深圳市某村一起水源性诺如病毒感染性胃肠炎暴发的调查

目的了解某村一起感染性腹泻暴发的特点和流行原因,探讨暴发疫情调查处理的经验并为制定防治对策提供科学依据。方法 采用现场流行病学调查分析和实验室检测方法。结果10月24-30日,该村发生感染性腹泻病例96例,罹患率为9.2%,最小2月龄,最大86岁,男女性别比为1.1：1,居家病例呈一定的家庭聚集性,病例的临床表现基本相同,以腹泻、腹痛、恶心、呕吐和发热等症状为主,病程1~3 d。病例对照研究显示,饮用山泉水和饭前用山泉水冲洗碗筷为危险因素。从病人粪便标本中和管网末梢水中检测到诺如病毒抗原,采取改用市政水、隔离治疗病人和健康教育等综合措施后,疫情迅速得到控制。结论本次疫情为一起诺如病毒感染性腹泻暴发,暴发原因是该村供水系统被污染。供水系统安全存在诸多薄弱环节,建议尽快改用市政自来水供水。

Epidemiological Investigation on a Waterborne Outbreak of Norovirus Gastroenteritis in a Rural Community of Shenzhen

Objective To analyze the epidemiological characters of an outbreak of norovirns diarrhea in a rural community of Shenzhen,and to provide scientific measures for the prevention and control of norovirns diarrhea. Methods Field epidemiological survey and RT-PCR were used in this study. Results The epidemic lasted for 7 days,and 96 cases of infectious diarrhea were found in this community.The attack rate was 9.2%.All the victims were inhabitants or workers who were living in this community,aged from 2 months to 86 years.The sex ratio was 1.1:1,and the case distribution was clustering in the family.The main clinical symptoms were fever,diarrhea,bellyache and vomit,with 1-day ～ 3-day course of the disease.The case-control study showed that drinking mountain water and washing dishes and chopsticks with mountain water before eating had been determined the risk factors.Norovirns antigen was detected from stool of patients and the tap water.The epidemic was controlled rapidly through isolating patients during treatment,replacing mountain water with city water and conducting health education. Conclusions The epidemic was an infectious gastroenteritis outbreak caused by norovirus.Some efficient measures should be taken to strengthen the management of waterworks and city water should be used as soon as possible.