van Duynhoven Y T H P, de Jager C M, Kortbeek L M, Vennema H, Koopmans M P G, van Leusden F, van der Poel W H M, van den Broek M J M
Centre for Infectious Disease Epidemiology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
Epidemiol Infect. 2005 Feb;133(1):9-21. doi: 10.1017/s0950268804002936.
In 2002, in The Netherlands a national study of gastroenteritis outbreaks was performed. Epidemiological information was collected by the Public Health Services (PHS) and the Food Inspection Services (FIS) using standardized questionnaires. Stool samples were collected for diagnostic testing. For foodborne outbreaks, food samples were taken. In total, 281 gastroenteritis outbreaks were included, mainly from nursing homes and homes for the elderly (57%), restaurants (11%), hospitals (9%) and day-care centres (7%). Direct person-to-person spread was the predominant transmission route in all settings (overall 78%), except for restaurant outbreaks where food was suspected in almost 90% (overall in 21% of outbreaks). The most common pathogen was norovirus (54%), followed by Salmonella spp. (4%), rotavirus group A (2%), Campylobacter spp. (1%) and only incidentally others. In conclusion, most outbreaks were reported from health and residential institutions, with norovirus as the dominant agent. Control should aim at reducing person-to-person spread. In foodborne outbreaks norovirus was common, due to contamination of food by food handlers. Salmonella, as the second foodborne pathogen, was mainly associated with raw shell eggs. These results stress the continuous need for food safety education, complementary to governmental regulation.
2002年，荷兰开展了一项全国性的肠胃炎暴发研究。公共卫生服务机构（PHS）和食品检验服务机构（FIS）使用标准化问卷收集了流行病学信息。采集粪便样本进行诊断检测。对于食源性暴发，采集了食品样本。总共纳入了281起肠胃炎暴发事件，主要来自养老院和老年护理院（57%）、餐馆（11%）、医院（9%）和日托中心（7%）。在所有场所中，除了餐馆暴发事件外，直接的人际传播是主要的传播途径（总体为78%），在餐馆暴发事件中，近90%怀疑是由食物引起的（总体在21%的暴发事件中）。最常见的病原体是诺如病毒（54%），其次是沙门氏菌属（4%）、A组轮状病毒（2%）、弯曲杆菌属（1%），其他病原体仅偶尔出现。总之，大多数暴发事件报告来自卫生和居住机构，诺如病毒是主要病原体。防控应旨在减少人际传播。在食源性暴发事件中，诺如病毒很常见，这是由于食品处理人员污染了食物。沙门氏菌作为第二大食源性病原体，主要与生的带壳鸡蛋有关。这些结果强调了持续开展食品安全教育的必要性，作为政府监管的补充。
