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目的了解河池市诺如病毒感染性腹泻暴发的流行病学、临床和病原学特征,探讨暴发危险因素,为防控诺如病毒感染提供科学依据。方法应用流行病学研究方法分析2006～2010年河池市3起诺如病毒感染性腹泻暴发资料,采用实时荧光定量PCR法检测诺如病毒病原学特征。结果 2006～2010年共报告3起诺如病毒感染性腹泻暴发疫情,3起疫情的罹患率分别为8.94%(371/4151)、12.40%(110/887)和3.64%(92/2527)。主要临床症状为腹痛、腹胀、恶心、呕吐、腹泻。生活用水标本余氯不达标率为66.67%(16/24),总大肠菌群超标率为100%,菌落总数超标率为95.83%(23/24)。粪便标本GⅡ型诺如病毒核酸阳性率为84.44%(38/45),疫情1病毒株经基因序列测定和比较被确定为GⅡ/4型变异株(HC01/2006),其与2006年日本AB294765株(Katori/061002/2006/JP)的同源性高达99.3%。结论感染性腹泻暴发均因生活用水被GⅡ型诺如病毒污染所致,饮水安全需要得到进一步的加强。
Objective To understand the epidemiological, clinical and etiological characteristics of Norovirus infectious diarrhea outbreak in Hechi City and to explore the risk factors of outbreak and provide a scientific basis for the prevention and control of Norovirus infection. Methods Epidemiological methods were used to analyze the data of three Norovirus infectious diarrhea outbreaks in Hechi from 2006 to 2010. The etiological characteristics of norovirus were detected by real-time fluorescence quantitative PCR. Results Three outbreaks of Norovirus infectious diarrhea were reported in 2006 ~ 2010. The outbreak rates of the three outbreaks were 8.94% (371/4151), 12.40% (110/887) and 3.64% (92/2527), respectively. The main clinical symptoms of abdominal pain, bloating, nausea, vomiting, diarrhea. The non-compliance rate of remaining chlorine in domestic water samples was 66.67% (16/24), the total coliform bacteria exceeded the standard rate of 100%, and the total number of colonies exceeded the standard rate of 95.83% (23/24). The positive rate of G Ⅱ norovirus was 84.44% (38/45) in stool samples. The outbreak of Epidemic 1 virus was identified as GⅡ / 4 mutant (HC01 / 2006) by gene sequence analysis and was compared with that of Japanese strain AB294765 The homology of the strain (Katori / 061002/2006 / JP) is as high as 99.3%. Conclusions Infectious diarrhea outbreaks are caused by the contamination of living water with Gnoviruses. Drinking water safety needs to be further strengthened.