Svraka Sanela, Duizer Erwin, Vennema Harry, de Bruin Erwin, van der Veer Bas, Dorresteijn Bram, Koopmans Marion
National Institute for Public Health and the Environment, Center for Infectious Disease Control, P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
J Clin Microbiol. 2007 May;45(5):1389-94. doi: 10.1128/JCM.02305-06. Epub 2007 Mar 14.
Acute gastroenteritis is one of the most common diseases worldwide. In developed countries, viruses, particularly noroviruses, are recognized as the leading cause. In The Netherlands, the surveillance of gastroenteritis outbreaks with suspected viral etiologies (as determined by Kaplan criteria) was established by the National Institute for Public Health and the Environment in 1994. This paper presents an overview of viral gastroenteritis outbreaks reported from 1994 through 2005. A minimum epidemiological data set consisting of the associated setting(s), the probable transmission mode, the date of the first illness and the date of sampling, the number of persons affected, and the number of hospitalizations was requested for each reported outbreak. Stool samples were tested for the presence of norovirus, sapovirus, rotavirus, astrovirus, adenovirus, and Aichi virus by electron microscopy, enzyme-linked immunosorbent assay, and/or reverse transcription-PCR. A total of 6,707 stool samples from 941 gastroenteritis outbreaks were investigated. Noroviruses were detected as the causative agent in 735 (78.1%) of the outbreaks, and rotaviruses, adenoviruses, and astroviruses were found to be responsible for 46 (4.9%), 9 (1.0%), and 5 (0.5%) outbreaks, respectively. Among the gastroenteritis outbreaks in which a mode of transmission was identified, most outbreaks (38.1%) were associated with person-to-person transmission, and the majority (54.9%) of the outbreaks investigated were reported by residential institutions. Since 2002, the total number of outbreaks reported and the number of unexplained outbreaks have increased. Furthermore, the number of rotavirus-associated outbreaks has increased, especially in nursing homes. Despite thorough testing, 115 (12.2%) outbreaks suspected of having viral etiologies remain unexplained. Increases in numbers of reported outbreaks may indicate undefined changes in the criteria for reporting or the emergence of new pathogens.
急性肠胃炎是全球最常见的疾病之一。在发达国家，病毒，尤其是诺如病毒，被认为是主要病因。1994年，荷兰国家公共卫生与环境研究所建立了对疑似病毒病因（根据卡普兰标准确定）的肠胃炎暴发的监测。本文概述了1994年至2005年期间报告的病毒性肠胃炎暴发情况。要求为每起报告的暴发提供一组最低限度的流行病学数据集，包括相关环境、可能的传播方式、首例发病日期和采样日期、受影响人数以及住院人数。通过电子显微镜、酶联免疫吸附测定和/或逆转录聚合酶链反应检测粪便样本中是否存在诺如病毒、札幌病毒、轮状病毒、星状病毒、腺病毒和爱知病毒。共对941起肠胃炎暴发的6707份粪便样本进行了调查。在735起（78.1%）暴发中检测到诺如病毒为病原体，轮状病毒、腺病毒和星状病毒分别导致46起（4.9%）、9起（1.0%）和5起（0.5%）暴发。在确定了传播方式的肠胃炎暴发中，大多数暴发（38.1%）与人际传播有关，所调查的大多数暴发（54.9%）是由住宿机构报告的。自2002年以来，报告的暴发总数和不明原因的暴发数量有所增加。此外，与轮状病毒相关的暴发数量有所增加，尤其是在养老院。尽管进行了全面检测，但仍有115起（12.2%）疑似病毒病因的暴发原因不明。报告的暴发数量增加可能表明报告标准发生了未明确的变化或出现了新的病原体。
