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目的调查与分析岳阳市平江县两所学校一起感染性腹泻暴发,并探讨病因和可能的危险因素,评价措施效果,为今后的防控提供参考。方法按照病例定义开展病例搜索,采用描述性流行病学方法进行分析,采用病例对照研究和队列研究验证假设;对学校食堂和饮用水进行卫生学调查;采集病例的肛拭子等生物样品和水源水、出厂水、学校管网末梢水等环境样品开展相关微生物检测。结果该起疫情共发病116例,A小学罹患率为10.98%(72/656),B中学罹患率为6.96%(33/474),另有学校附近居民病例11例;病例组直接饮用自来水的比例为78.9%,对照组直接饮用自来水的比例为36.0%(OR=6.68,95%CI=3.180~14.030);使用该乡自来水的乡镇街道居民罹患率为2.96%(11/371);周边不使用自来水的居民罹患率为0.33%(1/300),两者比较差异有统计学意义(χ2=6.54,P=0.011);检测14例病例肛拭子标本有10例诺如病毒核酸阳性,学校无二次供水,学校管网末梢水卫生学指标超标,水源水和B中学管网末梢水诺如病毒核酸弱阳性。结论此次疫情为一起诺如病毒引起的感染性腹泻暴发,发病原因为学生饮用被诺如病毒污染的自来水所致。
Objective To investigate and analyze the outbreaks of infectious diarrhea in two schools in Pingjiang County, Yueyang City, and to explore the etiology and possible risk factors and to evaluate the effect of the measures to provide reference for future prevention and control. Methods According to the definition of cases, the cases were searched, descriptive epidemiological methods were used for analysis, the case-control study and cohort study were used to verify the hypothesis, the school canteens and drinking water were investigated for hygiene, and the biological samples such as anal swab and water source Water, factory water, school pipe network water and other environmental samples to carry out related microbiological testing. Results A total of 116 outbreaks were reported in this outbreak. The incidence of primary school A was 10.98% (72/656), that of middle school B was 6.96% (33/474), and there were 11 cases of residents near the school. In case group, drinking tap water (OR = 6.68, 95% CI = 3.180 ~ 14.030); the incidence rate of township residents who used tap water in the township was 2.96% (11/371); the surrounding area was not The prevalence rate of residents using tap water was 0.33% (1/300), the difference was statistically significant (χ2 = 6.54, P = 0.011). In the 14 cases of rectal swab specimens, 10 cases of Norovirus positive were found, School no secondary water supply, school pipe network peripheral water hygiene indicators exceeded, water source and B middle school pipe network Norovirus nucleic acid weakly positive. Conclusions The outbreak was an outbreak of infectious diarrhea caused by Norovirus. The cause of the outbreak was due to students drinking tap water contaminated with Norovirus.