张家界市某酒店因二次供水污染导致的诺如病毒感染性腹泻暴发疫情的调查
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摘要
目的调查武陵源区某酒店一起游客诺如病毒感染性腹泻暴发疫情,查明原因,采取针对性措施,及时有效控制疫情。方法采用现场流行病学调查方法,描述病例分布和临床特征,分析危险因素,探讨其传播途径和方式,并对采集的标本进行实验室检测。结果本次疫情涉及到入住酒店的2个旅游团及部分酒店员工,共有病例33例,罹患率为29.73%,主要症状为腹泻、腹痛、恶心、呕吐;33份病例肛拭子标本中,12份检出诺如病毒GⅡ型阳性;自备水水池5份水标本中,全部检出诺如病毒GⅡ型阳性,菌落总数和大肠菌群超标;二次供水水塔5份水标本中,全部检出诺如病毒GⅡ型阳性,菌落总数和大肠菌群超标;早餐餐具涂抹10份标本中,2份检出诺如病毒GⅡ型阳性。结论本次疫情为一起由GⅡ型诺如病毒污染酒店二次供水引起的感染性腹泻暴发疫情。
Objective To investigate the outbreak of infectious diarrhea by norovirus resulted from contamination of secondary water supply in tourists in a hotel in Wulingyuan district. Methods Field epidemiological investigation was performed to describe the distribution and clinical characteristics of the cases. Anal swab samples were collected and subjected to laboratory tests, and the risk factors, together ways and routes of transmission were investigated and analyzed. Results Thirty-three victims(29.73%) were reported, including tourists with two tourist groups and partial hotel staff. The major symptoms were diarrhea, abdominal pain, nausea and vomiting. In the 33 anal swab specimens, 12 were found positive with norovirus G II. Positive G II was also detected in the 5 samples collected from the self-supplied water pool and another 5 samples from the tank of secondary water supply, with total number of colonies and coliform bacteria beyond the standard. In the 10 samples collected from the breakfast tableware, 2 were positive with norovirus G II. Conclusion The outbreak of infectious diarrhea in the hotel in Wulingyuan district is associated with norovirus G II resulted from contamination of secondary water supply.
Objective To investigate the outbreak of infectious diarrhea by norovirus resulted from contamination of secondary water supply in tourists in a hotel in Wulingyuan district. Methods Field epidemiological investigation was performed to describe the distribution and clinical characteristics of the cases. Anal swab samples were collected and subjected to laboratory tests, and the risk factors, together ways and routes of transmission were investigated and analyzed. Results Thirty-three victims(29.73%) were reported, including tourists with two tourist groups and partial hotel staff. The major symptoms were diarrhea, abdominal pain, nausea and vomiting. In the 33 anal swab specimens, 12 were found positive with norovirus G II. Positive G II was also detected in the 5 samples collected from the self-supplied water pool and another 5 samples from the tank of secondary water supply, with total number of colonies and coliform bacteria beyond the standard. In the 10 samples collected from the breakfast tableware, 2 were positive with norovirus G II. Conclusion The outbreak of infectious diarrhea in the hotel in Wulingyuan district is associated with norovirus G II resulted from contamination of secondary water supply.
引文
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2 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治措施建议.疾病监测,2014,29(7):516-521.
3 陈志永,陈小岳.诺如病毒暴发的流行病学研究进展.中国人兽共患病学报,2012,28(4):516-521.
4 胡红安,张勇兵,罗建辉,等.一起因厕所卫生不良致诺如病毒感染性腹泻暴发的调查.实用预防医学,2015,22(9):1061-1063.
5 施超,钱燕华,邵洁,等.诺如病毒性腹泻研究进展.江苏预防医学,2012,23(1):25-27.
6 李兰娟,任红.传染病学.第8版.北京:人民卫生出版社,2013:43-50.
7 刘波,刘红旗.人诺如病毒最新研究进展.中国医药导报,2017,14(12):60-64.
8 曾玫,陈洁,龚四堂,等.我国五所城市儿童医院诺如病毒和轮状病毒腹泻的流行病学监测.中华儿科杂志,2010,48(8):564-570.