Murata Toshio, Katsushima Noriko, Mizuta Katsumi, Muraki Yasushi, Hongo Seiji, Matsuzaki Yoko
Department of Microbiology, Yamagata Prefectural Institute of Public Health, Yamagata, Japan.
Pediatr Infect Dis J. 2007 Jan;26(1):46-9. doi: 10.1097/01.inf.0000247102.04997.e0.
Noroviruses (NV) are one of the leading causes of gastroenteritis in young children; however, the duration of NV shedding in young children is not well known.
Fecal specimens were collected from children with acute gastroenteritis at a pediatric clinic during the period from November to December 2002 and tested for NV by reverse transcription-polymerase chain reaction.
Of 71 children infected with NV, 60 (84.5%) were less than 3 years old. Among children aged <2 years and those aged 2 to 5 years, the duration of illness was longer (7 days versus 3.5 days, P = 0.0069), the maximum number of stools in a 24-hour period was greater (7 versus 3, P = 0.0078) and a 20-point severity score was higher (11 versus 8, P = 0.0031) in patients aged <2 years than in patients aged 2 to 5 years. Among the 23 children whose follow-up specimens were obtained, the median duration of NV shedding was 16 days (range, 5-47 days). Virus shedding for more than 2 weeks after onset was observed in 75% (6 of 8), 71.4% (5 of 7) and 25% (2 of 8) of children aged <1 year, 1 year and 2 to 3 years, respectively. Three infants aged <or=6 months continued to excrete NV for an extremely long period (more than 42, 44 and 47 days from onset) after recovery.
Long-term virus shedding after the disappearance of clinical symptoms was observed. Caution should be exercised when handling the excrement of infants and young children infected with NV.
诺如病毒（NV）是幼儿肠胃炎的主要病因之一；然而，幼儿诺如病毒排毒持续时间尚不清楚。
于2002年11月至12月期间，在一家儿科诊所收集急性肠胃炎患儿的粪便标本，采用逆转录-聚合酶链反应检测诺如病毒。
在71例感染诺如病毒的儿童中，60例（84.5%）年龄小于3岁。在2岁以下儿童和2至5岁儿童中，2岁以下患儿的病程更长（7天对3.5天，P = 0.0069），24小时内最大排便次数更多（7次对3次，P = 0.0078），且20分严重程度评分更高（11分对8分，P = 0.0031）。在获取随访标本的23名儿童中，诺如病毒排毒的中位持续时间为16天（范围为5 - 47天）。分别在1岁以下、1岁和2至3岁儿童中，75%（8例中的6例）、71.4%（7例中的5例）和25%（8例中的2例）在发病后2周以上仍有病毒排出。3例年龄≤6个月的婴儿在康复后仍持续排出诺如病毒很长时间（发病后超过42、44和47天）。
观察到临床症状消失后仍有长期病毒排出。处理感染诺如病毒的婴幼儿粪便时应谨慎。
