2014—2016年上海市闵行区诺如病毒腹泻流行病学特征

Epidemiological characteristics of norovirus diarrhea in Minhang District of Shanghai from 2014-2016

目的分析上海市闵行区诺如病毒感染性腹泻疫情的流行特征及影响因素,为进一步制定有效的防控措施提供依据。方法采用现场流行病学调查方法及描述分析方法,对2014—2016年上海市闵行区诺如病毒腹泻疫情报告及个案资料进行回顾性分析。结果 2014年1月—2016年12月,共报告疫情43起,累计病例793例,其中实验室诊断病例398例(50.19%),临床诊断病例738例(93.06%),无死亡病例。疫情暴发地点主要为学校(67.44%)和幼儿园(27.91%),时间分布有明显季节性,集中在10—12月和3—5月,占总疫情数的8.75%;病例年龄主要为10～19岁(59.39%)和5～9岁(25.73%),男女性别比为1.2∶1,<5岁年龄组的发病人数差异有统计学意义(P<0.05),女性发病人数差异有统计学意义(P<0.05),职业分布主要为学生。病例症状较轻,病程一般2～3天,有自限性。可能的传播途径为经水和食物、接触传播及气溶胶传播等。结论诺如病毒感染性腹泻暴发疫情多于秋季和初夏季节在人口密集的中小学发生,应加强闵行区腹泻病患者以及疫情监测工作、做好健康宣教和保障学校饮食卫生等防控措施,减少疫情的发生。

[Objective]To analyze the epidemic characteristics and influencing factors of norovirus diarrhea in Minhang District of Shanghai, and provide basis for further formulating effective preventive and control measures. [Methods] A retrospective analysis was made on the report and case data of norovirus diarrhea in Minhang District of Shanghai from January 2014 to December 2016 by using the method of field epidemiological investigation and descriptive analysis. [Results] A total of 43 cases were reported from January 2014 to December 2016, and 793 cases were diagnosed, including 398（50.19%） laboratory diagnosis cases, 738（93.06%） clinically diagnosed cases and no death cases. The outbreaks were mainly in schools（67.44%） and kindergartens（25.58%）, with a distinct seasonal distribution, concentrated in October to December and March to May, which accounted for 8.75% of the total number of outbreaks, and the case ages were mainly 10-19（59.39%） and 5-9（25.73%） years old, the male to female ratio was 1.2∶1. The differences of incidence cases in 5 years old and female were statistically significant（P 0.05）. The cases were mainly students. The symptom of cases was mild, course of disease was 2-3 days, which had selflimiting. Possible routes of transmission included water and food, contact propagation and aerosol transmission, etc.[Conclusion] The outbreak of infectious diarrhea of norovirus usually happens in the densely populated primary and middle schools in autumn and early summer. The monitoring work of diarrhea patients and epidemic situation in Minhang District should be strengthened, and prevention and control measures such as diarrhea patients and epidemic situation monitoring, health education and school food hygiene safeguard should be strengthened to reduce the occurrence of the epidemic situation.