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目的调查了解1起诺如病毒引起的急性胃肠炎暴发疫情的流行病学特点、传播途径及病原体,为制定预防控制对策提供依据。方法设立病例定义,在深圳市发生疫情的村子进行病例搜索,使用感染性腹泻个案调查表对所有搜索到的病例进行回顾性调查,并分别调查58例病例及74例对照的生活习惯;采用逆转录-聚合酶链反应(RT-PCR)和实时荧光PCR方法分别对病人粪便、肛拭子标本及村民饮用的水样进行诺如病毒核糖核酸(RNA)检测,分析其流行特征及可能传播途径。结果该起疫情首例病例发病时间为2009年10月23日,疫情历时11d,共搜索到97例病例,全村罹患率为9.41%(97/1031),以2岁以下的儿童为多,占53.1%。病例临床症状以腹泻、腹痛、腹胀、恶心、呕吐为主。病例组饮用生的山泉水及就餐前用生的山泉水冲洗碗筷的比例均高于对照组(P<0.05或P<0.01);13份病例粪便和肛拭子标本中,检测出12例诺如病毒阳性,阳性率为92.3%;检测7份水样(包括1份水源水、1份水池水、3份病例家中水龙头水和2份洗碗水),其中2份水龙头水和1份洗碗水检出诺如病毒,其余均为阴性。结论此起群体性胃肠炎暴发疫情是由诺如病毒感染引起;传播途径可能主要因水源污染和生活接触传播所致。
Objective To investigate the epidemiological characteristics, transmission routes and pathogens of 1 outbreak of acute gastroenteritis caused by Norovirus and to provide the basis for making prevention and control measures. Methods Case definitions were set up and case searches were conducted in the villages where the outbreak occurred in Shenzhen. All the cases searched were retrospectively surveyed using the case of infectious diarrhea. The lifestyle of 58 cases and 74 controls were investigated respectively. RT-PCR and real-time fluorescence PCR were used to detect norovirus RNA in patient’s feces, rectal swabs and villagers drinking water, respectively. The epidemiological characteristics and possible routes of transmission . Results The onset time of the first case was October 23, 2009, and the outbreak lasted 11 days. A total of 97 cases were searched. The attack rate in the whole village was 9.41% (97/1031), mostly children under 2 years of age, Accounting for 53.1%. Clinical symptoms of cases of diarrhea, abdominal pain, abdominal distension, nausea, vomiting. In the case group, the proportion of mountain spring water drinking raw spring water and tableware washed with raw mountain spring water before eating was higher than that of the control group (P <0.05 or P <0.01); in 13 cases of fecal and anal swab specimens, 12 Cases of Norovirus positive, the positive rate was 92.3%; detection of 7 water samples (including 1 water source, 1 pool water, 3 cases of home tap water and 2 wash water), of which 2 faucet water and 1 A portion of dishwashing water detected norovirus, the rest were negative. Conclusions This outbreak of gastroenteritis outbreak is caused by norovirus infection. The route of transmission may be mainly due to water pollution and exposure to life.