暴发的特点和流行原因,探讨暴发疫情调查处理的经验,为制定防治对策提供科学依据,预防今后类似事件的发生。方法采用描述流行病学的方法对昌江县某电厂2016年3月份发生的一起诺如病毒暴发疫情进行调查和分析。结果本次疫情该电厂第一食堂就餐人员及食堂员工出现腹泻、呕吐等症状的病例41例(含病例搜索),罹患率为1.64%。采集就餐人员病例和食堂员工肛拭子37份标本,其中10份检出诺如病毒阳性(GⅠ型8份、GⅡ型2份),10份阳性标本中6例为患者(注:食堂员工4例、到食堂就餐人员2例)、4例为隐性感染者。经对患者和隐性感染者居家隔离治疗,终末消毒食堂餐具、厨房、餐厅等疫点、疫区,开展爱国卫生运动和健康教育等综合措施后疫情得到控制。结论本起疫情是由诺如病毒GⅠ型、GⅡ型混合感染引起的急性胃肠炎暴发,可疑的传播途径是食堂员工感染了诺如病毒,在食堂工作过程中,污染了食物、食堂的环境等,导致食堂其他员工和到食堂就餐人员被感染而引起暴发疫情。严格食堂食品卫生安全监督检查,开展健康教育是控制疫情的关键。

Objective To understand the characteristics and epidemic causes of diarrhea outbreak caused by Norovirus infection, and explore the experience of investigation and treatment for outbreaks, so as to provide the evidence for formulatingprevention and control strategies to prevent the similar incidents in the future. Methods A descriptive epidemiologicalmethod was used to investigate and analyze an outbreak of Norovirus infection in a power plant in Changjiang County in March2016. Results In this outbreak of Norovirus infection, 41 cases of diarrhea and vomiting（including case search） were foundin the first canteen staff and canteen customers, with an incidence of 1.64%. Among the 37 fecal specimens taken by anal swab,10 specimens were Norovirus positive（8 cases of Genogroups I, 2 cases of Genogroups Ⅱ）. Among the 10 positive specimens,there were 6 patients（4 cases of canteen staff and 2 cases of canteen customers）, and 4 cases of latent Norovirus infectedpersons. The outbreak was controlled after comprehensive treatment, such as home isolation treatment for patients and latent Norovirus infected persons, disinfection of canteen utensils, and kitchen and restaurant epidemic areas, carrying out patriotichealth campaigns and health education. Conclusions This epidemic outbreak is acute gastroenteritis caused by a mixture of Norovirus of Genogroups GⅠ and GⅡ. The suspicious transmission way of this epidemic is the Norovirus infection in the canteenstaff. During the work in the canteen, the food and canteen environment are contaminated, which leads to the infection of otherstaff and customers in the canteen, causing the outbreak of Norovirus infection. The key to control the epidemic is to strictlymanage the safety supervision and inspection of the food in the canteen, and to carry out the health education.