2005-2010年国际邮轮急性胃肠炎疾病暴发的流行病学分析

目的了解2005—2010年期间国际邮轮暴发急性胃肠炎疾病流行的状况与特征,探讨大型船舶暴发胃肠道传染病流行的规律和特点及应对措施。方法收集美国CDC国家环境卫生中心船舶卫生项目(VSP)及文献报道的邮轮急性胃肠炎疾病暴发等疫情报告资料,进行流行病学统计与分析。结果收集2005—2010年期间的暴发疫情中明确病原体的有100起,其中病毒性胃肠炎疾病94起(76.4%),细菌性及其他6起(4.9%);病原体未知及未获得样本有23起(18.7%)。诺如病毒、肠产毒性大肠杆菌、志贺氏菌和沙门菌在邮轮急性胃肠道疾病疫情病原体中占主要地位。每年的10月至次年5月为邮轮急性胃肠道疾病疫情发病高峰,其中诺如病毒引发的发病高峰季节是10月至次年3月。邮轮乘客胃肠炎发病率呈逐年上升趋势。结论邮轮发生胃肠道传染性疾病的频率及乘客发病率呈缓慢波动上升趋势,控制由诺如病毒引起的邮轮急性胃肠炎疾病暴发疫情对胃肠道疾病暴发相关性发病率的降低至关重要。

Epidemiological analysis of acute gastroenteritison on cruise ships

Objective To observe the epidemiological characteristics of acute gastroenteritis（AGE） on cruise ships from 2005 to 2010,and to study the outbreak regulation of AGE on cruise ships and to explore the relevant prevention and control measures.Methods Using gastrointestinal illness surveillance data both from Vessel Sanitation Program of the Centers for Disease Control and Prevention and from the published scientific articles and reports on the internet,then the epidemiological characteristics and incidence rate of AGE on cruise ships were evaluated.Results During the study period,pathogens were detected in 100 cases,and the pathogen of the other 23 cases were unknown or specimens not obtained.Ninety-four outbreaks（76.4%） were due to viral pathogens,and the rest were due to bacteria,parasites,or agents of unknown etiology.The principal pathogen associated with outbreaks was norovirus which caused more than three-quarters of the outbreaks,the most AGE outbreaks reported ranged from October to May,and norovirus outbreaks are highly seasonal with the peak spanning from the October to the next March.The tendency of AGE outbreaks on cruise ships was in an upswing.Conclusion The outbreak-related AGE incidence have a annually ever-increaseing tendency.It is important to control the norovirus-caused outbreak for reducing the incidence of AGE on cruise ships.