上海市2017年聚集性呕吐腹泻疫情流行病学特征分析
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摘要
【目的】了解上海市聚集性呕吐腹泻疫情的流行病学特征。【方法】收集汇总2017年1—12月上海市发现和报告的聚集性呕吐腹泻疫情的调查报告,统计分析所有疫情的三间分布特征、病例临床特征、主要感染原因和病原菌等。【结果】本市聚集性呕吐腹泻疫情发病高峰在冬春季,有79.23%的疫情发生在11月到次年3月;以郊区为主,浦东新区和松江区报告了全市30%的疫情,而中心城区如徐汇、静安、黄浦3区仅报告了10%的疫情;96.92%的疫情发生在学校和幼儿园;病例临床表现以呕吐、腹泻为主,其中有呕吐症状的占91.26%;人传人接触传播是本市疫情的主要传播形式,占93.85%;诺如病毒是本市疫情的首要病原,占74.62%;疫情持续时间与首发病例出现到首次调查处置的时间间隔存在正相关。【结论】2017年上海市聚集性呕吐腹泻疫情主要发生在冬春季和集体单位,诺如病毒是其主要病原体,应加强重点地区和人员的监测及防护工作。
[Objective] To investigate the epidemiological characteristics of aggregative vomiting and diarrhea outbreak in Shanghai. [Methods] The investigation report of the epidemic situation of aggregated vomiting and diarrhea found and reported in Shanghai from January to December 2017 were collected and summarized.Statistical analysis were made of the three epidemic distribution characteristics,clinical characteristics,main causes of infection and pathogenic bacteria,etc. [Results] The epidemic peak of vomiting and diarrhea outbreak in Shanghai was in winter and spring,while 79.23% of the outbreaks occurred from November to March next year.The epidemic were mainly in the suburbs,while 30% of the epidemic situation were reported in Pudong New District and Songjiang District and 10% reported in the central districts such as Xuhui,Jingan and Huangpu Districts.And 96.92% of the epidemic were found to have occurred in schools and kindergartens.The main clinical manifestations were vomiting and diarrhea,and 91.26% of the patients had vomiting symptoms.Human-to-human contact was the main transmission route of the epidemic in Shanghai,accounting for 93.85% of all.Norovirus was the primary pathogen of the epidemic in Shanghai,accounting for 74.62%.The duration of the epidemic was positively correlated with the interval between occurrence of the first case and the time of first investigation and management. [Conclusion] In 2017,the epidemic situation of aggregated vomiting and diarrhea in Shanghai mainly occurred in winter and spring and in collective units.Norovirus proved to be the main pathogen.It is imperative to strengthen the surveillance and protection of key areas and personnel.
[Objective] To investigate the epidemiological characteristics of aggregative vomiting and diarrhea outbreak in Shanghai. [Methods] The investigation report of the epidemic situation of aggregated vomiting and diarrhea found and reported in Shanghai from January to December 2017 were collected and summarized.Statistical analysis were made of the three epidemic distribution characteristics,clinical characteristics,main causes of infection and pathogenic bacteria,etc. [Results] The epidemic peak of vomiting and diarrhea outbreak in Shanghai was in winter and spring,while 79.23% of the outbreaks occurred from November to March next year.The epidemic were mainly in the suburbs,while 30% of the epidemic situation were reported in Pudong New District and Songjiang District and 10% reported in the central districts such as Xuhui,Jingan and Huangpu Districts.And 96.92% of the epidemic were found to have occurred in schools and kindergartens.The main clinical manifestations were vomiting and diarrhea,and 91.26% of the patients had vomiting symptoms.Human-to-human contact was the main transmission route of the epidemic in Shanghai,accounting for 93.85% of all.Norovirus was the primary pathogen of the epidemic in Shanghai,accounting for 74.62%.The duration of the epidemic was positively correlated with the interval between occurrence of the first case and the time of first investigation and management. [Conclusion] In 2017,the epidemic situation of aggregated vomiting and diarrhea in Shanghai mainly occurred in winter and spring and in collective units.Norovirus proved to be the main pathogen.It is imperative to strengthen the surveillance and protection of key areas and personnel.
引文
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[6]关于做好2014年夏秋季传染病防控工作的通知[R].上海市卫生和计划生育委员会,2014.
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[9]宋泰霞,赵晓燕,杨静,等.2014—2017年成都市成华区诺如病毒感染聚集性疫情流行病学特征分析[J].国际病毒学杂志,2018,25(4):238-241.
[10]杨芬,孙立梅,李晖,等.广东省2008—2015年诺如病毒感染暴发的危险因素分析[J].中华流行病学杂志,2017,38(7):906-910.
[11]高志勇,刘白薇,侯力予,等.诺如病毒急性胃肠炎疫情中患者的感染特征分析[J].中华实验和临床病毒学杂志,2017,31(1):38-41.
[12]张之伦,张颖,李佳萌,等.天津市轮状病毒和诺如病毒性腹泻流行病学特征研究[J].中华流行病学杂志,2011,32(12):1304-1305.
[13]刘江艺,李锋平,吕文辉.2014—2017年泉州市诺如病毒性胃肠炎暴发疫情的流行特征分析[J].应用预防医学,2018,12(6):445-446.
[14]周晓红,李晖,杨杏芬,等.诺如病毒胃肠炎暴发后环境中病毒检测情况分析[J].中华流行病学杂志,2010,31(1):43-46.
[15]纪惠玲,陈艳,谢茜鸿,等.2015—2017年福州市诺如病毒性急性胃肠炎暴发的病原学特征分析[J].解放军预防医学杂志,2017,35(6):559-561.
[16]刑彦,江初,华伟玉,等.一起诺如病毒感染引起的学校突发公共卫生事件调查[J].中华流行病学杂志,2017,38(9):1174-1178.
[17]蒋艺梅,赵哲,王小云.一起由诺如病毒引起的急性胃肠炎聚集性疫情调查[J].江苏预防医学,2017,28(6):681-682.
[2]JONES T F,YACKLEY J.Foodborne disease outbreaks in the united states:a historical overview[J].Foodborne Pathog Dis,2018,15(1):11-15.
[3]RAMANI S,ATMAR R L,ESTES M K.Epidemiology of human noroviruses and updates on vaccine development[J].Curr Opin Gastroenterol,2014,30(1):25-33.
[4]何磊,余亮,孙荷.婴幼儿病毒性腹泻病的临床研究进展[J].国际病毒学杂志,2015,22(4):140-144.
[5]潘浩,黎健,吴寰宇,等.2013—2015年上海市腹泻病综合监测结果分析[J].中国公共卫生,2017,32(10):1507-1511.
[6]关于做好2014年夏秋季传染病防控工作的通知[R].上海市卫生和计划生育委员会,2014.
[7]张静,常昭瑞,孙军玲,等.我国诺如病毒感染性腹泻流行现状及防制措施建议[J].疾病监测,2014,29(7):516-521.
[8]陈志永,陈小岳.诺如病毒暴发的流行病学研究进展[J].中国人兽共患病学报,2012,28(4):398-402.
[9]宋泰霞,赵晓燕,杨静,等.2014—2017年成都市成华区诺如病毒感染聚集性疫情流行病学特征分析[J].国际病毒学杂志,2018,25(4):238-241.
[10]杨芬,孙立梅,李晖,等.广东省2008—2015年诺如病毒感染暴发的危险因素分析[J].中华流行病学杂志,2017,38(7):906-910.
[11]高志勇,刘白薇,侯力予,等.诺如病毒急性胃肠炎疫情中患者的感染特征分析[J].中华实验和临床病毒学杂志,2017,31(1):38-41.
[12]张之伦,张颖,李佳萌,等.天津市轮状病毒和诺如病毒性腹泻流行病学特征研究[J].中华流行病学杂志,2011,32(12):1304-1305.
[13]刘江艺,李锋平,吕文辉.2014—2017年泉州市诺如病毒性胃肠炎暴发疫情的流行特征分析[J].应用预防医学,2018,12(6):445-446.
[14]周晓红,李晖,杨杏芬,等.诺如病毒胃肠炎暴发后环境中病毒检测情况分析[J].中华流行病学杂志,2010,31(1):43-46.
[15]纪惠玲,陈艳,谢茜鸿,等.2015—2017年福州市诺如病毒性急性胃肠炎暴发的病原学特征分析[J].解放军预防医学杂志,2017,35(6):559-561.
[16]刑彦,江初,华伟玉,等.一起诺如病毒感染引起的学校突发公共卫生事件调查[J].中华流行病学杂志,2017,38(9):1174-1178.
[17]蒋艺梅,赵哲,王小云.一起由诺如病毒引起的急性胃肠炎聚集性疫情调查[J].江苏预防医学,2017,28(6):681-682.
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