摘要
目的 分析天津市河东区某幼儿园感染性腹泻暴发的原因及危险因素,为有效控制疫情提供参考依据.方法 采用描述流行病学方法描述病例的临床症状及三间分布;采用病例对照研究对相关危险因素进行分析;采集病例、食堂工作人员及食物标本进行病原学检测.结果 2020年12月7-15日共报告病例42例(40名幼儿和2名老师),其中临床诊断病例19例,确诊病例(实验室诊断病例)23例,罹患率为45.65％(42/92),临床表现以呕吐(97.62％)、发热(69.05％)及腹痛(61.90％)为主,无重症及死亡病例发生;男女罹患率比较差异无统计学意义(x2=0.08,P＞0.05);各个班级罹患率差异具有统计学意义(Fisher's精确概率法,P＜0.05);疫情传播的危险因素为共用未通风音乐教室(OR=95.67,95％CI:12.02～761.09);共采集30份生物样本进行诺如病毒检测,其中23份标本中检出诺如病毒GⅡ阳性,阳性率为76.67％;共采集6份食物标本进行诺如病毒、致泻性大肠埃希菌、金黄色葡萄球菌及沙门氏菌检测,均未检出.结论 本次疫情是一起由诺如病毒GⅡ型感染引起的暴发疫情,共用未通风音乐教室是主要的危险因素.
Abstract
Objective To analyze the causes and risk factors of infectious diarrhea outbreak in a kindergarten in Hedong District,Tianjin City to provide a reference for effective epidemic control.Methods The clinical symptoms and tricycle distribution of the cases were described by descriptive epidemiological method.Case-control studies were used to analyze the associated risk factors.Samples from cases,canteen staff,and food were collected for pathogenic testing.Results From December 7 to 15,2020,a total of 42 cases(40 children and 2 teachers)were reported,including 19 clinically diagnosed cases and 23 confirmed cases(laboratory-diagnosed cases),with a prevalence rate of 45.65％(42/92),and the clini-cal manifestations were vomiting(97.62％),fever(69.05％)and abdominal pain(61.90％),but no severe cases or deaths were found.There was no significant difference in the incidence rate between men and women(x2=0.08,P＞0.05).There was a statistically significant difference in the incidence rate among the classes(Fisher's exact probability method,P＜0.05).The risk factor for the spread of the epidemic was the shared-unventilated-music classroom(OR=95.67,95％CI:12.02-761.09).A total of 30 biological samples were collected for norovirus testing,and 23 of them were found to be positive for norovirus G Ⅱ,with a positive rate of 76.67％.A total of 6 food samples were collected for testing of norovirus,Escherichia coli,Staphylococ-cus aureus,and Salmonella,but none of them were detected.Conclusion This outbreak is an outbreak caused by norovirus G Ⅱ infection,and the shared-unventilated-music classroom is the main risk factor.
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