Koopmans Marion, von Bonsdorff Carl Henrik, Vinjé Jan, de Medici Dario, Monroe Steve
National Institute of Public Health and the Environment, Research Laboratory for Infectious Diseases, Antonie van Leeuwenhoeklaan 9, Bilthoven, The Netherlands.
FEMS Microbiol Rev. 2002 Jun;26(2):187-205. doi: 10.1111/j.1574-6976.2002.tb00610.x.
Foodborne and waterborne viral infections are increasingly recognized as causes of illness in humans. This increase is partly explained by changes in food processing and consumption patterns that lead to the worldwide availability of high-risk food. As a result, vast outbreaks may occur due to contamination of food by a single foodhandler or at a single source. Although there are numerous fecal-orally transmitted viruses, most reports of foodborne transmission describe infections with Norwalk-like caliciviruses (NLV) and hepatitis A virus (HAV), suggesting that these viruses are associated with the greatest risk of foodborne transmission. NLV and HAV can be transmitted from person to person, or indirectly via food, water, or fomites contaminated with virus-containing feces or vomit. People can be infected without showing symptoms. The high frequency of secondary cases of NLV illness and - to a lesser extent - of hepatitis A following a foodborne outbreak results in amplification of the problem. The burden of illness is highest in the elderly, and therefore is likely to increase due to the aging population. For HAV, the burden of illness may increase following hygienic control measures, due to a decreasing population of naturally immune individuals and a concurrent increase in the population at risk. Recent advances in the research of NLV and HAV have led to the development of molecular methods which can be used for molecular tracing of virus strains. These methods can be and have been used for the detection of common source outbreaks. While traditionally certain foods have been implicated in virus outbreaks, it is clear that almost any food item can be involved, provided it has been handled by an infected person. There are no established methods for detection of viruses in foods other than shellfish. Little information is available on disinfection and preventive measures specifically for these viruses. Studies addressing this issue are hampered by the lack of culture systems. As currently available routine monitoring systems exclusively focus on bacterial pathogens, efforts should be made to combine epidemiological and virological information for a combined laboratory-based rapid detection system for foodborne viruses. With better surveillance, including typing information, outbreaks of foodborne infections could be reported faster to prevent further spread.
食源性和水源性病毒感染日益被认为是人类疾病的病因。这种增加部分归因于食品加工和消费模式的变化，这些变化导致高风险食品在全球范围内可得。结果，由于单个食品处理人员或单一来源对食品的污染，可能会发生大规模疫情。虽然有许多粪口传播的病毒，但大多数食源性传播报告描述的是诺如样杯状病毒（NLV）和甲型肝炎病毒（HAV）感染，这表明这些病毒与食源性传播的最大风险相关。NLV和HAV可通过人与人之间传播，或通过受含病毒粪便或呕吐物污染的食物、水或污染物间接传播。人们可能在没有症状的情况下被感染。食源性疫情爆发后，NLV疾病以及程度较轻的甲型肝炎的二代病例高发导致问题扩大。疾病负担在老年人中最高，因此可能会因人口老龄化而增加。对于甲型肝炎，由于自然免疫个体数量减少以及同时处于风险中的人群增加，卫生控制措施实施后疾病负担可能会增加。NLV和HAV研究的最新进展导致了分子方法的发展，这些方法可用于病毒株的分子追踪。这些方法可以并且已经用于检测共同来源的疫情爆发。虽然传统上某些食物与病毒爆发有关，但很明显，几乎任何食品都可能涉及，只要它被感染者处理过。除了贝类，没有既定的方法来检测食品中的病毒。关于专门针对这些病毒的消毒和预防措施的信息很少。解决这个问题的研究受到缺乏培养系统的阻碍。由于目前可用的常规监测系统仅专注于细菌病原体，应努力将流行病学和病毒学信息结合起来，建立一个基于实验室的食源性病毒联合快速检测系统。通过更好的监测，包括分型信息，可以更快地报告食源性感染疫情，以防止进一步传播。
