Article(id=1325503319648633298, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325501865651216714, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025121, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1736784000000, receivedDateStr=2025-01-14, revisedDate=1742659200000, revisedDateStr=2025-03-23, acceptedDate=null, acceptedDateStr=null, onlineDate=1793954218065, onlineDateStr=2026-11-06, pubDate=1745510400000, pubDateStr=2025-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793954218065, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793954218065, creator=13701087609, updateTime=1793954218065, updator=13701087609, issue=Issue{id=1325501865651216714, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='4', pageStart='457', pageEnd='572 578', issueExtLink='null', onlineDate='null', pubDate='1745510400000', pubDateStr='2025-04-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793953871404, creator='13701087609', updateTime=1793953871404, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=601, endPage=603, ext={EN=ArticleExt(id=1325503321632539092, articleId=1325503319648633298, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Environmental contamination status of norovirus outbreaks in schools and nurseries in Linhai City, columnId=1325503320881758675, journalTitle=Chinese Journal of School Health, columnName=Health Supervision, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the environmental contamination of norovirus in nurseries and primary/secondary schools, so as to provide a scientific basis for effective prevention and control measures.

Methods

A total of 483 external environmental samples were collected from 34 cluster outbreaks of norovirus gastroenteritis in kindergartens and primary/secondary schools in Linhai City from 2021 to 2024. Pathogen detection was conducted using a rapid nucleic acid extraction kit and real-time fluorescence RT-PCR, and the results were analyzed using the χ2 test or Fisher's exact test.

Results

Among the collected external environmental samples, the total positive rate of surface contamination was 13.66%. The positive rates in kindergartens and primary/secondary schools were 12.20% and 15.82%, respectively. In kindergartens, the five surfaces with the highest detection rates were desks/chairs (23.33%), toilet stool troughs (20.69%), urinal troughs (12.00%), washbasins/sinks (11.11%), and toilet mops (9.38%). In primary/secondary schools, the top five were toilet stool troughs (38.30%), urinal troughs (23.53%), toilet door handles (13.04%), toilet mops (12.50%), and drinking cups (11.11%). The difference in positive detection rates among different external environments in primary/secondary schools was statistically significant (Fisher's exact probability test, P < 0.01). The positive detection rate in sanitary toilets was higher than that in classroom environments (χ2=17.38), while the positive detection rate in classroom environments of kindergartens was higher than that in primary/secondary schools (χ2=5.42)(P < 0.05).

Conclusions

Norovirus exhibits a high contamination rate in nurseries and schools, particularly in restroom areas. Strengthening sanitation and disinfection in high-risk environments, and improving hygiene awareness among children and staff, are essential for the effective prevent and control of norovirus.

, authors=Jianjun ZHENG1, Xi WANG1, Danyang HONG1, Yaling LI1, Qiumeng XU2, Huili ZHANG1, Qian HAN1, Da LU2, Qiao ZHENG2, authorsList=Jianjun ZHENG, Xi WANG, Danyang HONG, Yaling LI, Qiumeng XU, Huili ZHANG, Qian HAN, Da LU, Qiao ZHENG, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1325503324253979094, articleId=1325503319648633298, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=临海市学校与托幼机构诺如病毒疫情时外环境污染状况, columnId=1325503323356398037, journalTitle=中国学校卫生, columnName=卫生监督, runingTitle=null, highlight=null, articleAbstract=
目的

研究托幼机构和中小学校诺如病毒在外环境中的污染状况,为制定有效的防控措施提供科学依据。

方法

选取2021—2024年临海市辖区34起托幼机构和中小学校诺如病毒胃肠炎聚集性疫情中采集的483份外环境样本数据,采用核酸快速提取试剂盒和实时荧光RT-PCR技术进行病原学检测,并运用χ2检验或Fisher确切概率法对检测结果进行分析。

结果

采集的外环境样本中,表面污染总阳性率为13.66%。托幼机构和中小学校的外环境样本阳性率分别为12.20%和15.82%,托幼机构阳性检出率居前5位的外环境表面主要为书桌座椅、大便槽、小便槽、洗脸盆(槽)和拖把,分别为23.33%,20.69%,12.00%,11.11%和9.38%;中小学校阳性检出率居前5位的外环境表面为大便槽、小便槽、厕所门把手、拖把和水杯,分别为38.30%,23.53%,13.04%,12.50%,11.11%。中小学校不同外环境的阳性检出率差异有统计学意义(Fisher确切概率法,P<0.01),厕所的阳性检出率较教室内的外环境高(χ2=17.38);托幼机构教室内的外环境阳性检出率较中小学校高(χ2=5.42)(P值均<0.05)。

结论

托幼机构和中小学校诺如病毒疫情中外环境具有较高的污染率,尤其是厕所等区域。应加强高风险环境的卫生消毒,并提高儿童及教职工的卫生意识和自我防护能力,以有效预防和控制诺如病毒的传播。

, authors=郑建军1, 王曦1, 洪丹阳1, 李雅玲1, 徐秋梦2, 张慧利1, 韩倩1, 卢达2, 郑巧2, authorsList=郑建军, 王曦, 洪丹阳, 李雅玲, 徐秋梦, 张慧利, 韩倩, 卢达, 郑巧, authorCompany=null, correspAuthors=null, authorNote=

郑建军(1984- ),男,浙江台州人,大学本科,副主任医师,主要从事传染病防控工作。

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郑建军(1984- ),男,浙江台州人,大学本科,副主任医师,主要从事传染病防控工作。

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外环境选项托幼机构中小学校合计χ2值P值
样本数阳性数样本数阳性数样本数阳性数
名称大便槽5812(20.69)4718(38.30)10530(28.57)3.940.05
小便槽253(12.00)174(23.53)427(16.67)0.320.57
拖把323(9.38)162(12.50)485(10.42)0.001.00
厕所门把手141(7.14)233(13.04)374(10.81)1.00*
洗脸盆(槽)91(11.11)101(10.00)192(10.53)1.00*
水杯222(9.09)91(11.11)313(9.68)1.00*
玩具675(7.46)00675(7.46)
书桌座椅307(23.33)481(2.08)788(10.26)9.060.00
教室和楼梯外表面301(3.33)261(3.85)562(3.57)1.00*
分类厕所12919(14.73)10327(26.21)23246(19.83)4.750.03
生活用品或玩具988(8.16)192(10.53)11710(8.55)0.001.00
教室内外环境608(13.33)742(2.70)13410(7.46)5.420.02
), ArticleFig(id=1325503351852499483, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325503319648633298, language=CN, label=表1, caption=

临海市诺如病毒疫情时外环境表面污染阳性率学段间比较

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外环境选项托幼机构中小学校合计χ2值P值
样本数阳性数样本数阳性数样本数阳性数
名称大便槽5812(20.69)4718(38.30)10530(28.57)3.940.05
小便槽253(12.00)174(23.53)427(16.67)0.320.57
拖把323(9.38)162(12.50)485(10.42)0.001.00
厕所门把手141(7.14)233(13.04)374(10.81)1.00*
洗脸盆(槽)91(11.11)101(10.00)192(10.53)1.00*
水杯222(9.09)91(11.11)313(9.68)1.00*
玩具675(7.46)00675(7.46)
书桌座椅307(23.33)481(2.08)788(10.26)9.060.00
教室和楼梯外表面301(3.33)261(3.85)562(3.57)1.00*
分类厕所12919(14.73)10327(26.21)23246(19.83)4.750.03
生活用品或玩具988(8.16)192(10.53)11710(8.55)0.001.00
教室内外环境608(13.33)742(2.70)13410(7.46)5.420.02
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临海市学校与托幼机构诺如病毒疫情时外环境污染状况
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郑建军 1 , 王曦 1 , 洪丹阳 1 , 李雅玲 1 , 徐秋梦 2 , 张慧利 1 , 韩倩 1 , 卢达 2 , 郑巧 2
中国学校卫生 | 卫生监督 2025,46(4): 601-603
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中国学校卫生 |卫生监督 2025 , 46 (4) : 601 -603
临海市学校与托幼机构诺如病毒疫情时外环境污染状况
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郑建军1, 王曦1, 洪丹阳1, 李雅玲1, 徐秋梦2, 张慧利1, 韩倩1, 卢达2, 郑巧2
作者信息
  • 1浙江省临海市疾病预防控制中心传染病防制科, 317000
  • 2临海市疾病预防控制中心微生物检验科
作者简介:

郑建军(1984- ),男,浙江台州人,大学本科,副主任医师,主要从事传染病防控工作。

Environmental contamination status of norovirus outbreaks in schools and nurseries in Linhai City
Jianjun ZHENG1, Xi WANG1, Danyang HONG1, Yaling LI1, Qiumeng XU2, Huili ZHANG1, Qian HAN1, Da LU2, Qiao ZHENG2
Affiliations
  • 1Department for Infectious Disease Prevention and Control, Center for Disease Control and Prevention of Linhai City, Linhai (317000), Zhejiang Province, China
出版时间: 2025-04-25 doi: 10.16835/j.cnki.1000-9817.2025121
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目的

研究托幼机构和中小学校诺如病毒在外环境中的污染状况,为制定有效的防控措施提供科学依据。

方法

选取2021—2024年临海市辖区34起托幼机构和中小学校诺如病毒胃肠炎聚集性疫情中采集的483份外环境样本数据,采用核酸快速提取试剂盒和实时荧光RT-PCR技术进行病原学检测,并运用χ2检验或Fisher确切概率法对检测结果进行分析。

结果

采集的外环境样本中,表面污染总阳性率为13.66%。托幼机构和中小学校的外环境样本阳性率分别为12.20%和15.82%,托幼机构阳性检出率居前5位的外环境表面主要为书桌座椅、大便槽、小便槽、洗脸盆(槽)和拖把,分别为23.33%,20.69%,12.00%,11.11%和9.38%;中小学校阳性检出率居前5位的外环境表面为大便槽、小便槽、厕所门把手、拖把和水杯,分别为38.30%,23.53%,13.04%,12.50%,11.11%。中小学校不同外环境的阳性检出率差异有统计学意义(Fisher确切概率法,P<0.01),厕所的阳性检出率较教室内的外环境高(χ2=17.38);托幼机构教室内的外环境阳性检出率较中小学校高(χ2=5.42)(P值均<0.05)。

结论

托幼机构和中小学校诺如病毒疫情中外环境具有较高的污染率,尤其是厕所等区域。应加强高风险环境的卫生消毒,并提高儿童及教职工的卫生意识和自我防护能力,以有效预防和控制诺如病毒的传播。

日托幼儿园  /  肠道病毒感染  /  疾病暴发流行  /  环境  /  学生保健服务
Objective

To investigate the environmental contamination of norovirus in nurseries and primary/secondary schools, so as to provide a scientific basis for effective prevention and control measures.

Methods

A total of 483 external environmental samples were collected from 34 cluster outbreaks of norovirus gastroenteritis in kindergartens and primary/secondary schools in Linhai City from 2021 to 2024. Pathogen detection was conducted using a rapid nucleic acid extraction kit and real-time fluorescence RT-PCR, and the results were analyzed using the χ2 test or Fisher's exact test.

Results

Among the collected external environmental samples, the total positive rate of surface contamination was 13.66%. The positive rates in kindergartens and primary/secondary schools were 12.20% and 15.82%, respectively. In kindergartens, the five surfaces with the highest detection rates were desks/chairs (23.33%), toilet stool troughs (20.69%), urinal troughs (12.00%), washbasins/sinks (11.11%), and toilet mops (9.38%). In primary/secondary schools, the top five were toilet stool troughs (38.30%), urinal troughs (23.53%), toilet door handles (13.04%), toilet mops (12.50%), and drinking cups (11.11%). The difference in positive detection rates among different external environments in primary/secondary schools was statistically significant (Fisher's exact probability test, P < 0.01). The positive detection rate in sanitary toilets was higher than that in classroom environments (χ2=17.38), while the positive detection rate in classroom environments of kindergartens was higher than that in primary/secondary schools (χ2=5.42)(P < 0.05).

Conclusions

Norovirus exhibits a high contamination rate in nurseries and schools, particularly in restroom areas. Strengthening sanitation and disinfection in high-risk environments, and improving hygiene awareness among children and staff, are essential for the effective prevent and control of norovirus.

Child day care centers  /  Enterovirus infections  /  Disease outbreaks  /  Environment  /  Student health services
郑建军, 王曦, 洪丹阳, 李雅玲, 徐秋梦, 张慧利, 韩倩, 卢达, 郑巧. 临海市学校与托幼机构诺如病毒疫情时外环境污染状况. 中国学校卫生, 2025 , 46 (4) : 601 -603 . DOI: 10.16835/j.cnki.1000-9817.2025121
Jianjun ZHENG, Xi WANG, Danyang HONG, Yaling LI, Qiumeng XU, Huili ZHANG, Qian HAN, Da LU, Qiao ZHENG. Environmental contamination status of norovirus outbreaks in schools and nurseries in Linhai City[J]. Chinese Journal of School Health, 2025 , 46 (4) : 601 -603 . DOI: 10.16835/j.cnki.1000-9817.2025121
诺如病毒是一种常见病原体,引发的急性胃肠炎疫情以呕吐、腹泻为主要症状[1],该病毒具有极强的传染性、快速的传播速度以及低感染阈值等特征[2],在托幼机构、中小学校和养老机构等人群密集的场所,常常导致聚集性疫情的发生[3-5]。为探索诺如病毒在外环境中的污染状况,并为今后的防控工作提供科学依据,本研究选取了临海市辖区2021—2024年34起托幼机构和中小学校诺如病毒胃肠炎聚集性疫情的外环境样本,对其病原学检测结果进行分析。
收集临海市辖区2021年1月至2024年12月间,经实验室确证的34起托幼机构与中小学校诺如病毒胃肠炎聚集性疫情处置时,采集的483份外环境样本检测结果数据。
参考新型冠状病毒10混1采样技术,主要采集厕所(如大/小便槽、拖把、厕所门把手等)、生活用品或玩具[如洗脸盆(槽)、水杯、玩具]、教室内的外环境(如书桌座椅、教室楼梯外表面)等表面涂抹样本,低温保存送检。采用核酸快速提取试剂盒(磁珠法)[天根生化科技(北京)有限公司],运用实时荧光RT-PCR(real time RT-PCR)进行Nov核酸检测(北京卓诚惠生生物科技有限公司)。
采用EpiData 3.02软件建立数据库并录入数据,SPSS 27.0软件进行统计分析。计数资料用频数或百分率描述,率的比较采用χ2检验,当合计数N<40、理论频数T<1或P接近0.05时用Fisher确切概率法,检验水准α=0.05;后续两两比较采用α分割法,α'=α/k,k为比较次数。
采集的483份外环境涂抹样本中,总阳性率为13.66%(66/483)。托幼机构的总阳性率为12.20%(35/287),阳性率居前5位的外环境表面为书桌座椅、大便槽、小便槽、洗脸盆(槽)和拖把,分别为23.33%,20.69%,12.00%,11.11%和9.38%,教室和楼梯外表面(3.33%)的阳性率较低。中小学校的总阳性率为15.82%(31/196),阳性率居前5位的外环境表面为大便槽、小便槽、厕所门把手、拖把和水杯,分别为38.30%,23.53%,13.04%,12.50%,11.11%,书桌座椅(2.08%)、教室和楼梯外表面(3.85%)的阳性率较低。中小学校大便槽的阳性率较托幼机构高(χ2=3.94,P<0.05);托幼机构书桌座椅的阳性率较中小学校高(χ2=9.06,P<0.01);其他外环境样本阳性检出率差异均无统计学意义(P值均>0.05)。见表1。
托幼机构的厕所、生活用品或玩具、教室内外环境分类的阳性率分别为14.73%,8.16%,13.33%,不同外环境的阳性率差异无统计学意义(χ2=2.33,P=0.31)。中小学校的卫生厕所、生活用品或玩具、教室内外环境的阳性率分别为26.21%,10.53%,2.70%,不同外环境分类的阳性率差异有统计学意义(Fisher确切概率法,P<0.01);进一步两两比较结果显示,厕所的阳性率较教室内的外环境高(χ2=17.38,P<0.017)。托幼机构和中小学校的厕所阳性率差异有统计学意义(χ2=4.75,P<0.05);生活用品或玩具阳性率差异无统计学意义(Fisher确切概率法,P>0.05);教室内外环境阳性率差异也有统计学意义(χ2=5.42,P<0.05)。见表1。
本研究对2021—2024年34起托幼机构和中小学校诺如病毒胃肠炎聚集性疫情的外环境样本进行病原学分析,结果显示外环境样本的总阳性率为13.66%,其中托幼机构为12.20%,中小学校为15.82%。表明诺如病毒在托幼机构和中小学校的外环境中具有较高的污染率,应高度重视外环境的卫生消毒处理[6-7]。
汪晨夕等[8-9]研究表明,卫生间(厕所)点位的外环境表面诺如病毒检出率较高,与本研究结果一致,在不同外环境样本中,厕所的阳性率尤为突出,尤其是大便槽和小便槽的阳性率高于其他样本,特别是中小学校大便槽的阳性率。可能与中小学生感染诺如病毒后,腹泻症状较为普遍,从而大幅增加了厕所的使用频率有关[5, 10];加之厕所的清洁消毒工作若未能及时跟进或执行不到位,便极易导致病毒在这些关键区域的持续存在与传播。
戴映雪等[11]在研究诺如病毒感染疫情与厕所设计的关联时发现,相较于独立冲水的学校厕所,统一冲水的学校厕所往往伴随着更大规模的疫情。这一现象在本研究中也得到了印证,幼托机构中多为独立冲水的卫生马桶,中小学校普遍采用统一冲水的设计,大规模的疫情、较多的病例意味着更广泛的环境污染和更高的病毒检出率。
生活用品或玩具的阳性率同样不容忽视,尤其是水杯和玩具。这些物品与儿童的日常生活紧密相连,频繁的接触使得它们成为病毒传播的潜在媒介。在托幼机构中,由于儿童年龄较小,对玩具的依赖性较强,因此玩具的清洁消毒工作尤为关键。
在教室内的外环境表面,书桌座椅的阳性率相对较高,尤其是在托幼机构中,可能与低龄儿童的认知水平较低、在教室内发生呕吐事件的频率较高有关[5-6, 10]。呕吐物中携带的病毒颗粒若未能及时清理干净,便会污染书桌座椅等周边环境。教室外表面(如门把手)的阳性率虽然较低,但作为学生频繁接触的重点部位,如清洁消毒不及时,便可能通过接触传播途径扩散,其公共卫生意义不容忽视。
综上所述,本研究对托幼机构和中小学校的诺如病毒污染状况进行了探索分析,发现卫生厕所、生活用品、玩具以及书桌座椅等区域存在较高的污染风险。因此,在疫情处理过程中,相关人员需特别关注高风险环境的卫生状况,并严格按照规范开展消毒工作,以有效遏制诺如病毒的传播。此外,加强儿童和教职工的健康教育同样至关重要,可通过提高他们的卫生意识和自我防护能力,进一步巩固诺如病毒的防控[12]。

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2025年第46卷第4期
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doi: 10.16835/j.cnki.1000-9817.2025121
  • 接收时间:2025-01-14
  • 首发时间:2026-11-06
  • 出版时间:2025-04-25
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  • 收稿日期:2025-01-14
  • 修回日期:2025-03-23
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    1浙江省临海市疾病预防控制中心传染病防制科, 317000
    2临海市疾病预防控制中心微生物检验科
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
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