Objective To identify the cause and mode of transmission of a gastroenteritis outbreak in a village, Henan province. Methods Gastroenteritis patients were identified through family visits, interviewing the village doctors and reviewing diagnosis and prescription records at the village health clinic. Cases were defined as onset of one of the four symptoms from the village resident during July 20 to August 12,2010. The symptoms would include diarrhea ( ≥ 3 times/day), abdominal pain, nausea or vomiting. A retrospective cohort study was conducted to assess the association between drinking raw well water or eating noodles rinsed by raw well water and gastroenteritis. Stools or vomits of the ease-patients and the well water samples were tested for bacterial pathogens. Results Data for 60 case-patients were collected. All cases occurred in the northern part of the village. Persons who used water from a public well in the northern part of the village had an attack rate of 55%, which was 3.5 times of those who did not use the well water (16%) (RR=3.5,95%CI: 1.2-10). Results from the retrospective cohort study showed that drinking un-boiled water from the well was a risk factor (RR=1.7,95%CI: 1.3-2.3). Laboratory testing showed that total coliform and E. coli both greatly exceeded the limit considered safe for drinking, indicating there was fecal contamination in the well water. No bacterial pathogens were detected in the patients' stools or vomits. Conclusion The outbreak was mainly caused by drinking contaminated water from the public well in the northern part of the village.%目的 调查河南省某村发生的一起胃肠炎暴发疫情,分析传播途径和传染来源.方法 于2010年7月20日至8月12日,在河南省某村通过入户搜索、与村医访谈、查看村卫生所就诊和处方记录收集胃肠炎病例,病例定义为每日出现腹泻≥3次、腹痛、呕吐、恶心等症状之一者.开展回顾性队列研究,分析饮用生井水和吃过水凉面与胃肠炎关联性.并对患者粪便、呕吐物和井水等标本进行可疑致病菌的检测.结果 共搜索到60例病例,均居住在村北.回顾性队列调查结果显示,7月23日后村民使用北村公用井水(55%)的发病风险是不使用该井水村民(16%)的3.5倍(RR=3.5,95%CI:1.20～10.00);饮用生井水是发病的危险因素(RR=1.7,95%CI:1.30～2.30).经检测村北水井标本中总大肠菌群及大肠埃希菌均严重超标,提示水井受到了人畜粪便污染,但病例的排泄物和呕吐物中均未检测到致病菌.结论 村民直接饮用污染的村北井水是该次胃肠炎暴发的主要原因.
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