Peipins Lucy A, Highfill Kathy A, Barrett Elizabeth, Monti Michele M, Hackler Robert, Huang PengweI, Jiang Xi
Agency for Toxic Substances and Disease Registry, 1600 Clifton Rd., NE, E-31, Atlanta, GA 30333, USA.
J Environ Health. 2002 May;64(9):18-23, 32.
In May and June 1999, an outbreak of acute gastrointestinal illness occurred among long-distance hikers on the Appalachian Trail between Catawba and Troutville, Virginia. An investigation found that 45 out of 70 hikers had become ill within two days of arriving in Catawba, Virginia. Water samples were collected from a general store frequented by the hikers and from several nearby buildings and a popular all-you-can-eat restaurant. Symptoms were consistent with those caused by Norwalk-like viruses, and laboratory diagnosis detected Norwalk-like viruses in stool and serum specimens. People who consumed food items prepared at the general store were almost twice as likely to become ill as persons who did not consume those foods. Environmental sampling of water from the taps inside and outside the general store and from several surrounding establishments in Catawba found contamination by fecal coliform bacteria but not by Norwalk-like virus. Since several hikers reported illness prior to arriving at Catawba, person-to-person transmission of a highly contagious agent such as Norwalk-like virus could not be ruled out. Poor sanitation, scarce water supplies, and crowding can increase the risk of gastrointestinal illness among long-distance hikers.
1999年5月和6月，弗吉尼亚州卡托巴和特劳特维尔之间的阿巴拉契亚小径上，长途徒步旅行者中爆发了急性胃肠道疾病。一项调查发现，70名徒步旅行者中有45人在抵达弗吉尼亚州卡托巴后的两天内患病。从徒步旅行者常去的一家杂货店、附近几栋建筑以及一家受欢迎的自助餐厅采集了水样。症状与诺如病毒引起的症状一致，实验室诊断在粪便和血清样本中检测到了诺如病毒。食用杂货店制作的食品的人患病的可能性几乎是未食用这些食品的人的两倍。对卡托巴杂货店内外以及周边几家机构的水龙头水进行环境采样，发现有粪便大肠菌污染，但未发现诺如病毒污染。由于有几名徒步旅行者在抵达卡托巴之前就报告患病，因此不能排除诺如病毒这种高传染性病原体的人际传播。卫生条件差、水源稀缺和拥挤会增加长途徒步旅行者患胃肠道疾病的风险。
