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目的调查晋江市某小学诺如病毒胃肠炎暴发疫情的感染来源、传播途径及主要影响因素,为防控提供依据。方法开展流行病学调查。用病例对照研究,以29例患者为病例组,按年级1∶3匹配,随机抽取同年级无症状的87人为对照组,比较两组接触和可疑暴露、饮水、用餐和卫生习惯等;采集部分环境及生物学标本进行诺如病毒和致病菌检测。结果 29例均为学生,罹患率5.2%(29/558),教职工无病例。病例对照研究发现,直接或间接接触病例呕吐物的危险性是10.67倍,是疫情进展迅速的主要影响因素。从4份病例肛拭标本中检出诺如病毒Ⅱ型核酸阳性。结论根据现场流调、临床表现及实验室检测结果综合判定,该疫情是一起由诺如病毒引起的校内胃肠炎暴发疫情。
Objective To investigate the source of infection, transmission and main influencing factors of Norovirus gastroenteritis outbreak in a primary school in Jinjiang City, so as to provide basis for prevention and control. Methods To carry out epidemiological investigation. Using case-control study, 29 patients were selected as the case group and matched with grade 1: 3 according to the grade. 87 asymptomatic patients of the same grade were randomly selected as the control group. The two groups were compared with the exposure, drinking water, meals and hygiene habits. Environmental and biological specimens for Norovirus and pathogen detection. Results 29 cases were students, the attack rate of 5.2% (29/558), no case of staff. Case-control study found that the risk of direct or indirect contact with vomit is 10.67 times, which is the main influencing factor for the rapid progress of epidemic. Norovirus type II nucleic acid was detected in four swab specimens. Conclusions According to the scene flow adjustment, clinical manifestations and laboratory test results comprehensively determine that the outbreak is caused by norovirus and intra-school gastroenteritis outbreaks.