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目的调查丽水市莲都区老竹镇一起急性胃肠炎暴发疫情。方法制定病例定义,通过医疗机构主动搜索和入户调查等多种途径搜索病例,分析病例的三间分布,并作相应的卫生学调查和实验室检测,求证可能的暴发原因。结果共搜索到A村病例24例,罹患率为12.00%,其中男性8例,女性16例。临床表现以腹泻(20例,占83.33%)、腹痛(17例,占70.83%)和呕吐(11例,占45.83%)为主,仅4例出现发热,占16.67%。首发病例出现于2月11日,16日达到发病高峰(10例),末例病例出现于2月22日。使用A村蓄水池供水的罹患率高于相邻的B和C村(P<0.01)。使用A村蓄水池供水的村民罹患急性胃肠炎的风险是B村和C村的11.11倍(95%CI:2.66~46.32)。从5份病例肛拭子标本检出GⅡ型诺如病毒阳性;1份A村储存水和1份A村村尾水检出GⅡ型诺如病毒阳性。结论本次疫情为一起介水传播的GⅡ型诺如病毒暴发疫情,原因可能是含有诺如病毒的粪水污染A村蓄水池水源,村民饮用后感染。
Objective To investigate an outbreak of acute gastroenteritis in Laohu Town, Lidu City, Lishui City. Methods Define the case definition, search for cases through a variety of ways such as active search and household survey of medical institutions, analyze the three distributions of cases, and make corresponding health investigations and laboratory tests to verify the possible causes of outbreaks. Results A total of 24 cases were found in village A, the attack rate was 12.00%, including 8 males and 16 females. The main clinical manifestations were diarrhea (20 cases, 83.33%), abdominal pain (17 cases, 70.83%) and vomiting (11 cases, 45.83%). Only 4 cases had fever, accounting for 16.67%. The first case occurred on February 11, 16 peak incidence (10 cases), the last case occurred in February 22nd. The incidence of water use in village A reservoirs was higher than in villages B and C (P <0.01). The risk of acute gastroenteritis among village A reservoirs is 11.11 times that of villages B and C (95% CI: 2.66 to 46.32). Gonorrhoeae positive for type II was detected from 5 cases of rectal swab specimens; 1 piece of A-village stored water and 1 piece of A-village tail water were positive for G-type Norovirus. Conclusions The outbreak was an outbreak of G Ⅱ Norovirus infected with water. This may be caused by the contaminating of A village reservoir with norovirus containing manure and drinking after infection.