2017—2018年浙江省嘉善县诺如病毒感染性腹泻疫情分析

Epidemiological analysis of norovirus infectious diarrhea in from 2017 to 2018 Jiashan,Zhejiang

目的了解2017—2018年嘉善县感染性腹泻病例中诺如病毒感染状况和学校聚集性疫情特征。方法收集嘉善县第一人民医院2017—2018年腹泻病例就诊信息、粪便样本,并检测诺如病毒,收集疫情处置过程资料,对数据进行统计分析。结果共收集530例病例,诺如病毒阳性率为30.19%(160例),GⅡ型为主(156例),共发生12起聚集疫情。1、3和12月阳性率分别为56.52%(13/23)、53.19%(25/47)、48.81%(41/84),高于其他月份;散居儿童、幼托儿童和学生群体阳性率(34.71%,109例)高于其他人群(23.61%,51例);0~14岁组阳性率(35.86%,109例)高于15~59岁组(24.62%,48例)和60岁及以上组(9.68%,3例),差异均有统计学意义(P均<0.05)。12起学校聚集性疫情以冬春季节为主。幼托机构、小学和高中的罹患率分别为3.78%、1.10%、1.39%,幼托儿童、小学生出现呕吐症状的比例高于高中生,出现腹泻症状的比例低于高中生,差异均有统计学意义(P<0.01)。结论嘉善县诺如病毒感染性腹泻与季节、职业、年龄等有关,学校是感染的重点场所,需采取针对性防控措施。

Objective To understand norovirus infection in cases with infectious diarrhea in Jiashan County,Zhejiang from 2017 to 2018,as well as the characteristics of school cluster epidemics.Methods The clinical data and stool specimens of diarrhea cases were collected from the NO.1 People’s Hospital of Jiashan from 2017 to 2018,and norovirus was detected.Procedural data on epidemic situation was also collected to conduct statistical analysis.Results A total of 530 patients were collected with the norovirus positive rate of 30.19%(160 cases)and 12 epidemics occurred.The positive rates in January,March and December were 56.52%(13/23),53.19%(25/47)and 48.81%(41/84),respectively,which were higher than those in other months.The positive rate in scattered children,childcare and student group(34.71%,109 cases)was higher than that in other populations(23.61%,51 cases).The positive rate in 0-14 years old group(35.86%,109 cases)was higher than that in the 15-59(24.62%,48 cases)and 60 and above(9.68%,3 cases)groups.The differences were statistically significant(P<0.05).Twelve epidemics of norovirus infectious diarrhea were mainly in winter and spring.The prevalence rates of child care institutions,primary schools and high schools were 3.78%,1.10%and 1.39%,respectively.The proportion of vomiting among children and primary school students was higher than that of high school students,and the proportion of diarrhea was lower than that of high school students.The differences were statistically significant(P<0.01).Conclusions Norovirus infectious diarrhea in Jiashan is related to season,occupation and age.Schools are the main places for infection,and it is necessary to take preventive measures.