对某中学一起因札如病毒感染导致急性胃肠炎疫情的调查

Investigation of an epidemic of acute gastroenteritis caused by Sapovirus in a middle school

目的查明2021年深圳市某中学一起急性胃肠炎疫情的致病因子和危险因素,为疫情监测和防控提供参考。方法采用描述性流行病学方法阐述病例的临床症状和疫情的三间分布,通过分析性流行病学研究方法查找可疑食物及可疑用餐行为。开展现场卫生学调查,采集病例与厨工肛拭子、手拭子样本和环境涂抹样本进行实验室检测。结果本起疫情共发现病例26例,症状以腹泻为主,罹患率为2.85%。现场流行病学调查结果提示芝士焗饭和铁板饭是此次疫情可疑致病食物,3月1日学生用餐时有用手触碰嘴巴的行为习惯是导致其出现急性胃肠炎症状的可疑危险行为。经实验室检测3份学生肛拭子样本、5份厨工肛拭子样本、2份厨工手拭子样本,结果均检出札如病毒。结论食用被污染的芝士焗饭、铁板饭和接触污染的餐具是本次急性胃肠炎疫情发生的主要原因。建议卫生监管部门加强对餐饮单位的卫生管理,定期开展厨工健康监测,防止类似事件再次发生。

Objective To identify the pathogenic factors and risk factors of an acute gastroenteritis epidemic in a middle school in Shenzhen City in 2021,and to provide reference for surveillance,prevention and control of the epidemic.Methods A descriptive epidemiological method was used to elaborate the clinical symptoms of the cases and the three-dimensional distributions of the epidemic,and the suspicious food and dining behaviors were identified through an analytical epidemiological research method.A field hygiene investigation was carried out and samples of anal swabs,hand swab and environmental smear samples from cases and kitchen workers were collected for laboratory detection.Results A total of 26 cases were found in this epidemic,and the symptoms were mainly diarrhea,with an attack rate of 2.85%.The field epidemiological investigation results suggested that cheese baked rice and teppanyaki rice were suspicious disease-causing foods in the epidemic,and the students'habit of touching their mouths with hands was the suspicious risk behavior that led to the symptoms of acute gastroenteritis during the meal on March 1.Sapovirus was detected in 3 anal swab samples from students,5 anal swab samples and 2 hand swab samples from kitchen workers after laboratory tests.Conclusion Eating contaminated cheese baked rice,teppanyaki rice and touching contaminated tableware are the main reasons for the acute gastroenteritis epidemic.It is recommended to strengthen the sanitary management of catering units and regularly carry out health monitoring of kitchen workers by health regulatory authorities to prevent recurrence of similar incidents.