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目的分析重庆市万州区首起诺如病毒胃肠炎暴发疫情的原因,探索类似疫情防控重点。方法对发生疫情的某镇中学开展现场流行病学调查,采集样品进行实验室检测,用描述流行病学方法分析。结果本次疫情共发病90例,罹患率4.5%(90/2005),均为在校住读生。主要临床症状:腹痛(77.8%)、呕吐(57.8%)、恶心(41.1%)、腹泻(25.6%)、发热(2.2%)。教职及食堂员工无发病,学生罹患率4.5%(90/2 005)。病人肛拭子诺如病毒核酸阳性率38.1%(8/21);食堂厨师及员工肛拭子诺如病毒核酸阳性率26.9%(7/26)。结合临床表现、流行病学调查和实验室检测结果,判定是一起由诺如病毒感染引起的胃肠炎暴发疫情。结论加强食堂从业人员健康监管,日常岗前自律排查,落实食堂日常的消毒制度,可避免类似事件发生。
Objective To analyze the causes of the outbreak of Norovirus gastroenteritis in Wanzhou District of Chongqing Municipality and to explore the similar prevention and control focus of epidemic situation. Methods Epidemiological investigation was carried out in a middle school in a town where the epidemic occurred. Samples were collected for laboratory testing and analyzed by descriptive epidemiological methods. Results The total outbreak of the epidemic 90 cases, the attack rate of 4.5% (90/2005), are living in school students. The main clinical symptoms were abdominal pain (77.8%), vomiting (57.8%), nausea (41.1%), diarrhea (25.6%) and fever (2.2%). Staff and canteens staff no incidence, the student attack rate of 4.5% (90/2 005). The positive rate of Norovirus in patients with anal swab was 38.1% (8/21). The positive rate of Norovirus RNA in rectal swab and staff was 26.9% (7/26). Combined with clinical manifestations, epidemiological investigations and laboratory test results, determine the outbreak of gastroenteritis caused by norovirus infection. Conclusion It is necessary to strengthen health supervision of canteens practitioners, conduct self-discipline routine checkup and implement daily disinfection system in canteens to avoid similar incidents.