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目的调查某大学一起急性胃肠炎暴发事件的感染来源和流行病学特征。方法开展病例搜索,用描述性流行病学方法分析;用RT-PCR法检测诺如病毒核酸,进行基因测序和核酸分型。结果事件共发生感染性腹泻疑似病例473例,罹患率7.7%,确诊97例(20.5%);临床症状以腹泻(100%)和呕吐(67%)为主,病例分布无聚集性,无性别差异;采集病例和厨工肛拭子、食堂剩余食物、环境涂抹样和生活饮用水样本共53份,细菌分离培养阴性,肛拭子诺如病毒RT-PCR阳性率60.0%(9/15),经基因测序分型5份为诺如病毒GⅡ.4型Sydney 2012变异株,4份为GⅡ.3型。结论该起事件由诺如病毒GⅡ.4型Sydney 2012变异株和GⅡ.3型混合感染所致,传播途径可能为食源性传播和接触传播,卫生监管部门应加强对集体单位食堂的监管。
Objective To investigate the source of infection and epidemiological characteristics of an acute gastroenteritis outbreak in a university. Methods To carry out case search and analysis by descriptive epidemiological method. Norovirus DNA was detected by RT-PCR and gene sequencing and nucleic acid typing were performed. Results A total of 473 suspected cases of infectious diarrhea were observed, with a prevalence rate of 7.7% and 97 confirmed cases (20.5%). Clinical symptoms were diarrhea (100%) and vomiting (67%), with no clustering of cases and no sex (53.0%). The positive rate of RT-PCR of norovirus was 60.0% (9/15) Five strains of Norovirus type GⅡ.4 Sydney 2012 were genotyped by genotyping and four were GⅡ.3. Conclusion The incident was caused by mixed infection of Norovirus GⅡ.4 Sydney 2012 variant and G Ⅱ. 3. The route of transmission may be foodborne transmission and contact transmission, and the health regulatory authorities should strengthen supervision over the collective unit canteens.