一起教育培训机构诺如病毒感染性腹泻暴发调查

Investigation on an outbreak of norovirus infectious diarrhea in an education and training institution

目的对山东省枣庄市某教育培训机构一起感染性腹泻诺如病毒的病原和传播危险因素调查分析,为采取针对性预防控制措施提供依据。方法按照病例定义开展病例搜索,采用描述性流行病学方法分析暴发疫情的流行特征和相关因素。采用荧光PCR检测诺如病毒核酸。结果2020年6月,某教育培训机构出现感染性腹泻30例,总罹患率为13.22%(30/227),以腹泻96.67%(29/30)、腹痛66.67%(20/30)、恶心60.00%(18/30)为主要临床表现。男性罹患率18.18%(24/132),女性6.32%(6/95),罹患率差异有统计学意义(P<0.01)。学员罹患率14.55%(24/165),食堂服务人员罹患率为25.00%(4/16),教职员工罹患率4.35%(2/46),罹患率差异无统计学意义(P>0.05)。采集人体生物标本17份,诺如病毒阳性6份(GⅠ基因型5例,GⅡ基因型1例),总阳性率35.29%(6/17)。发病例数占总病例数的53.33%(16/30)。所有病例均有共同饮食暴露史。结论此次疫情可能是由于被诺如病毒污染的食物引起。

Objective To investigate and analyze the pathogen and transmission risk factors of norovirus in an education and training institution in Zaozhuang city,Shandong province,so as to provide the basis for taking targeted prevention and control measures.Methods Case search was carried out according to the case definition,and descriptive epidemiological methods were used to analyze the epidemiological characteristics and associated factors of the outbreak.Norovirus nucleic acid was detected by fluorescent PCR.Results In June 2020,30 cases of infectious diarrhea were reported in an education and training institution.The total attack rate was 13.22%(30/227),with diarrhea 96.67%(29/30),abdominal pain 66.67%(20/30),and nausea 60.00%(18/30)as the main clinical manifestations.The attack rates of men and women were 18.18%(24/132)and 6.32%(6/95),respectively,and the difference was statistically significant(P<0.01).The attack rates of trainees,canteen staff and teaching staff were 14.55%(24/165),25.00%(4/16)and 4.35%(2/46),respectively.There was no significant difference in attack rates(P>0.05).A total of 17 human biological samples were collected,and 6 samples were norovirus-positive(5 cases with GⅠgenotype and 1 case with GⅡgenotype).The total positive rate was 35.29%(6/17).The number of emergent cases accounted for 53.33%(16/30)of the total cases.All cases had a history of common dietary exposure.Conclusion The outbreak may be caused by food contaminated with norovirus.