CAJ | 학술논문

目的：分析2012年1月至2014年6月广东省哨点医院诺如病毒GII.4 Sydney变异株流行状况，以及由诺如病毒GII.4 Sydney变异株感染引起的暴发疫情特征。方法2012年1月至2014年6月在广东省选取22家医院的门诊科室为监测哨点，将采集的腹泻病例粪便样本（共10750份）送至市级CDC，进行病毒核酸提取及诺如病毒核酸检测，所有阳性样本递送至广东省CDC，并按照随机数字法抽取了855份进行诺如病毒基因分型，共成功测序样本690份。采用χ2检验比较不同年龄组、不同时期内腹泻病例诺如病毒感染情况。通过广东省突发公共卫生事件管理信息系统，收集2012年1月至2014年6月广东省13起由诺如病毒GII.4 Sydney变异株感染引起的社区暴发疫情数据，进行社区流行病学分析。结果2012年8月首次检出诺如病毒GII.4 Sydney变异株，2012年11月检出比例为13/15。2012年11月至2013年1月（T1时期），各月份中腹泻病例诺如病毒感染阳性率分别为23.8%（100/421）、15.9%（61/383）、19.2%（95/495），2013年11月至2014年1月（T2时期），各月份中腹泻病例诺如病毒感染阳性率分别为17.0%（90/529）、8.7%（37/426）、11.2%（46/409），均低于T1时期（χ2值分别为6.65、9.93、10.74，P值分别为0.010、0.002、0.001）。T1时期内≥15、<15岁组腹泻病例诺如病毒感染阳性率分别为26.3%（143/543）、14.9%（113/756）（χ2=25.90，P<0.001）；T2时期≥15、<15岁组阳性率分别为10.1%（52/516）、14.3%（121/848）（χ2=5.09，P=0.024）。13起暴发疫情中，食源性传播占10/13。结论广东省2012年8月首次检出诺如病毒GII.4 Sydney变异株，2012年11月起呈现社区流行，流行1年后，强度降低；由诺如病毒GII.4 Sydney变异株引起的暴发疫情主要以食源性传播为主。
목적：분석2012년1월지2014년6월광동성초점의원낙여병독GII.4 Sydney변이주류행상황，이급유낙여병독GII.4 Sydney변이주감염인기적폭발역정특정。방법2012년1월지2014년6월재광동성선취22가의원적문진과실위감측초점，장채집적복사병례분편양본（공10750빈）송지시급CDC，진행병독핵산제취급낙여병독핵산검측，소유양성양본체송지광동성CDC，병안조수궤수자법추취료855빈진행낙여병독기인분형，공성공측서양본690빈。채용χ2검험비교불동년령조、불동시기내복사병례낙여병독감염정황。통과광동성돌발공공위생사건관리신식계통，수집2012년1월지2014년6월광동성13기유낙여병독GII.4 Sydney변이주감염인기적사구폭발역정수거，진행사구류행병학분석。결과2012년8월수차검출낙여병독GII.4 Sydney변이주，2012년11월검출비례위13/15。2012년11월지2013년1월（T1시기），각월빈중복사병례낙여병독감염양성솔분별위23.8%（100/421）、15.9%（61/383）、19.2%（95/495），2013년11월지2014년1월（T2시기），각월빈중복사병례낙여병독감염양성솔분별위17.0%（90/529）、8.7%（37/426）、11.2%（46/409），균저우T1시기（χ2치분별위6.65、9.93、10.74，P치분별위0.010、0.002、0.001）。T1시기내≥15、<15세조복사병례낙여병독감염양성솔분별위26.3%（143/543）、14.9%（113/756）（χ2=25.90，P<0.001）；T2시기≥15、<15세조양성솔분별위10.1%（52/516）、14.3%（121/848）（χ2=5.09，P=0.024）。13기폭발역정중，식원성전파점10/13。결론광동성2012년8월수차검출낙여병독GII.4 Sydney변이주，2012년11월기정현사구류행，류행1년후，강도강저；유낙여병독GII.4 Sydney변이주인기적폭발역정주요이식원성전파위주。
Objective To analyze epidemiological characteristics of norovirus variant of GII.4 Sydney from January 2012 to June 2014 in sentinel hospitals of Guangdong province, as well as the outbreaks caused by norovirus variant of GII.4 Sydney. Methods During January 2012 to June 2014, a total of 10 750 fecal samples were obtained from 22 hospitals of surveillance sites in Guangdong province. Those samples were sent to the local municipal CDCs for extracting and detecting norovirus nucleic acid. Then, all the positive samples were delivered to Guangdong provincial CDC that used Random Number Method to draw 855 positive samples for norovirus genotyping, and 690 samples were successfully sequenced. Chi?square tests were used to compare norovirus infection status of diarrhea cases in different age groups as well as during different periods. Epidemiological data of 13 outbreaks which were caused by norovirus variant of GII.4 Sydney from January 2012 to June 2014 were collected from the Public Health Emergency Management Information System of Guangdong Province, and the epidemiological characteristics were analyzed. Results The norovirus variant of GII.4 Sydney was first detected in August 2012 and the detection rate was 13/15 in November 2012. During November 2012 to January 2013(period T1), the norovirus positive rate of each month was 23.8% (100/421), 15.9% (61/383) and 19.2% (95/495), respectively. During November 2013 to January 2014(period T2), the norovirus positive rate of each month was 17.0% (90/529), 8.7% (37/426) and 11.2% (46/409), respectively which were significantly lower than that of period T1(χ2 value was 6.65, 9.93 and 10.74. P value was 0.010, 0.002, and 0.001 ,respectively). In period T1, the norovirus positive rate of people ages 15 and older was 26.3%(143/543)and the rate of people under 15 was 14.9%(113/756) (χ2=25.90, P<0.001). In period T2, the norovirus positive rate of people ages 15 and older was 10.1%(52/516)and the rate of people under 15(14.3%(121/848))(χ2=5.09, P=0.024). The foodborne transmission was the infection source for ten of thirteen outbreaks. Conclusion The norovirus variant of GII.4 Sydney was first detected in August 2012. The epidemic began to occur in the community since November 2012, and the strength of the epidemic declined 1 year later. The foodborne transmission was the main infection sources for the outbreaks caused by norovirus variant of GII.4 Sydney.