2018年成都市郫都区1起饮用水污染事件的流行病学调查分析

Investigation and Analysis of An Incident of Cluster Diarrhea Caused by Drinking Water Pollution in Pidu District

目的调查2018年成都市郫都区某镇于强降雨后发生1起聚集性腹泻事件的原因并进行科学处置,为有效预防该类事件提供科学依据。方法于2018-07-15对事件发生地开展现场卫生调查,对出现急性胃肠炎的患者开展现场流行病学个案调查并收集患者临床表现等资料,同时采集相应生物和环境样品进行检测,采用SPSS 20.0软件对数据进行描述性和分析性研究。结果此次事件共计发病27人,罹患率为4.5%(27/600)。腹泻(100.0%)和腹痛(85.2%)为临床主要症状,部分患者有头痛(37.0%)、发热(33.3%)和恶心(7.4%)。采集肛拭、餐饮具及环境涂抹样品及患者大便标本共计34份,均未检出阳性结果;检测该镇集中式供水出厂水及末梢水水样各1份,未发现异常;检测该部队自备水、现制水及桶装水水样,其中自备水及现制水微生物严重超标。结论该起事件是由于武警官兵饮用了受污染的饮用水所致,致病菌可能为大肠埃希氏菌,喝生水是本次事件的危险因素。建议加强水源卫生防护和饮水消毒,同时加大宣传及卫生监督指导力度,从而保障饮水安全。

Objective To investigate a case of clustered diarrhea which happened in a town of Pidu district after the flood caused by rain storm so as to provide scientific basis for the effective prevention of such event.Methods On-site health investigation was carried out,and epidemiological investigation was carried out on the patients with acute gastroenteritis,and data on the clinical manifestations of the patients were collected.Related biological and environmental samples were collected and examined.SPSS 20.0 was used to analyze the data.Results The outbreak caused 27 cases of attack,the incidence was 4.5%(27/600).Diarrhea(100.0%)and abdominal pain(85.2%)were the main symptoms.Some patients have a headache(37.0%),fever(33.3%),and nausea(7.4%).A total of 34 samples of anal swabs,stool and environmental smears were collected.However,none of those samples were detected as positive.No abnormality was detected in the factory water and peripheral water of the town’s centralized water supply,whereas the microbial indexes of the self-provided water and the existing water-making in the army were seriously exceeded the standard.Conclusion This gathering diarrhea case is Escherichia coliinfective,which is caused by contaminated water after the rain storm.The water source protection and disinfection should be strengthened,meanwhile publicity and supervision guidance should be intensified to ensure drinking water safety for troops and soldiers.