一起伴2种食源性致病菌感染的诺如病毒性胃肠炎暴发事件调查与实验室分析

Investigation and laboratory analysis of a norovirus gastroenteritis outbreak with two foondborne pathogens'infection

目的调查分析桐乡市某中学一起的胃肠炎暴发疫情原因,为预防类似事件的发生提供科学依据。方法依据相关标准,结合现场流行病学调查结果以及实验室进行的细菌学、病毒学检测的结果,分析找出致病原因。结果累计病例数124例,主要症状为腹痛、腹泻(95.97%)和恶心、呕吐(54.03%),病例以八年级(44.35%)、九年级(37.10%)为主,不同年级的腹泻病例阳性率差异有统计学意义(χ^(2)=18.13,P<0.05),性别和住校情况经分析差异均无统计学意义;实验室共检出4份GⅡ型诺如病毒核酸阳性,3份金黄色葡萄球菌阳性,7份β型溶血性链球菌阳性。金黄色葡萄球菌仅对青霉素耐药,β型溶血性链球菌对红霉素、青霉素、复方新诺明耐药。结论本次疫情存在一定客观的疏漏,需引起重视应引以为戒,学校是食源性疾病防控的重点场所,更应加强监测,建立长效的食品卫生安全机制。

Objective This paper aims to investigate and analyze the causes of an outbreak of gastroenteritis in a middle school in Tongxiang City,so as to provide scientific basis for preventing the occurrence of similar events.Methods According to the relevant standards,combined with the results of the field epidemiological survey and the bacteriological and virological tests con-ducted in the laboratory,the cause of the disease was analyzed and found.Results The cumulative number of cases was 124,and the main symptoms were diarrhea and abdominal pain(95.97%),and vomiting and nausea(54.03%).The cases were mainly in grade 8(44.35%)and grade 9(37.10%).There was statistical significance on the difference in the positive rate of diarrhea cases among different grades(χ^(2)=18.13,P<0.05),but not on the differences of gender and school accommodation(P>0.05).A total of 4 samples were positive for G-Ⅱ norovirus nucleic acid,3 samples were positive for Staphylococcus au-reus and 7 samples were positive forβ-type Hemolytic streptococcus.Staphylococcus aureus was only resistant to penicillin,whileβ-type Hemolytic streptococcus was resistant to erythromycin,penicillin and cotrimoxazole.Conclusion There are some objective omissions in this epidemic,which need to be paid attention to and should be taken as a warning.Schools are key places for the prevention and control of foodborne diseases,and should strengthen monitoring and establish a long-term mecha-nism for food hygiene and safety.