武汉市一起幼儿园诺如病毒疫情暴发及感染者排毒时间调查

裴红兵; 颜芝闻; 吴晓旻; 祁莉; 吴昌汉

doi:10.16835/j.cnki.1000-9817.2024236

武汉市一起幼儿园诺如病毒疫情暴发及感染者排毒时间调查

doi: 10.16835/j.cnki.1000-9817.2024236

裴红兵¹,
颜芝闻^1, ,,
吴晓旻²,
祁莉³,
吴昌汉^1, ,

1.
武汉市青山区疾病预防控制中心传染病防制科，湖北 430080
2.
武汉市疾病预防控制中心
3.
武汉市青山区疾病预防控制中心检验科

详细信息

作者简介:
裴红兵(1967-)，男，湖北老河口人，大学本科，主任医师，主要研究方向为疾病控制

通讯作者:
颜芝闻，E-mail: 409967713@qq.com

吴昌汉，E-mail: 1449528998@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R181.3⁺² R511 G478
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出版历程
- 收稿日期: 2024-02-08
- 修回日期: 2024-04-06
- 网络出版日期: 2024-08-31
- 刊出日期: 2024-08-25

Investigation of a kindergarten norovirus outbreak and detoxification time of infected children in Wuhan

PEI Hongbing¹,
YAN Zhiwen^{1
, ,},
WU Xiaomin²,
QI Li³,
WU Changhan^{1
, ,}

1.
Department of Infections Disease Prevention and Control, Qingshan District Center for Disease Control and Prevention, Wuhan (430080), Hubei Province, China

摘要

摘要: 目的分析一起幼儿园诺如病毒疫情暴发特征，持续监测有症状幼儿排毒特征，为采取针对性控制措施提供科学依据。方法 2023年2月24日，收集武汉市1所暴发诺如病毒疫情的幼儿园病例16人的个人基本信息、临床表现、发病就诊情况，在疫情暴发后每隔7 d采集幼儿肛拭子进行诺如病毒检测。组间率的比较采用χ²检验，不同组间排毒时间的比较采用Log-rank检验，病例排毒时间的影响因素分析采用Cox多因素回归分析。结果 2023年2月19—28日，该起疫情共报告18例病例，均为幼儿，16例参与排毒期监测，研究对象在疫情暴发后第1, 2, 3, 4次采样，阳性率依次为60%，100%，75%，0；逆转录聚合酶链反应循环阈值(Ct值)分别为(25.83±5.74，28.83±5.55，36.13±4.30)和未检出。排毒时间中位数为19.42 d，95%CI为(18.21~20.64)d。Cox回归分析结果显示，就诊组排毒时间短于未就诊组[HR值(95%CI)=5.09(1.39~18.58)，P < 0.05]。结论感染诺如病毒的儿童排毒时长远超其隔离时间，病例就诊后使用药物可缩短其排毒时间；病例返园后应加强病例的管理和消毒工作。
- 肠道病毒感染 /
- 疾病暴发流行 /
- 时间 /
- 流行病学研究 /
- 儿童，学龄前
Abstract: Objective To analyze the characteristics of a norovirus outbreak in a kindergarten, and factors affecting the detoxification time, so as to provide a scientific basis for targeted control measures. Methods On February 24, 2023, the basic personal information, clinical manifestations, morbidity and treatment of 16 kindergarten cases with a norovirus outbreak in Wuhan were collected. Anal swabs were collected every 7 d after the outbreak to detect norovirus. Chi-square test was used for comparison of intergroup rates. The comparison of detoxification time between different groups was conducted by Log-rank test, and the influencing factors of detoxification time in cases were analyzed by Cox multiple regression analysis. Results From February 19-28, 2023, a total of 18 cases were reported and 16 of them participated in the detoxication time monitoring. In the first, second, third and fourth sampling after the outbreak, the positive rates were 60.00%, 100.00%, 75.00% and 0, respectively. The reverse transcriptionpolymerase chain reaction cycle threshold (Ct values) were (25.83±5.74, 28.83±5.55, 36.13±4.30), and undetected, respectively. The median time of detoxification was 19.42 d with 95%CI=(18.21-20.64)d. The results of Cox regression showed that the detoxication time was shorter in the treatment group than in the non-treatment group[HR(95%CI)=5.09(1.39-18.58), P < 0.05]. Conclusion Children infected with norovirus has a long duration of detoxification, and case management, which could be shortened by drugs, and disinfection should be strengthened after the case returned to school.
- Enterovirus infections /
- Disease outbreaks /
- Time /
- Epidemiologic studies /
- Child, preschool
注释:

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表 1 武汉市一起幼儿园诺如病毒暴发疫情感染者排毒时间单因素分析

Table 1. Univariate analysis of detoxification time of infected with norovirus outbreak in a kindergarten in Wuhan

组别	选项	人数	M(95%CI)/d	χ²值	P值
性别	男	10	19.54(18.21~20.87)	1.59	0.21
	女	6	18.92(17.01~20.83)
年龄/岁	3~ < 4	5	19.63(19.18~20.08)	0.01	1.00
	4~ < 5	7	19.54(17.95~21.13)
	≥5	4	11.13(4.44~17.82)
症状	呕吐合并腹泻^*	2	17.83	0.10	0.75
	仅呕吐	14	19.42(18.28~20.56)
就诊情况	就诊	9	17.83(0.18~35.48)	5.77	0.02
	未就诊	7	19.63(19.52~19.75)
合计		16	19.42(18.21~20.64)
注： *病例数较少，未得到95%CI。

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表 2 武汉市一起幼儿园诺如病毒暴发疫情病例排毒时间的多因素Cox回归模型分析(n=16)

Table 2. Multivariate Cox regression model analysis of detoxification time of norovirus outbreak cases in a kindergarten in Wuhan(n=16)

变量	分类	B值	标准误	Wald χ²值	P值	HR值(95%CI)
就诊情况	就诊	1.63	0.66	6.06	0.01	5.09(1.39~18.58)
性别	男	-1.45	0.91	2.51	0.11	0.24(0.04~1.41)
年龄/岁	3~ < 4	-0.94	0.92	1.05	0.31	0.39(0.06~2.38)
	4~ < 5	-0.23	0.80	0.08	0.78	0.80(0.17~3.83)
症状	呕吐合并腹泻	-1.40	0.98	2.02	0.16	0.25(0.04~1.70)

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