CAJ | 학술논문

目的对湖州市某中学发生的一起以腹泻、呕吐为特征的暴发疫情进行调查和分析,查找病因、分析危险因素.方法采用现场流行病学调查方法,结合临床表现及实验室检测结果进行调查与综合分析.结果该校共发生急性胃肠炎病例578例,罹患率为23.58%;临床表现主要为腹泻、呕吐、腹痛、恶心,少见发热,大多症状较轻,病程1～3 d;各班均有发病,无明显聚集性;共采集患者粪便标本15份,采用RT-PCR方法检出诺如病毒阳性标本11份,其中Ⅱ型6份,Ⅰ型阳性3份,Ⅰ型、Ⅱ型混合阳性2份(同一学生,两次采样).病例对照研究显示,饮用未加热桶装水是此次发病的危险因素(OR=2.46,95% CI=1.19～5.23),且饮水量与发病存在剂量反应关系(X2=24.18,P<0.01).通过采取隔离治疗传染源、改桶装水为供应开水、卫生消杀及健康教育等综合措施后,疫情迅速得到控制.结论本次疫情是由诺如病毒引起的急性胃肠炎暴发,可疑的传播途径为饮用未加热的桶装水与日常接触.
목적 대호주시모중학발생적일기이복사、구토위특정적폭발역정진행조사화분석,사조병인、분석위험인소.방법 채용현장류행병학조사방법,결합림상표현급실험실검측결과진행조사여종합분석.결과해교공발생급성위장염병례578례,리환솔위23.58%;림상표현주요위복사、구토、복통、악심,소견발열,대다증상교경,병정1～3 d;각반균유발병,무명현취집성;공채집환자분편표본15빈,채용RT-PCR방법검출낙여병독양성표본11빈,기중Ⅱ형6빈,Ⅰ형양성3빈,Ⅰ형、Ⅱ형혼합양성2빈(동일학생,량차채양).병례대조연구현시,음용미가열통장수시차차발병적위험인소(OR=2.46,95% CI=1.19～5.23),차음수량여발병존재제량반응관계(X2=24.18,P<0.01).통과채취격리치료전염원、개통장수위공응개수、위생소살급건강교육등종합조시후,역정신속득도공제.결론 본차역정시유낙여병독인기적급성위장염폭발,가의적전파도경위음용미가열적통장수여일상접촉.
Objective To investigate the cause of an outbreak characterized by diarrhea and vomit in a middle school in Huzhou City. Methods Comprehensive analysis was conducted based on field epidemiological study, clinical characteristics of the cases and laboratory test. Results 578 cases of acute gastroenteritis were found. The attack rate was 23.58%. The most frequently observed clinical symptoms were diarrhea, vomiting,abdominal pain and nausea. Some few had fever. Most cases had slight clinical symptom with a course from 1 to 3 days. The cases were distributed in every class, showing no phenomenon of clustering. Norovirus were detected in 11 out of 15 stool samples by using RT-PCR. 6 were genogroup Ⅱ norovirus. 3 were genogroup Ⅰ norovirus.Genogroup Ⅰ and Ⅱ norovirus were detected at the same time in 2 stool samples (the same student with 2 tests).Case-control study showed that drinking unheated bottled water was risk factor(OR=2.46,95% CI = 1.19-5.23),and had a dose response relation with the disease(X2=24.18, P<0.01). The epidemic was controlled soon through isolating patients during treatment, providing boiled water, disinfecting and health education. Conclusion This was an infectious diarrhea outbreak caused by norovirus. The suspected transmission ways were drinking unheated bottled water and contact daily.