| 张萌,龙遗芳,郭莉敏,吴崧霖,方苓,杨芬,李晖,黄琼,孙立梅.广东省2013－2017年3种基因型诺如病毒感染暴发疫情的流行特征[J].中华流行病学杂志,2018,39(9):1210-1215 |
| 广东省2013－2017年3种基因型诺如病毒感染暴发疫情的流行特征 |
| Epidemiological characteristics of outbreaks of norovirus-GⅡ.2, GⅡ.17 and GⅡ.4/Sydney in Guangdong province, 2013-2017 |
| 收稿日期:2018-02-22 出版日期:2018-09-20 |
| DOI：10.3760/cma.j.issn.0254-6450.2018.09.013 |
| 中文关键词: 诺如病毒 暴发 基因型 流行病学特征 |
| 英文关键词: Norovirus Outbreak Genotype Epidemiological characteristic |
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| 中文摘要: |
| 目的 分析2013－2017年广东省115起由GⅡ.2、GⅡ.17和GⅡ.4/Sydney 3种基因型引起的诺如病毒感染暴发的流行特征，为诺如病毒感染疫情的防控提供科学依据。方法 通过“突发公共卫生事件报告管理信息系统”收集2013年1月1日至2017年11月30日广东省报告的诺如病毒感染暴发疫情，采用RT-PCR方法对每起疫情的病例标本进行诺如病毒核酸检测，经基因测序后确定病毒基因型，对GⅡ.2、GⅡ.17和GⅡ.4/Sydney 3种基因型暴发疫情特点进行分析，采用直接标准化法计算病例呕吐和腹泻的比例。结果 广东省2013年1月1日至2017年11月30日共报告诺如病毒感染暴发疫情167起，GⅡ.2、GⅡ.17和GⅡ.4/Sydney 3种基因型引起115起。暴发场所中，GⅡ.2型为小学占39.68%（25/63）、托幼机构占28.57%（18/63）、中学占25.40%（16/63）、大学占6.35%（4/63）；GⅡ.17型为中学占41.03%（16/39）、其他社会单位占20.51%（8/39）、小学占15.38%（6/39）、大学占12.82%（5/39）、社区和托幼机构各占5.13%（2/39）；GⅡ.4/Sydney型为大学占53.85%（7/13）、托幼机构和其他社会单位各占15.38%（2/13）、小学和中学各占7.69%（1/13）。传播途径中，GⅡ.2型为接触传播占77.78%（49/63）、食源性传播占17.46%（11/63）；GⅡ.17型为食源性传播占53.85%（21/39）、接触传播占15.38%（6/39）、水源性传播占12.82%（5/39）；GⅡ.4/Sydney型为食源性传播占53.85%（7/13）、接触传播占38.46%（5/13）。临床表现中，GⅡ.2型的标准化呕吐比例为73.76%、腹泻比例为42.85%；GⅡ.17型的标准化呕吐比例为76.37%、腹泻比例为51.40%；GⅡ.4/Sydney型的标准化呕吐比例为54.10%、腹泻比例为55.95%。结论 GⅡ.2型主要涉及小学、托幼机构和中学，以接触传播为主；GⅡ.17型主要涉及中学和其他社会单位，以食源性传播为主；GⅡ.4/Sydney型主要涉及大学，食源性传播比例最高，接触传播也有较高比例。 |
| 英文摘要: |
| Objective To understand the epidemiologic characteristics of outbreaks, caused by norovirus-GⅡ.2、GⅡ.17 and GⅡ.4/Sydney in Guangdong Province from 2013 to 2017 and to provide scientific evidence for epidemic prevention and control. Methods Incidence data of norovirus outbreaks in Guangdong from January 1st 2013 to November 30th 2017 were collected from Public Health Emergency Management Information System. RT-PCR was performed for every case of each outbreak to detect norovirus nucleic acid and gene sequencing was conducted to identify the genotype of norovirus. Characteristics of norovirus GⅡ.2, GⅡ.17 and GⅡ.4/Sydney outbreaks were analyzed. Directly standardized method was used to calculate the proportion of symtoms as diarrhea and vomitting. Results From January 1st 2013 to November 30th 2017, a total of 167 norovirus outbreaks were reported in Guangdong, and 115 outbreaks were caused by norovirus GⅡ.2, GⅡ.17 and GⅡ.4/Sydney respectively. The outbreaks caused by norovirus GⅡ.2 accounted for 39.68% (25/63) in primary schools, 28.57% (18/63) in child care settings, 25.40% (16/63) in middle schools and 6.35% (4/63) in universities. Outbreaks caused by norovirus GⅡ.17 accounted for 41.03% (16/39) in middle schools, 20.51% (8/39) at workplaces, 15.38% (6/39) in primary schools, 12.82% (5/39) in universities, 5.13% (2/39) in communities and child care settings respectively. The outbreaks caused by norovirus GⅡ.4/Sydney accounted for 53.85% (7/13) in universities, 15.38% (2/13) in child care settings and at workplaces respectively, 7.69%(1/13) in primary schools and middle schools respectively. The outbreaks caused by norovirus GⅡ.2 had 77.78% (49/63) of contact transmission, 17.46% (11/63) of food-borne transmission. The outbreaks caused by norovirus GⅡ.17 showed 53.85% (21/39) of food-borne transmission, 15.38% (6/39) of contract transmission, 12.82% (5/39) of water-borne transmission. The outbreaks caused by norovirus GⅡ.4/Sydney had 53.85% (7/13) of food-borne transmission, 38.46% (5/13) of the contact transmission. In terms of the clinical manifestations, the standardized proportion of vomit was 73.76% and the proportion of diarrhea was 42.85% in cases infected with norovirus GⅡ.2, the proportion of standardized of vomit was 76.37% and the proportion of diarrhea was 51.40% in cases infected with norovirus GⅡ.17, with the standardized proportion of vomit was 54.10% and the proportion of diarrhea was 55.95% in cases infected with norovirus GⅡ.4/Sydney. Conclusions The outbreaks caused by norovirus GⅡ.2 through contact transmission mainly occurred in primary schools, child care settings and middle schools. The outbreaks caused by norovirus GⅡ.17 through food-borne transmission mainly occurred in middle schools and at workplaces. The outbreaks caused by norovirus GⅡ.4/Sydney food-borne transmission and contact mainly occurred in universities. |
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