Podewils L J, Zanardi Blevins L, Hagenbuch M, Itani D, Burns A, Otto C, Blanton L, Adams S, Monroe S S, Beach M J, Widdowson M
Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Epidemiol Infect. 2007 Jul;135(5):827-33. doi: 10.1017/S0950268806007370. Epub 2006 Nov 1.
On 3 February 2004, the Vermont Department of Health received reports of acute gastroenteritis in persons who had recently visited a swimming facility. A retrospective cohort study was conducted among persons attending the facility between 30 January and 2 February. Fifty-three of 189 (28%) persons interviewed developed vomiting or diarrhoea within 72 h after visiting the facility. Five specimens tested positive for norovirus and three specimen sequences were identical. Entering the smaller of the two pools at the facility was significantly associated with illness (RR 5.67, 95% CI 1.5-22.0, P=0.012). The investigation identified several maintenance system failures: chlorine equipment failure, poorly trained operators, inadequate maintenance checks, failure to alert management, and insufficient record keeping. This study demonstrates the vulnerability of recreational water to norovirus contamination, even in the absence of any obvious vomiting or faecal accident. Our findings also suggest that norovirus is not as resistant to chlorine as previously reported in experimental studies. Appropriate regulations and enforcement, with adequate staff training, are necessary to ensure recreational water safety.
2004年2月3日，佛蒙特州卫生部收到报告，称近期去过一家游泳设施的人出现了急性肠胃炎。对1月30日至2月2日期间前往该设施的人员进行了一项回顾性队列研究。在接受访谈的189人中，有53人（28%）在参观该设施后的72小时内出现呕吐或腹泻。5份标本检测出诺如病毒呈阳性，3份标本序列相同。进入该设施两个泳池中较小的那个泳池与患病显著相关（相对危险度5.67，95%可信区间1.5 - 22.0，P = 0.012）。调查发现了几个维护系统故障：氯设备故障、操作人员培训不足、维护检查不充分、未向管理层发出警报以及记录保存不足。这项研究表明，即使没有任何明显的呕吐或粪便事故，娱乐用水也容易受到诺如病毒污染。我们的研究结果还表明，诺如病毒对氯的抗性并不像之前实验研究报告的那样强。为确保娱乐用水安全，需要有适当的法规和执法措施，并对工作人员进行充分培训。
