诺如病毒 Norovirus

进入秋冬病毒性肠胃炎高发季，今年九月以来，全国已经报告超过30起诺如病毒病爆发，涉及病例约1500例，主要发生在学校。提醒大家务必关注日常卫生保健，防范诺如病毒。

Entering the autumn and winter peak season of high incidence of viral gastroenteritis, more than 30 outbreaks of norovirus disease have been reported nationwide since September this year, involving about 1500 cases, mainly occurring in schools. Remind everyone to pay attention to daily health care and guard against norovirus.

概述

Overview

诺如病毒属于杯状病毒科诺如病毒属，为单股正链RNA病毒，表面无包膜。诺如病毒变异快、免疫保护时间短。同一个人可以重复感染同一毒株或不同型别的诺如病毒，不同基因型之间无交叉免疫。

Norovirus belongs to the genus of cowardly virus in the family Caliciviridae, which is a single femoral positive-stranded RNA virus without an envelope on the surface. Norovirus mutation is fast, short immune protection time. The same individual can be reinfected with the same strain or different types of norovirus, with no cross-immunity between different genotypes.

临床表现

Clinical Manifestations

诺如病毒感染潜伏期短，通常为24-48小时，最短12小时，最长72小时。发病以轻症为主，最常见的症状为腹泻和呕吐，其次为恶心、腹痛、头痛、发热、畏寒和肌肉酸痛等。儿童以呕吐为主，成人则腹泻居多。诺如病毒感染属于自限性疾病，多数患者发病后无需治疗，休息1-3天即可康复，少数患者因出现严重并发症需要及时进行治疗。目前无疫苗和特效药物。

The incubation period of norovirus infection is short, usually from 24-48 hours, with a minimum of 12 hours and a maximum of 72 hours. The disease is mainly mild, the most common symptoms are diarrhea and vomiting, followed by nausea, abdominal pain, headache, fever, chills and muscle soreness. Children mainly vomit, while adults mostly have diarrhea. Norovirus infection is a self-limited disease. Most patients do not need treatment after the onset, and can rest for 1-3 days, while a few patients need timely treatment due to serious complications there are currently no vaccines or specific drugs.

传播途径

Transmission Routes

感染诺如病毒的病人及隐性感染者均为诺如病毒感染的传染源。诺如病毒传播途径多样。接触感染诺如病毒的病人，比如处理病人的呕吐物或排泄物，通过摄入粪便或呕吐物产生的气溶胶或间接接触被排泄物污染的环境传播；也可通过食用和饮用被病毒污染的食物和水传播。

Norovirus-infected patients and asymptomatic patients are the source of norovirus infection. Norovirus spreads in a variety of ways. Contact with a patient infected with norovirus, such as handling the patient's vomit or excreta, through ingestion of aerosols from feces or vomitus or indirect contact with an environment contaminated by excreta; also through eating and drinking virus-contaminated Food and water spread.

居家隔离注意事项

Precautions of Home Quarantine

1

不让患者与他人接触。

Keep patients from contacting with others.

患者需根据病情居家或入院隔离至症状完全消失后3天，检测呈诺如病毒阳性但无感染性腹泻症状的隐性感染者，也需居家隔离3天。患者勤洗手，保持手卫生，尽量不要和其他健康的家人近距离接触，尤其不要做饭或照顾老人和幼儿。

Patients need to be quarantined at home or hospitalized according to their condition until 3 days after the symptoms disappear completely. Those who are latently infected who test positive for norovirus but have no symptoms of infectious diarrhea also need to be quarantined at home for 3 days. Patients should wash their hands frequently, keep their hands hygienic, and try not to have close contact with other healthy family members, especially not to cook or take care of the elderly and young children.

2

东西要做熟，

Things should be cooked,

尤其是贝类等海鲜食品更要煮熟煮透。

especially shellfish and other seafood food should be cooked thoroughly .

3

注意个人卫生。

Pay attention to personal hygiene.

注意，消毒纸巾和免洗手消毒剂对诺如病毒无效，不能代替洗手。

Disinfectant wipes and hand sanitizer are not effective against norovirus and cannot replace hand washing.

预防建议

Tips on Norovirus Prevention

1

病人呕吐物/粪便在固定容器中

Patient vomit/feces were in a fixed container

①配制含量为5000mg/L~10000mg/L含氯消毒液，以有效氯为5%~6%的消毒液为例，消毒液与水的比例为1：5；

The prepared content is 5000mg/L~10000mg/L chlorine-containing  disinfectant, take the effective chlorine is 5%~6% disinfectant as an example, the ratio of disinfectant to water is 1:5;

②小心倒入配置好的含氯消毒液，直至将呕吐物/粪便完全覆盖；

Carefully pour in the configured chlorine-containing disinfectant until the vomit/feces is completely covered;

③消毒30分钟以上；

Disinfection for more than 30 minutes;

④由厕所马桶冲走。

Flushed away by the toilet.

2

呕吐物/粪便在地面等表面

Vitus/feces on the ground

①配制含量为5000 mg/L~10000 mg/L含氯消毒液，消毒液与水的比例为1：5；

The prepared content is 5000mg/L~10000mg/L chlorine-containing disinfectant, and the ratio of disinfectant and water is 1:5;

②用一次性吸水材料展区配置好的含氯消毒液，完全覆盖污染物，小心清除干净。同时，在不接触污染物的情况下，对地面进行彻底消毒；

Use the chlorine-containing disinfectant equipped with a disposable water-absorbing material exhibition area to completely cover the pollutants and carefully. At the same time, in the case of no contact with pollutants, the ground is thoroughly disinfected;

③清理的污染物放入黄色垃圾袋，按医疗废物集中处置；

Put the cleaned pollutants into yellow garbage bags and dispose them centrally according to medical waste;

④消毒中使用的抹布等工具必须用含有效氯5000mg/L消毒剂溶液， 浸泡消毒30分钟后彻底冲洗，才可再次使用。

The rag and other tools used in the disinfection must be used with a 5,000mg/L disinfectant solution containing effective chlorine, soaked and disinfected for 30 minutes, and then thoroughly washed before they can be used again.

3

呕吐物/粪便在地面、墙壁

Vitus/feces on the grounds and walls

①采用喷洒消毒或擦拭消毒，使用有效氯浓度为1000mg/L，配制浓度为1000mg/L含氯消毒液；

Disinfection by spraying or wiping, using an effective chlorine concentration of 1000mg/L, and preparing a chlorine-containing disinfectant with a concentration of 1000mg/L;

②消毒作用时间应不少于30分钟；

The disinfection time should not be less than 30 minutes;

③有肉眼可见污染物时，应先清除污染物再消毒。

When there are visible pollutants, the pollutants should be removed before the disinfection.

4

呕吐物/粪便在课桌椅、玩具等物体表面

Vitus/feces on desks, chairs, toys and other objects

①高频率接触物体表面是消毒的重点区域，可使用浓度为1000mg/L含氯消毒液定期消毒；

High frequency of contact surface is the key area of disinfection, a concentration of 1000mg/L. chlorine-containing disinfectant can be used regularly poison;

②进行浸泡、喷洒或擦拭消毒；

Soak, spray, or wipe and disinfect;

③作用30分钟，然后用清水擦拭干净。

Action for 30 minutes, and then wipe it clean with water.

5

呕吐物/粪便接触皮肤、粘膜

Vitus/feces on skin and mucous membranes

①皮肤被污染物污染时，应立即清除污染物。然后用一次性吸水材料沾取0.5%碘伏消毒液，擦拭消毒3分钟以上，后用清水洗净；

When the skin becomes contaminated with pollutants, the pollutants should be removed immediately. Then use a disposable water-absorbing material to dip in 0.5% iodophor disinfectant, wipe and disinfect for more than 3 minutes, and then wash it with water;

②粘膜应用大量生理盐水冲洗。

The mucosa should be washed with large amounts of normal saline.

除此之外，诺如患者产生的生活垃圾应采用双层医疗废物袋，按医疗废物集中收集处置。同时，家中应保持室内空气流通，无人空间也可用紫外线对空气消毒。

In addition, the domestic waste generated by Noro patients should be collected and disposed of in a double-layer medical waste bag as medical waste. At the same time, indoor air circulation should be maintained at home, and ultraviolet rays can also be used to disinfect the air in unoccupied spaces.

注意：由于诺如病毒抵抗力较强，推荐使用含氯消毒剂进行消毒，如84消毒液、含氯消毒片等，配制时注意消毒剂的含量，并于配制时做好个人防护，如佩戴口罩、眼镜、手套等。

Note: Due to the strong resistance of norovirus, it is recommended to use chlorine-containing disinfectants for disinfection, such as 84 disinfectant, chlorine-containing disinfection tablets, etc., pay attention to the content of disinfectants when preparing, and take personal protection when preparing, such as wearing Masks, glasses, gloves, etc.

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