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为了解杭州市某大学急性胃肠炎暴发疫情波及范围,并确定疾病暴发的病原学病因以及流行病学病因。根据病例定义开展病例搜索,进行个案流行病学调查。采用描述性流行病学和病例对照研究方法分析病例发病的危险因素。样本采用RT-PCR检测诺如病毒(norwalk viruses,NV)核酸。结果显示,2014年11月26日~12月5日西湖区某校共发生诺如病毒胃肠炎病例82例,罹患率为1.11%;病例主要集中在12月1~3日,占总病例数的80.72%;病例以学三楼和学二楼为主,占59.04%;病例临床表现以呕吐(61例,74.39%)和腹泻(44例,53.66%)为主。生活用水使用井水的罹患率(1.64%)是使用市政自来水的罹患率(0.23%)的7.13倍。病例对照研究结果显示同宿舍或同伴中有同学出现呕吐症状是独立危险因素(OR=5.01,95%CI=1.44~17.45,P=0.011)。实验室检测结果发现9份患者肛拭子诺如病毒核酸阳性。根据病例临床表现、流行病学调查以及实验室检测结果判断该起疫情为诺如病毒GⅡ型引起的急性胃肠炎暴发,暴发的主要原因可能为食用受污染的井水,同时,接触传播也是主要的传播途径。
In order to understand the scope of the outbreak of acute gastroenteritis outbreak in a university in Hangzhou and to determine the etiological and etiological factors of the disease outbreak. According to the case definition of case search, case epidemiological investigation. Descriptive epidemiology and case-control studies were used to analyze the risk factors for the onset of the disease. Samples were used to detect norwalk viruses (NV) nucleic acids by RT-PCR. The results showed that from November 26, 2014 to December 5, 2014, there were 82 cases of Norovirus gastroenteritis in a school in Xihu District with an attack rate of 1.11%. The cases mainly concentrated on December 1 to 3, accounting for the total cases 80.72% of the cases. The cases were mainly on the third floor and the second floor of the study, accounting for 59.04%. The main clinical manifestations were vomiting (61 cases, 74.39%) and diarrhea (44 cases, 53.66%). Domestic water use The prevalence of well water (1.64%) was 7.13 times that of municipal tap water (0.23%). Case-control study showed that students in the same dormitory or companion patients with vomiting were independent risk factors (OR = 5.01, 95% CI = 1.44 ~ 17.45, P = 0.011). Laboratory tests revealed that 9 patients had anal swab Norovirus nucleic acid positive. According to the clinical manifestations, epidemiological investigation and laboratory test results to determine the outbreak situation is Norovirus G Ⅱ-induced acute gastroenteritis outbreaks, the main reason for the outbreak may be contaminated well water, at the same time, contact transmission is The main route of transmission.