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目的了解一起敬老院戊型肝炎(HE)暴发疫情的可能传染源,明确该起疫情的病原特点。方法对疫点和相关人员进行现场访谈和病例对照研究,并采集116人份血标本进行抗-HEV IgM和抗-HEV-IgG检测,通过RT-PCR对病毒感染者和可疑传染源进行HEV RNA检测和序列分析。结果本次疫情共发病19例,亚临床感染11人。病例对照研究显示是否使用公共餐具P=0.062,自带餐具者无感染;人源、水源、猪源HEV毒株均为HEV-Ⅳd亚型,水源和人源毒株同源性100%,人源毒株与猪源同源性93.7%～95.5%。该敬老院自养生猪和自种菜地并施粪肥;食堂操作不规范,可能导致携带HEV的猪粪或污水污染餐具,是引起本起疫情的原因。结论该起暴发疫情与当地生猪HEV病毒携带率高,疫点食堂卫生管理欠规范有关。
Objective To understand the possible sources of infection in a hehe-old hepatitis E (HE) outbreak and determine the pathogenic characteristics of the outbreak. Methods A total of 116 blood samples were collected for detection of anti-HEV IgM and anti-HEV-IgG. The viral infection and suspicious source of infection were detected by RT-PCR. HEV RNA Detection and sequence analysis. Results The epidemic outbreak in 19 cases, 11 cases of subclinical infection. Case-control study showed that whether the use of common tableware P = 0.062, no infection with their own tableware; human, water, pig HEV-Ⅳd subtypes are HEV strains, water and human homology 100%, human The homology of the source strain and the pig source is 93.7% -95.5%. The nursing home self-supporting pigs and self-cultivation of vegetables and manure; canteen operation is not standardized, may lead to pig manure carrying HEV or sewage pollution tableware, is the cause of the epidemic. Conclusions The outbreak was related to the high carrying rate of live pig HEV virus and the poor standard of health management in the canteens.