【摘要】 目的 掌握上海市宝山区聚集性呕吐腹泻疫情流行病学与病原学特征，为制定针对性防控措施提供依据。方法 采用现场流行病学调查方法，对2019—2021年宝山区聚集性呕吐腹泻事件开展流行病学调查，采集病例、重点人群等肛拭子和环境涂抹标本开展病原学检测。结果 2019—2021年共报告聚集性呕吐腹泻疫情69起，总罹患率为1.58%。主要检出病原体为诺如病毒(51起，占73.91%),疫情主要分布在冬春季节(67起，97.10%),主要发生在托幼机构(57.97%)和小学(28.97%)。疫情介入时间间隔为0～5 d,中位数为2 d, 60起(86.96%)疫情在3 d内上报疾控中心；疫情持续时间为4～15 d,中位数为6 d, 76.81%的疫情持续时间为4～6 d,疫情持续时间与疫情介入时间间隔的Spearman相关系数r=0.64(P<0.01)。结论 聚集性呕吐腹泻疫情以人传人和接触传播为主，疫情发生多与病例处置措施不当有关，如未及时离开污染场所或未正确处置呕吐物等。早发现、早报告、早处置对于疫情的发生、发展至关重要。更多还原

【Abstract】 Objective To investigate the epidemiological and etiological characteristics of cluster vomiting and diarrhea epidemics in Baoshan District, Shanghai Municipality, so as to provide insights into formulation of targeted control measures. Methods A field epidemiological survey was performed for cluster vomiting and diarrhea events in Baoshan District from 2019 to 2021.Anal swab and environmental application samples were collected from cases and high-risk populations for etiological examinations. Results A total of 69 cluster vomiting and diarrhea epidemics were reported in Baoshan District from 2019 to 2021,with an attack rate of 1.58%.Norovirus was the main pathogen(51 epidemics, 73.91%),and the epidemics mainly occurred in winter and spring(67 epidemics, 97.10%) and in kindergartens(57.97%) and primary schools(28.97%).The interval of epidemics management ranged from 0 to 5 days, with a median of 2 days, and 60 epidemics(86.96%) were reported to center of disease control and prevention within 3 days.The duration of epidemics ranged from 4 to 15 days, with a median of 6 days, and the duration of 76.81% of epidemics were 4 to 6 days.Spearman correlation analysis showed that the duration of epidemics correlated with the interval of epidemic management(r=0.64,P < 0.01).Conclusions Cluster vomiting and diarrhea epidemics mainly occur through human-to-human and contact transmission, and the occurrence of epidemics is mainly associated with improper management of cases, such as untimely departure from contaminated places or incorrect disposal of vomits.Early identification, early report and early disposal is of great importance for the development and progression of cluster vomiting and diarrhea epidemics.更多还原