Zhang M, Long Y F, Guo L M, Wu S L, Fang L, Yang F, Li H, Huang Q, Sun L M
Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
Guangdong Field Epidemiology Training Program, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China; Qingyuan Qingcheng District of Center for Disease Control and Prevention, Qingyuan 511515, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Sep 10;39(9):1210-1215. doi: 10.3760/cma.j.issn.0254-6450.2018.09.013.
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. Incidence data of norovirus outbreaks in Guangdong from January 1(st) 2013 to November 30(th) 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. From January 1(st) 2013 to November 30(th) 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. 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.
了解2013年至2017年广东省由诺如病毒GⅡ.2、GⅡ.17和GⅡ.4/悉尼株引起的疫情流行病学特征，为疫情防控提供科学依据。收集2013年1月1日至2017年11月30日广东省诺如病毒疫情发病数据，来自突发公共卫生事件管理信息系统。对每起疫情的每个病例进行逆转录聚合酶链反应（RT-PCR）检测诺如病毒核酸，并进行基因测序以鉴定诺如病毒基因型。分析诺如病毒GⅡ.2、GⅡ.17和GⅡ.4/悉尼株疫情的特征。采用直接标准化法计算腹泻和呕吐等症状的比例。2013年1月1日至2017年11月30日，广东省共报告167起诺如病毒疫情，其中分别由诺如病毒GⅡ.2、GⅡ.17和GⅡ.4/悉尼株引起的疫情有115起。由诺如病毒GⅡ.2引起的疫情在小学占39.68%（25/63），在托幼机构占28.57%（18/63），在中学占25.40%（16/63），在大学占6.35%（4/63）。由诺如病毒GⅡ.17引起的疫情在中学占41.03%（16/39），在工作场所占20.51%（8/39），在小学占15.38%（6/39），在大学占12.82%（5/39），在社区和托幼机构分别占5.13%（2/39）。由诺如病毒GⅡ.4/悉尼株引起的疫情在大学占53.85%（7/13），在托幼机构和工作场所分别占15.38%（2/13），在小学和中学分别占7.69%（1/13）。由诺如病毒GⅡ.2引起的疫情中，接触传播占77.78%（49/63），食源性传播占17.46%（11/63）。由诺如病毒GⅡ.17引起的疫情中，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）。由诺如病毒GⅡ.4/悉尼株引起的疫情中，食源性传播占53.85%（7/13），接触传播占38.46%（5/13）。在临床表现方面，感染诺如病毒GⅡ.2的病例中，呕吐的标准化比例为73.76，腹泻的比例为42.85；感染诺如病毒GⅡ.17的病例中，呕吐的标准化比例为76.37，腹泻的比例为51.40；感染诺如病毒GⅡ.4/悉尼株的病例中，呕吐的标准化比例为54.10，腹泻的比例为55.95。由诺如病毒GⅡ.2通过接触传播引起的疫情主要发生在小学、托幼机构和中学。由诺如病毒GⅡ.17通过食源性传播引起的疫情主要发生在中学和工作场所。由诺如病毒GⅡ.4/悉尼株通过食源性传播和接触传播引起的疫情主要发生在大学。
