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目的调查一起诺如病毒引起的感染腹泻疫情,核实信息、明确病因、查找感染来源及传播途径,并提出针对性防控建议。方法按统一的病例定义,对病例进行搜索,并采用现场流行病学调查方法,通过对临床症状及体征描述、暴露因素的病例对照研究等方法了解发病情况及传播途径。采集病例便、肛拭子、厨具涂抹、水等样品进行荧光定量PCR核酸检测和细菌分离培养。结果该起疫情共发现患者12例,流行曲线较接近为“人传人的传播模式”。病例对照研究提示就餐、饮水暴露因素与腹泻暴发无关联,其OR值和95%CI分别为1.36(95%CI:0.25~7.37)、1.87(95%CI:0.51~6.85)。采集到的9例患者便样本检测诺如病毒GⅡ型核酸阳性。现场卫生学调查发现职工在生产、生活、办公中可能存在着直接或间接接触。结论该公司12名职工发生了一起感染腹泻疫情,可能是由于诺如病毒感染引起的。传播途径可能为首发病例引入后以直接或间接接触的人传人传播为主。建议公司强化职工卫生防病知识,提高管理人员的防护意识和能力,并加强医疗单位对病毒感染性腹泻的疾病监测。
Objective To investigate the epidemic of infectious diarrhea caused by Norovirus, verify the information, clarify the cause, find the source of infection and the route of transmission, and put forward the targeted prevention and control suggestions. Methods According to the definition of a common case, the cases were searched and the epidemiological investigation methods were used. The clinical symptoms and signs, the case-control study of exposure factors and other methods were used to understand the pathogenesis and route of transmission. Collect cases, anal swabs, kitchen appliances smear, water and other samples for fluorescence quantitative PCR nucleic acid detection and bacterial isolation and culture. Results The onset of the disease were found in 12 patients, the epidemic curve is closer to “human transmission mode ”. Case-control studies suggest that eating and drinking exposure factors are not associated with diarrhea outbreaks. The OR and 95% CIs were 1.36 (95% CI: 0.25-7.37) and 1.87 (95% CI: 0.51-6.85), respectively. Nine samples collected from patients were tested for Norovirus G Ⅱ nucleic acid positive. Site hygiene survey found that workers in the production, living, office may exist in direct or indirect contact. Conclusion A total of 12 workers in the company had an outbreak of diarrhea that may be caused by norovirus infection. Transmission may be the first case after the introduction of direct or indirect contact with people-based transmission. It is suggested that the Company reinforce the knowledge of workers on disease prevention and control, raise the awareness and ability of managers in prevention and control, and strengthen the monitoring of the disease caused by virus-infected diarrhea by medical units.