2016—2022年北京市石景山区急性胃肠炎聚集性疫情流行特征及危险因素调查

Epidemiological characteristics and risk factors of acute gastroenteritis cluster outbreak in Shijingshan District of Beijing from 2016 to 2022

目的掌握急性胃肠炎聚集性疫情临床和流行特征,为指导急性胃肠炎聚集性疫情处置提供依据。方法汇总2016—2022年北京市石景山区急性胃肠炎聚集性疫情现场流行病学调查资料和病例个案调查数据,采集病例肛拭子或粪便标本使用荧光定量PCR检测5种常见的胃肠炎病毒,分析临床和流行特征,探索聚集性疫情发生的危险因素。采用SPSS 17.0软件进行统计分析,率的比较采用χ^(2)检验,检验水准α=0.05。结果调查处置急性胃肠炎聚集性疫情161起,涉及病例1474例,胃肠炎病毒检出率为19.72%。79起可定性的疫情中,主要由GⅡ组诺如病毒感染所致(70.89%),疫情发生场所以学校和托幼机构为主,病例年龄以14岁以下的儿童为主,职业以学生和托幼儿童为主,每年高峰时间不一致。疫情持续时间3 d及以上(OR=1.976,95%CI:1.048~3.731),人传人传播方式(OR=7.417,95%CI:4.382~12.553),教室通风情况差(OR=2.336,95%CI:1.227~4.464),教室与厕所距离10 m以内(OR=3.484,95%CI:1.811~6.711),首例病例带病上课(OR=7.353,95%CI:3.436~15.625),未规范处理呕吐物(OR=4.878,95%CI:1.721~13.889),未规范消毒(OR=3.03,95%CI:1.028~8.929),发病班级未及时停课(OR=13.889,95%CI:6.329~31.250)是聚集性疫情发生的危险因素。结论北京市石景山区急性胃肠炎疫情病原主要是GⅡ组诺如病毒,应将肠道致病菌培养纳入样品检测体系,加强学校和托幼机构教职员工急性胃肠疫情防控工作培训。

Objective To understand the clinical and epidemiological characteristics of acute gastroenteritis cluster outbreaks,and to provide reference for the treatment of acute gastroenteritis outbreak.Methods Epidemiological investigation and case investigation data of acute gastroenteritis cluster outbreaks in Shijingshan District from 2016 to 2022 were summarized.Anal swabs and fecal samples of cases were collected for detection of five common gastroenteritis viruses by using quantitative fluorescent PCR.Clinical and epidemiological characteristics of this outbreak were analyzed,and risk factors of cluster outbreaks were explored.Chi-suare test was used by SPSS 17.0software,and the test levelα=0.05.Results A total of 161 acute gastroenteritis outbreaks were investigated,involving 1474 cases,and the detection rate of gastroenteritis virus was 19.72%.The79 identifiable outbreaks were mainly caused by Group GⅡnorovirus infection(70.89%).Most of the outbreaks occurred in schools and nursery institutions,and most of the cases were students and nursery children.Risk factors for the cluster outbreaks included the duration of the epidemic lasting for3 days or more(OR=1.976,95%CI:1.048-3.731),the mode of human-to-human transmission(OR=7.417,95%CI:4.382-12.553),poor ventilation in the classrooms(OR=2.336,95%CI:1.227-4.464),the distance between the classroom and the toilet was less than 10 meters(OR=3.484,95%CI:1.811~6.711),the first case attended class with illness(OR=7.353,95%CI:3.436-15.625),the vomit was not treated properly(OR=4.878,95%CI:1.721-13.889),not standardized disinfection(OR=3.03,95%CI:1.028-8.929),and not timely closure of infected classes(OR=13.889,95%CI:6.329-31.250).Conclusions The pathogen of acute gastroenteritis is mainly Group GⅡnorovirus in Shijingshan District.The culture of intestinal pathogenic bacteria should be included in the sample detection system,and the training on prevention and control of acute gastrointestinal epidemic of teachers and staff in schools and kindergartens should be strengthened.