长沙市岳麓区一起成人诺如病毒感染性腹泻疫情调查

Investigation of An Outbreak of Norovirus Diarrhea in An Adult in Yuelu District of Changsha

目的:调查长沙市岳麓区某公司一起成人诺如病毒感染引起的感染性腹泻疫情,分析引起暴发的因素,探讨疫情控制措施和处理经验。方法:对现场流行病学调查结果进行描述性分析,采用病例对照研究分析疫情暴发的危险因素,通过PCR实验室检测确定病原体。结果:该起疫情共出现病例65例,罹患率为9.29%(65/700),13份肛试子样品诺如病毒GⅡ型核酸检测阳性;发病曲线有两处高峰,两个高峰间隔1个潜伏期中位数,但首发病例与第1个流行高峰间隔两个潜伏期中位数;主要危险因素为1月5—6日在食堂用餐。结论:因食堂工作人员呕吐后未对呕吐物进行消毒处理,继而引起GⅡ型诺如病毒感染性腹泻疫情暴发。在疫情调查过程中,应注意采集无症状暴露人员和环境标本,以追踪无症状感染者和完善传播链。此次疫情应引起重视,后续应加强成人集体单位,尤其是食堂从业人员传染病防治知识的健康教育工作。

OBJECTIVE To investigate an outbreak of norovirus infection among adults in a company in Yuelu District of Changsha,and to analyze the factors causing the outbreak,and discuss the control measures and investigation experience.METHODS Descriptive analysis was carried out through field epidemiological investigation,case-control study and PCR laboratory test were used to identify the causes.RESULTS There were 65 cases in this epidemic,the attack rate was 9.29%(65/700),13 samples of anal swab were positive for norovirus GII.There were two peaks in the incidence curve,with a median incubation period between the two peaks,but there were two median incubation periods between the first case and the first epidemic peak.The main risk factors were dining in the canteen on 5th and 6th of January.CONCLUSION The outbreak of norovirus GII diarrhea was caused by the staff of the canteen who did not disinfect the vomitus after vomiting.During the investigation of Norovirus outbreak,it should pay attention to the collection of asymptomatic exposed persons and environmental samples in order to trace asymptomatic infected persons and perfect the transmission chain.It should pay more attention to the outbreak of norovirus infection in adults and strengthen the health education on the prevention and treatment of infectious diseases in the adult collective units,especially the canteen workers.