20182023年上海市闵行区聚集性呕吐腹泻疫情的流行病学特征

Epidemiological characteristics of clustered vomiting and diarrhea outbreaks in Minhang District of Shanghai from 2018 to 2023

  • 摘要:
    目的 分析上海市闵行区聚集性呕吐腹泻疫情的流行病学特征,探讨疫情规模和持续时间的影响因素,为进一步加强重点场所监测预警和优化防控措施提供科学依据。
    方法 收集2018—2023年闵行区接报的聚集性呕吐腹泻资料进行描述性流行病学分析,应用logistic回归分析聚集性疫情规模的影响因素,Spearman秩相关分析疫情持续时间的关联因素。
    结果 闵行区2018—2023年报告136起聚集性呕吐腹泻疫情均发生在学校,总罹患率为0.90%。疫情发生有明显季节性,主要集中在10—12月(43.38%)和3—5月(32.35%),发生场所主要为幼托机构(45.59%)和小学(44.12%),发病人群多为学生(99.48%)。临床表现多为呕吐(90.44%),传播途径多为人⁃人接触传播(98.53%),主要病原为诺如病毒Ⅱ型(71.32%)。规范疫点终末消毒(OR=0.39,95%CI=0.20~0.74)、有效隔离发病班级(OR=0.23,95%CI=0.09~0.57)与疫情规模负相关;疫情响应时间(r=0.64,P<0.001)和病例代次数(r=0.71,P<0.001)与疫情持续时间正相关。
    结论 学校是闵行区聚集性呕吐腹泻疫情防控的重点场所,主要发生在秋季和春季。疫情早发现、早报告、早处置,加强学校报告制度和规范处置措施尤为重要。

     

    Abstract:
    Objective To analyze the epidemiological characteristics of clustered vomiting and diarrhea outbreaks in Minhang District of Shanghai, to identify the influencing factors of outbreak scale and duration of epidemic, and to provide scientific evidence for further strengthening surveillance early-warning efforts in key settings and for optimizing prevention and control measures.
    Methods The data for describing epidemiological characteristics of clustered vomitting and diarrhea outbreaks in Minhang District from 2018 to 2023 were collected, multivariable logistic regression models were applied to analyze the influencing factors for epidemic scale,and Spearman rank correlation analyses were applied to analyze the factors duration.
    Results A total of 136 clustered vomiting and diarrhea outbreaks were reported in Minhang District from 2018 to 2023, all occurring in school settings, with an overall attack rate of 0.90%. The outbreaks exhibited distinct seasonality, predominantly occurring from October to December (43.38%) and March to May (32.35%). The primary settings were preschools (45.59%) and elementary schools (44.12%), with students accounted for the majority of cases (99.48%). The predominant clinical manifestation was vomiting (90.44%), with person-to-person contact being the primary transmission route (98.53%). Norovirus genogroup Ⅱ was identified as the main pathogen (71.32%). Standardized terminal disinfection of outbreak sites (OR=0.39, 95%CI=0.20‒0.74) and effective isolation of affected classes (OR=0.23, 95%CI=0.09‒0.57) were significant protective factors for reducing outbreak scale. Both response time (r=0.64, P<0.001) and the number of case generations (r=0.71, P<0.001) showed positive correlations with outbreak duration.
    Conclusion Schools are the key settings for the prevention and control of clustered vomiting and diarrhea outbreaks in Minhang District, with peak occurring in autumn and spring. Early detection, timely reporting, and prompt response to outbreaks are crucial. Strengthening school-based surveillance systems and standardizing outbreak management protocols are of particular importance.

     

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