2019-2020年河南省食源性疾病患者诺如病毒感染状况调查

Investigation on norovirus infection in patients with foodborne diseases in Henan province from 2019 to 2020

目的 通过对河南省食源性疾病监测哨点医院的诺如病毒散发病例进行分析,了解河南省食源性疾病患者诺如病毒感染状况。方法 选取10家哨点医院,采集符合病例定义的3 987名食源性疾病患者的粪便或呕吐物标本,进行诺如病毒GⅠ和GⅡ双重实时荧光PCR检测,在食源性疾病监测报告系统填报病例信息和标本信息,采用SPSS17.0软件进行数据分析。结果 共采集标本3 987份,诺如病毒阳性率6.35%(253/3 987),其中2019和2020年阳性率分别为4.76%(95/1 996)和7.94%(158/1 991),差异有统计学意义(χ^(2)=16.920,P<0.001)。诺如病毒基因Ⅰ型、Ⅱ型和Ⅰ型+Ⅱ型阳性率分别为0.38%、4.82%和0.08%。7月份的阳性病例最多(45例),主要临床症状是腹泻(98.42%)、呕吐(36.36%)、发热(28.85%),诺如病毒和非诺如病毒阳性病例在腹痛和恶心症状中所占比例差异有统计学意义(χ^(2)=44.007,P<0.001;χ^(2)=35.884,P<0.001)。1~5岁婴幼儿感染率最高(10.70%)。可疑暴露食品蛋与蛋制品(20.16%)、豆及豆制品(10.00%)、乳与乳制品(7.97%)和水果类及其制品(6.60%)关联病例的诺如病毒阳性率较高。结论 诺如病毒在不同时间段的感染趋势存在一定差异,Ⅱ型是河南省食源性疾病诺如病毒感染的主要基因型。腹泻、呕吐、发热症状的病例占比较高,婴幼儿人群标本中阳性率较高,蛋与蛋制品、豆及豆制品是主要可疑食品。

Objective To understand the status of norovirus infection among patients with foodborne diseases in Henan province through the analysis of norovirus sporadic cases from 10 sentinel hospitals monitored for foodborne diseases in Henan province.Methods Ten sentinel hospitals were selected to collect 3987 fecal or vomit samples from 3987 patients with foodborne diseases who met the case definition.Norovirus G Ⅰ and G Ⅱ were detected by dual real-time fluorescent PCR,and the case information and sample information were collected through the foodborne disease monitoring and reporting system.SPSS 17.0software was used to analyze the monitoring data.Results Of the 3 987 samples,253 were tested to be positive for norovirus,with a positive rate of 6.35%.In 2019 and in 2020,95 samples and 158 samples were tested to be positive,representing the positive rates of 4.76% and 7.94%,respectively,and the difference was statistically significant(χ~2=16.920,P <0.001).The positive rates of norovirus genotypes I,II and I + II were 0.38%,4.82% and 0.08%,respectively.More positive cases(45 cases)were detected in July,and the main symptom included diarrhea(98.42%),vomiting(36.36%) and fever(28.85%).The proportions of cases with abdominal pain and nausea between norovirus infection cases and non-norovirus infection cases were statistically significant(χ~2=44.007,P <0.001;χ~2=35.884,P <0.001).The infection rate in children aged 1 ~ 5 years was the highest(10.70%).The positive rates of norovirus were high among the cases with suspected exposed food of eggs and egg products(20.16%),beans and bean products(10.00%),milk and dairy products(7.97%) and fruits and their products(6.60%)was high.Conclusion There are some differences in the infection rate of norovirus in different time periods;type II is the main genotype of norovirus infection in patients with foodborne diseases in Henan province.Cases with the symptom of diarrhea,vomiting and fever accounted for a high proportion.Norovirus has a high incidence rate in infants and young children.Eggs and egg products,beans and bean products were the main suspect foods.