【摘要】 目的 调查2024年12月海珠区某养老院聚集性呕吐腹泻疫情，为养老院疫情防控提供参考依据。方法 对2024年12月18日以来居住在某养老院的病例和感染者开展流行病学调查，应用描述性流行病学方法分析流行特征。结果2024年12月24日-2025年1月2日，养老院报告诺如病毒感染病例共88例，总罹患率为11.83%，其中老人53人，罹患率为9.38%；护理员32人，罹患率为22.07%；厨工3人，罹患率为25.00%；老人、护理员和厨工之间的罹患率差异有统计学意义（χ~2=19.22,P<0.001）。首例病例时间为2024年12月21日8时，12月24日新增病例数达到最高峰21例，占报告总数23.86%(21/88)。采用实时荧光定量RT-PCR法进行诺如病毒核酸检测，采集人员肛拭子样本160份，阳性61份，阳性率为38.13%；采集环境样本97份，其中走廊扶手、病例房间的门把手、厕所等13份样本阳性，阳性率为13.40%。结论 诺如病毒是本次疫情病原体，病例呕吐、腹泻导致的接触和气溶胶传播，叠加无感染控制的护理服务导致交叉传播等是引起暴发和感染持续存在的主要危险因素。更多还原

【Abstract】 Objective To investigate a cluster of vomiting and diarrhea cases in a nursing home in Haizhu district in December 2024 and provide reference for epidemic prevention and control in nursing homes. Methods Epidemiological investigations were conducted on cases and infected individuals residing in the nursing home since December 18, 2024, and descriptive epidemiological methods were applied to analyze the epidemic characteristics. Results From December 24, 2024, to January 2, 2025, a total of 88 norovirus infection cases were reported in the nursing home, with an overall attack rate of 11.83%. Among them, 53 were elderly residents(attack rate: 9.38%), 32 were caregivers(attack rate: 22.07%), and 3 were kitchen staff(attack rate: 25.00%). The differences in attack rates among the elderly, caregivers, and kitchen staff were statistically significant （χ~2=19.22, P<0.001）. The first case occurred at 8:00 on December 21, 2024, and the number of new cases peaked on December 24 with 21 cases, accounting for 23.86%(21/88) of the total reported cases. Norovirus nucleic acid was detected using real-time fluorescent quantitative RT-PCR. Among the 160 anal swab samples, 61 tested positive(positivity rate: 38.13%). Of the 97 environmental samples collected, 13 were positive, including corridor handrails, door handles in case rooms, and toilets(positivity rate: 13.40%). Conclusions Norovirus was the causative agent of this outbreak. Contact and aerosol transmission due to vomiting and diarrhea, combined with cross-infection from uncontrolled care services, were the main risk factors leading to the outbreak and sustained transmission.更多还原