【摘要】 目的查找某中学学生胃肠炎样传染病爆发的原因和影响因素,采取针对性防治措施,控制和扑灭疫情。方法在疾病爆发期间,对所有病例进行流行病学个案调查;应用ELISA对大便标本检测诺瓦克样病毒抗原;采用相关方法对水源水、食物、呕吐物、肛拭子标本检测细菌总数、总大肠菌群、沙门氏菌、志贺氏菌、副溶血性弧菌、金黄色葡萄球菌和乙型溶血性链球菌以及对食堂消毒餐具定性检测大肠菌群。结果符合病例有200例、罹患率7·60%,大多数病例均有恶心、呕吐、腹泻、腹痛及腹胀等症状,症状较轻,有自限性倾向;病例时间分布存在两个明显的发病高峰,两峰间隔44h;病例以男生为主,男女之比24:1,病例在宿舍、班级表现了一定的聚集性;检测病例组大便标本19份、诺瓦克样病毒抗原阳性5份,检测对照组大便标本26份全部阴性。检测学校食堂员工大便标本22份、阳性8份,阳性率36·36%。其他学校食堂员工大便标本186份、阳性1份,阳性率0·54%;男生宿舍生活用水水源受到污染;食堂销售窗口餐具亦受到污染。结论这是一起诺瓦克样病毒胃肠炎爆发疫情,是食堂因素、水源污染和接触传播共同作用的结果。更多还原

【Abstract】 Objective To investigative the cause of outbreak of gastroenteritis for making control measures. Methods All possible cases were selected by epidemiological individual survey. ELISA technique was applied to detect Norwalk-like virus (NLVs) in the stool. Bacterial cultivation techniques were applied to detect aerobic bacteria,Coliform bacteria,Salmonella,Shigella,Vibrio parahaemolyticus, Staphylococcus aureus, Streptococcus hemolyticus in water source,food,vomit and anus wipe according to< General regulation for microbiological examination of food hygiene> (GB/T4789). The Coliform bacteria in disinfected dinning utensils in canteen was detected according to <Hygienic standard for disinfection of dinning and drinking utensils>. Results There were 200 possible cases with an incidence of 7.60%. Most of cases showed the symptoms of nausea,vomiting,diarrhoea,abdominal pain and abdominal distension. The symptoms were light and self-limited. There were two peaks with the interval of 44 hours between the two peaks. Most of the cases male students. The ratio of male to female was 24: Gathering in class and dormitory was the observed . Out of the 19 stool samples 5 were positive for NLVs. All 26 samples in the control group gave negative results. Out of the 22 stool samples from workers of the canteen 8 were positive with a positive rate of 36.36%. 186 stool samples from workers of other canteen only one positive with a positive rate of 0.54%. The water source of male dormitory and dining utensil were contaminated. Conclusion This is an outbreak of gastroenteritis caused by Norwalk virus due to the combined results of contamination of dinning and drinking utensils, water source and contact transmission.更多还原