首都公共卫生

目的 分析北京市昌平区诺如病毒感染性腹泻的流行病学特征，为进一步制定有效的防控措施提供依据。方法 用现场流行病学调查方法和描述分析方法，对2017-2020年北京市昌平区诺如病毒腹泻疫情报告和个案资料进行回顾性分析。结果 2017年1月-2020年12月，共报告疫情168起，累计病例1 876例，其中实验室诊断病例575例(30.65%),临床诊断病例1 799例(95.90%),无死亡病例。疫情以中小学(51.79%)为主要场所，其次是幼儿园(38.69%);时间上呈双峰分布；病例以3～17岁儿童为主(95.74%)。不同年度发病人数构成比在疫情发生场所(χ²=18.770,P=0.005)、年龄组(χ²=22.215,P<0.001)、性别(χ²=7.864,P=0.049)和职业(χ²=204.93,P<0.001)间比较，差异有统计学意义。结论 诺如病毒感染引起的急性胃肠炎疫情发生场所以中小学校和幼儿园为主，发生时间段集中在学生开学期间，进入假期后大幅减少，学校应加强晨午检工作，及时停班并规范处置疫情，加强学校在传染病疫情处置方面的培训，做好疫情监测、健康教育宣传指导，降低传染病发病率。

Objective To determine epidemiological characteristics of norovirus infective diarrhea in Changping district of Beijing, and provide the basis for further prevention and control of norovirus diarrhea.Methods The epidemic report and case data of norovirus diarrhea in Changping district of Beijing from 2017 to 2020 were retrospectively analyzed using the method of field epidemiological investigation and descriptive analysis method.Results Totally 168 outbreaks of norovirus infective diarrhea were reported in Changping district from 2017 to 2020, involving 1 876 cases with 575 laboratory diagnosis cases(30.65%), 1 799 clinical diagnosed cases(95.90%), and no death.Primary and secondary schools were the main outbreak sites(51.79%), followed by kindergartens(38.69%); the time of cases showed a bimodal distribution; 95.74% case aged 3-17 years. There were statistically significant differences in the composition ratio of the cases in different years among the different sites(χ²=18.770,P=0.005), age groups(χ²=22.215,P<0.001), genders(χ²=7.864,P=0.049)and occupations(χ²=204.93,P<0.001). Conclusions Outbreaks of acute gastroenteritis caused by norovirus infection mainly occur in primary and secondary schools and kindergartens, especially at the beginning of the semester. The numbers of outbreaks during summer and winter vacations are significantly reduced. School prevention and control measures should be strengthened to reduce the incidence of infectious diseases, including carrying out morning and afternoon inspections, early detection, early isolation, timely shutdown, standardizing disinfection and disposal work, strengthening the training of school doctors and instructors in infectious disease management, and monitoring epidemics and conducting health promotion.