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目的了解诺如病毒(NOV)聚集性胃肠炎疫情密切接触者病毒感染及环境污染情况。方法选取3起养老机构NoV聚集性胃肠炎疫情,采集患者、无症状密切接触者的粪便或肛拭子,院内环境表面涂抹样本,采用实时荧光RTPCR进行NoV核酸检测。结果 3起疫情报告病例59例,涉及老年病例56例,护工3例,罹患率在15.71%～37.67%,平均罹患率为25.00%;无症状密切接触者41人,NoV阳性者15人,感染率为36.59%,其中护工11人,感染率为32.35(11/34),保洁、保健医生各2人;环境样本27份,污染率为37.04%(10/27),其中马桶表面污染4份、床单元3份、扶梯2份、门把手1份。结论诺如病毒胃肠炎疫情中密切接触者病毒隐性感染较多,院内环境存在病毒污染,应加强患者密切接触者的管理和院内环境的消毒,防止疫情扩散。
Objective To understand the virus infection and environmental pollution caused by close contacts of Norovirus (NOV) aggregated gastroenteritis. Methods Three NoV collectable gastroenteritis outpatients were selected for the outpatient service. The stools or anal swabs of patients with asymptomatic close contacts were collected. Samples of the nosocomial environment were smeared and real-time fluorescent RTPCR was used to detect NoV nucleic acid. Results There were 59 cases reported from 3 outbreaks, including 56 elderly patients and 3 nursing workers. The attack rate was 15.71% ~ 37.67% and the average attack rate was 25.00%. There were 41 asymptomatic close contacts and 15 NoVs were infected Rate of 36.59%, of which 11 were nursing workers, the infection rate was 32.35 (11/34), cleaning and health care doctors each 2; 27 environmental samples, the pollution rate was 37.04% (10/27), of which 4 toilet surface contamination 3 beds, 2 escalators and 1 door handle. Conclusions Norovirus virus gastroenteritis epidemic in close contact with the virus more latent infections, nosocomial environment of the virus contamination should be strengthened in close contact with patients management and hospital environment disinfection to prevent the spread of the epidemic.