成都市龙泉驿区40起诺如病毒感染聚集性疫情分析

Cluster Epidemic Analysis of Norovirus Infection in 40 Clusters in Longquanyi District of Chengdu City

目的了解2015-2018年成都市龙泉驿区诺如病毒感染聚集性疫情的流行病学特征及影响因素。方法整理2015-2018年成都市龙泉驿区调查处置的40起诺如病毒感染聚集性疫情资料。采用描述性流行病学方法分析,用t检验比较地区和场所分布对病例均数的影响。结果40起诺如病毒感染疫情共涉及病例数384例,春季(13起/110例)、夏季(2起/19例)、秋季(12起/113例)、冬季(13起/142例)。非涉农区域24起(60.00%)。托幼机构(55%)聚集性疫情略高于学校(45%),但平均每起疫情涉及病例数则是学校高于托幼机构(t=3.047,P<0.05)。接报方式主要为疫情单位所属社区卫生服务中心/乡镇卫生院报告(27起,67.50%)。男女性别比1.19∶1。病例症状以呕吐为主(91.93%),31起(77.50%)疫情中追溯到的"首发病例"首次呕吐发生在校(园)内。结论冬季和春/秋季为诺如病毒感染疫情高发季节;非涉农区域易发生聚集性疫情;学校比托幼机构更需要加强疫情防控;应强化培训正确及时呕吐物处置流程;需加强家长及医务人员培训,发病后及时采取居家隔离,对疾病防控尤其重要。

Objective To analyze the epidemic characteristics and influencing factors of norovirus infection in Longquanyi district of Chengdu City from 2015 to 2018.Methods A descriptive analysis was conducted by collecting data of 40 norovirus clusters in Longquanyi district from 2015 to 2018.T test was used to compare the influence of regional and local distribution on the mean number of cases.Results The 40 norovirus infections involved 384 cases,the incidence seasons were spring(13 clusters/110 cases),summer(2 clusters/19 cases),autumn(12 clusters/113 cases)and winter(13 clusters/142 cases).There were 24 clusters were found in Non-agricultural areas(60.00%).Cluster outbreaks were slightly higher in nurseries(55%)than that in schools(45%),but the average number of cases per outbreak was higher in schools than that in nurseries(t=3.047,P<0.05).The community health service centers/township health centers were the mainly reported unit of the epidemic(27 cases,67.50%).The incidence between boys and girls was 1.19∶1.The symptoms of the cases were mainly vomiting(91.93%),and the"first case"of 31 clusters(77.50% of total)were vomiting which first occurred in the school(campus).Conclusion Winter and spring/autumn were the seasons with high incidence of norovirus infection.Non-agricultural areas wrre prone to cluster outbreaks.Schools need to strengthen epidemic preventioneven than that in nurseries.Training should be strengthened properly and timely on disposal of vomit.We should strengthen the training of parents and medical staff,and take t home isolated in time when outbreak which is especially important for disease prevention and control.