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目的调查成都市一起小学急性胃肠炎聚集性疫情,查找感染来源、传播途径和危险因素。方法应用现场流行病学调查方法进行调查,采集患者及厨师肛拭子、食物留样等标本进行检测分析。结果 2015-03-12/16,该校共发生急性胃肠炎搜索病例255例,总罹患率15.00%,主要症状为恶心、呕吐、腹痛,轻症为主;4年级罹患率明显高于1、2年级(P<0.05),学生罹患率明显高于教职工罹患率,差异有统计学意义(P<0.05);病例对照结果显示12日午餐可增加发病风险(OR=1.088,95%CI:1.035~1.144);7份病例肛拭子、3份厨师肛拭子、1份食品留样检出诺如病毒核酸阳性。结论此次疫情为诺如病毒感染引起的急性胃肠炎聚集性疫情,主要系食物被诺如病毒污染所致。加强食品安全管理,是有效杜绝类似食源性肠道传染病的关键。疫情发生后快速准确判断,是有效控制疫情的关键。
Objective To investigate the epidemic situation of acute gastroenteritis in a primary school in Chengdu and to find the source of infection, the route of transmission and the risk factors. Methods The method of field epidemiological investigation was used to investigate the samples collected from patients and chefs such as anal swab and food samples. Results There were 255 cases of acute gastroenteritis (15.00%) in the school from March 15, 2015 to January 15, 2015. The main symptoms were nausea, vomiting, abdominal pain and mild illness. The attack rate in grade 4 was significantly higher than 1 , Grade 2 (P <0.05). The attack rate of students was significantly higher than that of faculty workers (P <0.05). The case-control study showed that luncheon on the 12th increased the risk of onset (OR = 1.088, 95% CI : 1.035 ~ 1.144); 7 cases of anal swabs, 3 chef anal swabs, 1 food samples were detected norovirus positive. Conclusion The outbreak was caused by norovirus infection caused by acute gastroenteritis epidemic, mainly caused by food contamination by Norovirus. Strengthening food safety management is the key to effectively prevent similar food-borne enteric diseases. Rapid and accurate judgment after the outbreak is the key to effective control of the epidemic.