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目的调查、分析一起感染性腹泻暴发疫情的病因及传播因素。方法通过现场流行病学调查与实验室检测,采集水源水、食堂末稍水、病例肛拭子等进行致病菌培养和病毒检测。结果该事件涉及教职工122人,学生1 662人,覆盖40个班;首发病例发病于8月30日,持续20 d,高峰段为9月9-12日间;搜索病例共101例,学生的罹患率(6.02%)是老师(0.82%)的7.34倍,差异有统计学意义(P<0.05);女性的罹患率(8.50%)是男性(0.76%)的11.11倍,差异有统计学意义(P<0.05)。在大食堂就餐者的罹患率(10.24%)是小食堂(1.86%)的5.49倍,差异有统计学意义(P<0.05);二年级的罹患率(8.77%)是一年级(3.47%)的2.53倍,差异有统计学意义(P<0.05)。症状以腹泻腹痛为主。实验结果显示:大食堂小作坊末梢水菌落总数、总大肠菌群、耐热大肠杆菌、大肠埃希菌均超标,检出铜绿假单胞菌、诺如病毒核酸阳性;井水菌落总数、总大肠菌群均未超标;6份病例肛拭子中诺如病毒核酸阳性占66.7%,5株诺如病毒核酸高度同源。调查发现从水箱到食堂末稍水管道部分暴露于污水,单位无水消毒设施;餐具无消毒措施。结论本次疫情是本区域内首次因诺如病毒引起的感染性腹泻聚集性疫情,单位的食堂用水被污染是可能的危险因素。
Objective To investigate and analyze the etiology and transmission factors of an outbreak of infectious diarrhea. Methods Epidemiological investigation and laboratory tests were conducted to collect pathogenic bacteria and detect virus in drinking water, canteens, and anal swabs. Results The incident involved 122 faculty members and 1,662 students, covering 40 classes. The first case occurred on August 30 for 20 days and the peak was September 9-12. A total of 101 cases were searched and students (6.02%) was 7.34 times higher than that of the teachers (0.82%) (P <0.05). The incidence rate of women (8.50%) was 11.11 times higher than that of men (0.76%), the difference was statistically significant Significance (P <0.05). The prevalence of diners in the cafeteria (10.24%) was 5.49 times that of the cafeteria (1.86%), with a significant difference (P <0.05). The sophomore attack rate (8.77% 2.53-fold, the difference was statistically significant (P <0.05). The main symptoms of diarrhea and abdominal pain. The experimental results showed that the total number of colony of terminal water, total coliforms, heat-resistant Escherichia coli and Escherichia coli in large canteen were too high, and the positives of Pseudomonas aeruginosa and Norovirus were positive. The total number of well-water colonies, Coliform bacteria were not exceeded; 6 cases of anal swab Norovirus positive for 66.7%, 5 strains of Norovirus nucleic acid highly homologous. The survey found that the water pipe from the tank to the end of the canteen is slightly exposed to sewage water, water disinfection facilities units; no disinfection measures tableware. Conclusion The outbreak is the first case of infectious diarrhea-related epidemic caused by Inoruvirus in this area. It is possible that the unit’s canteen water is polluted.