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目的查明1起学校感染性腹泻暴发疫情的原因,以制定有效的防控措施,控制疫情蔓延。方法 本次调查采用病例对照研究,对2010年9月8～19日发病的176例感染性腹泻患者进行流行病学个案调查,并选取105例对照。信息收集主要包括调查患者的基本情况、发病情况、临床表现、流行病学史等4个方面。结果暴发罹患率为4.02%(176/4376)。患者全部出现腹泻,部分伴恶心、呕吐、腹痛和发热等症状。病例对照研究提示校内就餐是此次暴发疫情的危险因素,OR值为4.88(χ2=4.54,P<0.05)。采集7例现症患者的粪便标本和3份水样,检测出致泻性大肠杆菌和杯状病毒。对学校的自备水供应系统的水源水、出厂水和管网末梢水均采样检测,结果显示菌落总数、总大肠菌群,耐热大肠菌群严重超标。结论 根据患者临床表现、流行病学调查及实验室检测结果,可认定为是1起水源污染引起的感染性腹泻暴发疫情,病原体为致泻性大肠杆菌和杯状病毒。
Objective To identify the causes of an outbreak of infectious diarrhea in schools to formulate effective prevention and control measures to control the spread of the epidemic. Methods A case-control study was conducted in this survey. A total of 176 cases of infectious diarrhea from September 8 to September 2010 were enrolled in the epidemiological investigation and 105 controls were selected. Information collection includes investigating the basic situation of patients, the incidence, clinical manifestations, epidemiology and other four aspects. The outbreak rate was 4.02% (176/4376). All patients with diarrhea, some with nausea, vomiting, abdominal pain and fever and other symptoms. Case-control studies suggest that school dining is a risk factor for this outbreak, with an OR of 4.88 (χ2 = 4.54, P <0.05). Stool specimens from 7 cases of patients with disease and 3 water samples were collected and diarrhea-causing Escherichia coli and Calicivirus were detected. The water supply system of the school’s own water supply system, factory water and pipe network water sampling and testing, the results showed that the total number of colonies, total coliform bacteria, heat-resistant coliform bacteria seriously overweight. Conclusion According to the clinical manifestations of patients, epidemiological investigation and laboratory test results, can be identified as a source of infectious diarrhea outbreak caused by water pollution, pathogens are diarrhea Escherichia coli and calicivirus.