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目的分析杭州市诺如病毒肠炎暴发疫情流行特征。方法采用荧光PCR检测诺如病毒核酸,应用现场流行病学调查方法分析诺如病毒肠炎暴发疫情。结果2006年12月至2007年4月,杭州市共报告4起诺如病毒肠炎暴发疫情,发病85例,总罹患率7.38%,4起暴发疫情分布在医院、福利院、中学、小学,发病者主要为伴有基础病变的老年患者和低龄学生;主要临床症状以腹泻、呕吐、腹痛、发热为主,呕吐比例较高,大部分病例病程较短(1~3 d)。12份送检样本经荧光PCR法检出诺如病毒核酸阳性。对医院发生的诺如病毒肠炎暴发疫情,经病例对照分析,有3个因素差异有统计学意义,存在有较高的发病机会:年龄≥60岁(χ2=16.57,P=0.00,OR=29.75)、南区病房(χ2=2.37,P=0.12,OR=0.33)、有基础病变者(χ2=15.87,P=0.00,OR=16.10)。结论杭州市存在诺如病毒肠炎暴发疫情,主要侵袭老年患者和低龄学生,及时采取消毒为主的综合控制措施可避免疫情扩散。
Objective To analyze the epidemiological characteristics of norovirus enteritis in Hangzhou. Methods Nucleic acid of Norovirus was detected by fluorescence PCR. The outbreak of Norovirus enteritis was analyzed by field epidemiological investigation. Results From December 2006 to April 2007, a total of 4 outbreaks of norovirus enteritis were reported in Hangzhou City, including 85 cases and a total prevalence rate of 7.38%. Four outbreaks were reported in hospitals, welfare institutions, middle schools and primary schools The main clinical symptoms were diarrhea, vomiting, abdominal pain and fever, with a high proportion of vomiting. Most patients had shorter duration (1-3 days). Twelve samples were submitted for detection of Norovirus nucleic acid by fluorescence PCR. There was a statistically significant difference between the three outbreaks of norovirus enteritis outbreaks in the hospital due to case-control analysis. There was a high chance of morbidity: ≥60 years (χ2 = 16.57, P = 0.00, OR = 29.75 (Χ2 = 2.37, P = 0.12, OR = 0.33), with underlying lesions (χ2 = 15.87, P = 0.00, OR = 16.10). Conclusions The outbreak of norovirus enteritis in Hangzhou City is mainly caused by the epidemic situation in Hangzhou. It mainly affects older patients and younger students, and promptly takes the disinfection-based comprehensive control measures to prevent the outbreak from spreading.