摘要
目的对自贡市高新区某养老机构发生的一起GⅡ型诺如病毒暴发疫情进行调查及影响因素分析,为以后有效控制此类暴发疫情提供科学依据。方法采用现场流行病学调查方法,收集2025年2月自贡市高新区某养老机构疫情爆发期间确诊病例的基本信息、临床症状和相关危险因素。对患者的呕吐物、腹泻物和环境标本用RT-PCR方法进行肠道病毒和常见致病菌检测,包括诺如病毒GⅡ核酸检测。统计分析采用χ^(2)检验,检验水准设定α=0.05。结果本次该养老机构暴发疫情共发现病例25例,罹患率为29.41%(25/85),流行曲线提示为点源暴发模式,病例主要集中在2月17日2∶00至15∶00,占总病例数的44.00%(11/25)。临床表现主要是腹泻(96.00%)和呕吐(88.00%),少部分出现恶心(20.00%)和发热(12.00%)。病例年龄在41~95岁之间,年龄中位数为83岁,病例中男女性罹患率分别为31.81%(7/22)和28.57%(18/63)差异无统计学意义(χ^(2)=0.08,P=0.784)。不同楼层中病例最多的是五楼(50.00%),各楼层之间罹患率差异有统计学意义(χ^(2)=24.57,P=0.001)。多因素分析结果显示,短距离(1 m内)暴露过患者呕吐物或粪便(cOR:30.69,95%CI:1.92~489.58)和经过五楼走廊垃圾桶(cOR:17.21,95%CI:2.25~131.85)是GⅡ型诺如病毒感染发病的危险因素。采集的生物标本、环境标本和留样食品实验室检测,有6人呕吐物检出诺如病毒GⅡ核酸阳性,其余均为阴性。结论本次事件为GⅡ型诺如病毒感染导致的暴发疫情,疫情暴发由人与人传播,主要为院外感染者带入引起。
Objective Investigate and analyze the outbreak of GⅡtype norovirus in a nursing home in Gaoxin District of Zigong City,and to provide scientific basis for the effective control of such outbreaks in the future.Methods A descriptive epidemiological survey method was used to collect the basic information,clinical symptoms and related risk factors of confirmed cases during the outbreak of the epidemic in a certain elderly care institution in the high-tech zone of Zigong City in February 2025.Biological samples(the vomitus,diarrheal substances of patients)and environmental samples were detected for enterovirus and common pathogenic bacteria by RT-PCR method,including norovirus GⅡnucleic acid detection.Statistical analysis was conducted usingχ^(2)-test,with a test level ofα=0.05.Results A total of 25 cases were identified in the outbreak of this nursing home,with an attack rate of 29.41%(25/85).The epidemic curve indicated a point source pattern,with cases mainly concentrated between 2:00 and 15:00 on February 17th,for 44.00%(11/25)of the total cases.Clinical manifestations were mainly diarrhea(96.00%)and vomiting(88.00%),with a small part of experiencing nausea(20.00%)and fever(12.00%).The age of the cases ranged from 41 to 95 years old,with a median age of 83 years old,the incidence rates of males and females in the cases were 31.81%(7/22)and 28.57%(18/63),respectively.The difference was not statistically significant(χ^(2)=0.08,P=0.784);The most cases were on the fifth floor(50.00%),and the difference of the incidence rate among different floors was considered statistically significant(χ^(2)=24.57,P=0.001).The results of multi-factor analysis showed that exposure to patient's vomit or feces within a short distance(within 1 m)(cOR:30.69,95%CI:1.92~489.58)and passing the trash can in the corridor on the fifth floor(cOR:17.21,95%CI:2.25~131.85)were risk factors for the onset of the disease caused by norovirus type GⅡinfection.Laboratory detection of collected biological specimens,environmental specimens and leftover food,with 6 people vomiting was detected positive virus GⅡnucleic acid,and the rest were negative.Conclusion This case was an outbreak caused by norovirus type GⅡinfection,and the outbreak of the epidemic was transmitted from person to person,mainly caused by the infected people brought in from outside the hospital.
作者
杜柯楠
邓思梦
吴锋
张正东
DU Kenan;DENG Simeng;WU Feng;ZHANG Zhengdong(Zigong City Center for Disease Control and Prevention,Zigong 643000,Sichuan Province,China)
出处
《预防医学情报杂志》
2025年第7期888-894,共7页
Journal of Preventive Medicine Information
关键词
养老机构
诺如病毒
暴发疫情
调查
nursing home
norovirus
outbreak of epidemic
investigation
