中小学及托幼机构急性胃肠炎患者诺如病毒流行病学研究

An epidemiological study of Norovirus in patients with acute gastroenteritis in primary and secondary schools as well as childcare facilities

  • 摘要:
    目的 分析常州市武进区突发公共卫生事件中来自中小学及托幼机构的急性胃肠炎患者诺如病毒感染流行病学特征,以期为该地区诺如病毒的科学防控提供依据。
    方法 收集常州市武进区2020年11月—2022年10月突发公共卫生事件中涉及中小学及托幼机构的有急性胃肠炎症状者(n=231)及与其密切接触的无症状人员(n=95)的肛拭子样本,采用荧光定量聚合酶链反应(PCR)法对样本进行诺如病毒及基因分型检测。
    结果 326份样本中,诺如病毒阳性检出率为45.09%(147/326); 诺如病毒基因分型以GⅡ型为主,占85.71%(126/147)。140例诺如病毒阳性的急性胃肠炎患者的主要临床表现为呕吐(占95.71%, 134/140), 且GⅠ型诺如病毒感染患者的呕吐症状更严重。4~6月的诺如病毒阳性检出率最高, 为59.21%(45/76); 男性感染诺如病毒的风险更高,诺如病毒阳性检查率达54.94%(89/162)。年龄小是诺如病毒的易感因素, 0~6岁婴幼儿的诺如病毒阳性检出率最高(56.69%),其次为7~12岁儿童(46.43%)。
    结论 常州市武进区突发公共卫生事件中,诺如病毒感染患者的临床症状多为呕吐,且诺如病毒以GⅡ基因型为主。诺如病毒感染好发于春季和冬季,男性和0~6岁婴幼儿是易感人群,相关机构需在高发期加强对诺如病毒的监测和防控工作。

     

    Abstract:
    Objective To analyze the epidemiological characteristics of Norovirus infection in patients with acute gastroenteritis in primary and secondary schools as well as childcare facilities during public health emergencies in Wujin District of Jiangsu Province, and to establish a robust scientific foundation for the prevention and control strategies of this area.
    Methods Anal swab samples were collected from patients with symptoms of acute gastroenteritis (n=231) and asymptomatic persons (n=95) in close contact with primary and secondary schools and childcare facilities involved in public health emergencies from November 2020 to October 2022 in Wujin District of Changzhou City. Fluorescent quantitative polymerase chain reaction (PCR) was used for the detection of Norovirus and its genotypes in anal swab specimens collected from patients.
    Results In 326 samples, the positive rate of Norovirus was 45.09%(147/326). The genotype of Norovirus was mainly GⅡ type, accounting for 85.71%(126/147). The main clinical manifestation of 140 patients with Norovirus-positive acute gastroenteritis was vomiting (95.71%, 134/140), and the vomiting symptom was more serious in patients with type GⅠNorovirus infection. The positive rate of Norovirus from April to June was the highest, accounting for 59.21% (45/76). Males exhibited a higher risk of Norovirus infection, with a positive rate of 54.94%(89/162). Younger age continued to be a determining factor in susceptibility to Norovirus, with the highest positivity rate observed in infants and young children aged 0 to 6 years, accounting for 56.69%, followed by children aged 7 to 12 years (46.43%).
    Conclusion Vomiting represents the primary clinical symptom observed in individuals affected by Norovirus during public health emergencies in Wujin District of Changzhou. The predominant genotype detected is Norovirus G Ⅱ, with the highest incidence occurring in the spring and winter. Males along with infants and young children aged 0 to 6 years are identified as vulnerable populations susceptible to Norovirus infection. Relevant agencies need to strengthen the surveillance and prevention of norovirus during the high incidence period.

     

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