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预防医学  2025, Vol. 37 Issue (9): 917-921    DOI: 10.19485/j.cnki.issn2096-5087.2025.09.011
  疾病控制 本期目录 | 过刊浏览 | 高级检索 |
一起职业技术学校GⅡ型诺如病毒急性胃肠炎暴发疫情调查
张辉1, 年云鹏2,3, 李华2,3, 张磊乐1, 兰宁1,2, 李小虎2,4
1.西安市疾病预防控制中心,陕西 西安 710054;
2.陕西省疾病预防控制中心现场流行病学培训项目,陕西 西安 710054;
3.陕西省疾病预防控制中心,陕西 西安 710054;
4.富平县疾病预防控制中心,陕西 富平 711700
Epidemiological investigation of an outbreak of acute gastroenteritis caused by GⅡ norovirus at a vocational and technical school
ZHANG Hui1, NIAN Yunpeng2,3, LI Hua2,3, ZHANG Leile1, LAN Ning1,2, LI Xiaohu2,4
1. Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi 710054, China;
2. Training Program for Field Epidemiology of Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi 710054, China;
3. Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi 710054, China;
4. Fuping County Center for Disease Control and Prevention, Fuping, Shaanxi 711700, China
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摘要 目的 调查2024年陕西省某职业技术学校一起急性胃肠炎暴发疫情,为校园疫情处置提供参考。方法 参考《诺如病毒感染暴发调查和预防控制技术指南(2015版)》开展病例搜索、个案调查和现场卫生学调查,采用病例对照研究分析可能危险因素;采集病例、全体食堂从业人员肛拭子和环境涂抹样本检测常见肠道病原体,采集食堂全部留样食物样本检测常见病原菌。结果 2024年10月26日—11月5日累计发病53例,罹患率为1.47%。临床症状以呕吐(83.02%)、腹痛(56.60%)、腹泻(30.19%)和发热(26.42%)为主。流行曲线提示间歇同源暴发,病例人群和空间分布无明显聚集性特征。病例对照研究结果显示,10月28日晚餐于食堂一楼盖码饭档口就餐是发病的危险因素(OR=11.025,95%CI:2.186~55.601)。6例病例、2例隐性感染食堂从业人员肛拭子和盖码饭档口3份环境涂抹样本检出GⅡ型诺如病毒阳性,留样食物样本常见病原菌检测结果均为阴性。结论 本次疫情为GⅡ型诺如病毒感染引起的急性胃肠炎暴发,传播模式符合间歇同源暴发,传染源可能为隐性感染的食堂从业人员,以食源性传播为主,在盖码饭档口就餐是本次疫情暴发的主要危险因素。
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张辉
年云鹏
李华
张磊乐
兰宁
李小虎
关键词 诺如病毒急性胃肠炎暴发流行病学调查    
AbstractObjective To investigate an outbreak of acute gastroenteritis at a vocational and technical school in Shaanxi Province in 2024, ao as to provide the reference for the handling of school outbreaks. Methods The conducted case searches, individual case investigations, and on-site hygienic investigations were established in accordance with the Guidelines on outbreak investigation, prevention and control of Norovirus infection (2015). The potential risk factors were analyzed by case-control study. Anal swab samples from cases and all canteen staff, as well as environmental swab samples were collected to detect common intestinal pathogens. All reserved food samples in canteen were collected to test for common pathogenic bacteria. Results From October 26 to November 5, 2024, a cumulative total of 53 cases were reported, with an attack rate of 1.47%. The main clinical symptoms included vomiting (83.02%), abdominal pain (56.60%), diarrhea (30.19%), and fever (26.42%). The epidemic curve suggested an intermittent common-source outbreak, with no obvious clustering characteristics in terms of the population and spatial distribution of cases. The case-control analysis revealed that having dinner at the rice-with-dishes-on-top stall on the first floor of the canteen on October 28 was a risk factor for illness (OR=11.025, 95%CI: 2.186-55.601). GⅡ norovirus was detected as positive in anal swab samples from 6 cases and 2 asymptomatic infected canteen staff, as well as in 3 environmental swab samples from the rice-with-dishes-on-top stall. The test results for common pathogenic bacteria in the reserved food samples were all negative. Conclusions This outbreak was caused by an acute gastroenteritis epidemic induced by GⅡ norovirus infection, with a transmission pattern consistent with an intermittent homologous outbreak. The possible source of infection was asymptomatic infected canteen staff mainly through foodborne trasmission, and having meals at the rice-with-dishes-on-top stall was the primary risk factor for this outbreak.
Key wordsnorovirus    acute gastroenteritis    outbreak    epidemiological investigation
收稿日期: 2025-06-18      修回日期: 2025-08-14      出版日期: 2025-09-10
中图分类号:  R512.5  
基金资助:陕西省自然科学基础研究项目(2020JQ-969); 西安市科技计划项目(2024JH-YLYB-0462)
作者简介: 张辉,硕士,副主任医师,主要从事传染病防控工作
通信作者: 李小虎,E-mail:275493267@qq.com   
引用本文:   
张辉, 年云鹏, 李华, 张磊乐, 兰宁, 李小虎. 一起职业技术学校GⅡ型诺如病毒急性胃肠炎暴发疫情调查[J]. 预防医学, 2025, 37(9): 917-921.
ZHANG Hui, NIAN Yunpeng, LI Hua, ZHANG Leile, LAN Ning, LI Xiaohu. Epidemiological investigation of an outbreak of acute gastroenteritis caused by GⅡ norovirus at a vocational and technical school. Preventive Medicine, 2025, 37(9): 917-921.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2025.09.011      或      http://www.zjyfyxzz.com/CN/Y2025/V37/I9/917
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