2015—2018年北京市西城区急性胃肠炎暴发疫情流行病学特征
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摘要
目的 2015—2018年北京市西城区急性胃肠炎暴发疫情的流行特征和病原体进行分析。方法采用现场流行病学调查方法对每一起急性胃肠炎暴发疫情进行调查,收集疫情相关信息,采集病例及相关人员便标本进行肠道病毒检测,并对数据进行分析。结果 2015—2018年西城区共报告急性胃肠炎暴发疫情14起,发病526人,每起疫情发病人数在20～86例之间,罹患率为7.02%～68.97%,疫情平均流行时间5天。4年疫情报告整体呈上升趋势,夏季为高发季节,好发场所为小学12起(85.71%)。病例临床症状主要为呕吐(499例,94.87%)和腹泻(141例,26.81%)。共采集相关人员便标本共361件,148件检出诺如病毒核酸,均为GⅡ型,阳性率为41.00%,其中病例标本阳性率最高84.46%。结论 GⅡ型诺如病毒是引起2015—2018年北京市西城区急性胃肠炎暴发疫情的主要病原体,疫情夏季高发,小学为高发场所。加强食堂工作人员及隐性感染者的监测与管理对于疫情的防控有着重要意义。
[Objective]To analyze the epidemiological characteristics and pathogens of acute gastroenteritis outbreaks in Xicheng District of Beijing from 2015-2018.[Methods]Field epidemiological investigation was used to investigate each outbreak of acute gastroenteritis,collect epidemic information,and collect stool specimens from cases and relevant personnel for enterovirus detection.The data were analyzed.[Results]There were 14 outbreaks with a total of 526 patients of acute gastroenteritis in Xicheng District of Beijing from 2015-2018,the number of cases per outbreak was between 20 and 86 patients,and the attack rate was between7.02% and 68.97%. The average epidemic time was five days. The epidemic report showed an overall upward trend in four years.The summer was a high-risk season,and the high-risk place was primary school(12 outbreaks,85.71%). The clinical symptoms of the cases were mainly vomiting(499 cases,94.87%) and diarrhea(141 cases,26.81%). A total of 361 specimens were collected from relevant personnel,and 148 samples were detected as positive for Norovirus nucleic acids,all of which were GII type,with a positive rate of 41.00%,and the positive rate of case specimens was 84.46%.[Conclusion] GII type Norovirus is the main pathogen causing the outbreak of acute gastroenteritis in Xicheng District of Beijing from 2015-2018. The peak season is summer and the primary school is the high-risk place. Strengthening the monitoring and management of canteen staff and hidden infections is necessary for the prevention and control of the epidemic.
[Objective]To analyze the epidemiological characteristics and pathogens of acute gastroenteritis outbreaks in Xicheng District of Beijing from 2015-2018.[Methods]Field epidemiological investigation was used to investigate each outbreak of acute gastroenteritis,collect epidemic information,and collect stool specimens from cases and relevant personnel for enterovirus detection.The data were analyzed.[Results]There were 14 outbreaks with a total of 526 patients of acute gastroenteritis in Xicheng District of Beijing from 2015-2018,the number of cases per outbreak was between 20 and 86 patients,and the attack rate was between7.02% and 68.97%. The average epidemic time was five days. The epidemic report showed an overall upward trend in four years.The summer was a high-risk season,and the high-risk place was primary school(12 outbreaks,85.71%). The clinical symptoms of the cases were mainly vomiting(499 cases,94.87%) and diarrhea(141 cases,26.81%). A total of 361 specimens were collected from relevant personnel,and 148 samples were detected as positive for Norovirus nucleic acids,all of which were GII type,with a positive rate of 41.00%,and the positive rate of case specimens was 84.46%.[Conclusion] GII type Norovirus is the main pathogen causing the outbreak of acute gastroenteritis in Xicheng District of Beijing from 2015-2018. The peak season is summer and the primary school is the high-risk place. Strengthening the monitoring and management of canteen staff and hidden infections is necessary for the prevention and control of the epidemic.
引文
[1]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.
[2]刘潇潇,陈瑜,李继珊,等.2013—2016年北京市西城区诺如病毒感染聚集性疫情流行特征分析[J].现代预防医学,2018,45(11):1929-1931.
[3]李继珊,秦迪,崔海洋. 2015年北京市西城区诺如病毒感染聚集性和暴发疫情分析[J].职业与健康,2016. 32(22):3137-3139.
[4]黄艳红,刘潇潇,初艳慧,等.北京市西城区2017年急性胃肠炎疫情流行特征与病原学分析[J].国际病毒学杂志,2018,25(6):397-399.
[5]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].中华实验与临床病毒性杂志,2017,31(1):38-41.
[6]REPP KK,KEENE WE.A point-source norovirus outbreak caused by exposure to fomites[J].Infect Dis,2012,205(11):1639-1641.
[7]REPP KK,HOSTETLER TP,KEENE WE,et al.A norovirus outbreak related to contaminated environmental surfaces[J].Infect Dis,2013,207(10):105-107.
[8]汪金生,孙琴,曹孟婵,等.一起水源性诺如病毒引起的急性胃肠炎疫情的调查分析[J].安徽预防医学杂志,2016,22(2):87-90.
[9]LOURY P,LE GUYADER FS,LE SAUX JC,et al.A norovirus oysterrelated outbreak in a nursing home in France,january 2012[J].Epidemiol Infect,2015,143(12):2486-2493.
[10]宋晓佳,张静,施国庆.2000—2013年我国诺如病毒感染性胃肠炎暴发流行病学特征分析[J].疾病监测,2017,32(2):127-131.
[11]蔡伟,应华清,邢彦,等.2016年北京市海淀区诺如病毒感染聚集、暴发疫情特征分析[J].疾病监测,2017,32(8):656-659.
[12]戴映雪,速丽媛,刘云升.成都市2016年诺如病毒聚集性疫情及影响因素分析[J].中国学校卫生,2017,38(10):1533-1535.
[13]肖达勇,凌华,赵春芳,等. 2016年重庆市诺如病毒感染疫情流行特征分析[J].现代预防医学,2017,44(18):3278-3280.
[14]农皓,刘海燕,裴建新,等. 2015—2016年南宁市诺如病毒疫情调查报告[J].中国卫生检验杂志,2017,27(11):1624-1626.
[15]郭建欣,张海艳,吴伟. 2014年北京市东城区诺如病毒疫情特征分析[J].现代预防医学,2015,42(23):4371-4373.
[16]宋灿磊,袁佳春,李澜,等.诺如病毒胃肠炎疫情密切接触者感染及环境污染状况调查[J].中国卫生检验杂志,2013,23(16):3290-3292.
[17]段蓉,刘景壹,沈红,等. 2013—2015年上海市徐汇区诺如病毒感染聚集性疫情流行特征与病原学分析[J].职业与健康,2017,33(1):63-65,70.
[18]HAESSLER S,GRANOWITZ EV. Norovirus gastroenteritis in immunocompromised patients[J]. N Engl J Med,2013,368(10):971.
[19]赵科伕,张磊. 2015年合肥市诺如病毒聚集性疫情流行特征[J].职业与健康,2017,33(12):1654-1656.
[20]张海燕,徐文彩,郭建欣,等.北京市东城区2013—2015年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,2016,23(4):242-245.
[2]刘潇潇,陈瑜,李继珊,等.2013—2016年北京市西城区诺如病毒感染聚集性疫情流行特征分析[J].现代预防医学,2018,45(11):1929-1931.
[3]李继珊,秦迪,崔海洋. 2015年北京市西城区诺如病毒感染聚集性和暴发疫情分析[J].职业与健康,2016. 32(22):3137-3139.
[4]黄艳红,刘潇潇,初艳慧,等.北京市西城区2017年急性胃肠炎疫情流行特征与病原学分析[J].国际病毒学杂志,2018,25(6):397-399.
[5]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].中华实验与临床病毒性杂志,2017,31(1):38-41.
[6]REPP KK,KEENE WE.A point-source norovirus outbreak caused by exposure to fomites[J].Infect Dis,2012,205(11):1639-1641.
[7]REPP KK,HOSTETLER TP,KEENE WE,et al.A norovirus outbreak related to contaminated environmental surfaces[J].Infect Dis,2013,207(10):105-107.
[8]汪金生,孙琴,曹孟婵,等.一起水源性诺如病毒引起的急性胃肠炎疫情的调查分析[J].安徽预防医学杂志,2016,22(2):87-90.
[9]LOURY P,LE GUYADER FS,LE SAUX JC,et al.A norovirus oysterrelated outbreak in a nursing home in France,january 2012[J].Epidemiol Infect,2015,143(12):2486-2493.
[10]宋晓佳,张静,施国庆.2000—2013年我国诺如病毒感染性胃肠炎暴发流行病学特征分析[J].疾病监测,2017,32(2):127-131.
[11]蔡伟,应华清,邢彦,等.2016年北京市海淀区诺如病毒感染聚集、暴发疫情特征分析[J].疾病监测,2017,32(8):656-659.
[12]戴映雪,速丽媛,刘云升.成都市2016年诺如病毒聚集性疫情及影响因素分析[J].中国学校卫生,2017,38(10):1533-1535.
[13]肖达勇,凌华,赵春芳,等. 2016年重庆市诺如病毒感染疫情流行特征分析[J].现代预防医学,2017,44(18):3278-3280.
[14]农皓,刘海燕,裴建新,等. 2015—2016年南宁市诺如病毒疫情调查报告[J].中国卫生检验杂志,2017,27(11):1624-1626.
[15]郭建欣,张海艳,吴伟. 2014年北京市东城区诺如病毒疫情特征分析[J].现代预防医学,2015,42(23):4371-4373.
[16]宋灿磊,袁佳春,李澜,等.诺如病毒胃肠炎疫情密切接触者感染及环境污染状况调查[J].中国卫生检验杂志,2013,23(16):3290-3292.
[17]段蓉,刘景壹,沈红,等. 2013—2015年上海市徐汇区诺如病毒感染聚集性疫情流行特征与病原学分析[J].职业与健康,2017,33(1):63-65,70.
[18]HAESSLER S,GRANOWITZ EV. Norovirus gastroenteritis in immunocompromised patients[J]. N Engl J Med,2013,368(10):971.
[19]赵科伕,张磊. 2015年合肥市诺如病毒聚集性疫情流行特征[J].职业与健康,2017,33(12):1654-1656.
[20]张海燕,徐文彩,郭建欣,等.北京市东城区2013—2015年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,2016,23(4):242-245.