Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
Am J Epidemiol. 2010 May 1;171(9):1014-22. doi: 10.1093/aje/kwq021. Epub 2010 Apr 1.
Existing estimates of the incidence of infectious intestinal disease (IID) caused by norovirus are based on electron microscopy or reverse transcription-polymerase chain reaction (RT-PCR). Neither method accurately represents norovirus disease burden: Electron microscopy has poor diagnostic sensitivity, and RT-PCR has poor diagnostic specificity. In this study, viral load measurements were used to identify cases of norovirus-associated IID and to produce new incidence estimates for England. IID cases were ascertained in the Study of Infectious Intestinal Disease in England (1993-1996), and stool specimens were tested by semiquantitative real-time RT-PCR for norovirus. The age-adjusted community incidence of norovirus-associated IID was 4.5/100 person-years (95% credibility interval: 3.8, 5.2), equating to 2 million episodes/year. Among children aged less than 5 years, the community incidence was 21.4/100 person-years (95% credibility interval: 15.9, 27.7), and the incidence of consultations to general practitioners for norovirus-associated IID was 3.2/100 person-years (95% credibility interval: 2.6, 3.8), with 100,000 children visiting their general practitioner for norovirus-associated IID each year. Norovirus is the most common cause of IID in the community in England and is responsible for a similar number of pediatric primary care consultations as rotavirus.
现有诺如病毒引起的感染性肠道疾病 (IID) 发病率的估计是基于电子显微镜或逆转录-聚合酶链反应 (RT-PCR)。这两种方法都不能准确地代表诺如病毒的疾病负担：电子显微镜的诊断灵敏度较差，而 RT-PCR 的诊断特异性较差。在这项研究中，病毒载量测量用于确定诺如病毒相关 IID 病例，并为英格兰产生新的发病率估计。在英格兰感染性肠道疾病研究 (1993-1996) 中确定了 IID 病例，并通过半定量实时 RT-PCR 检测粪便标本中的诺如病毒。校正年龄后的社区诺如病毒相关 IID 的发病率为 4.5/100 人年（95%可信度区间：3.8，5.2），相当于每年 200 万例。在 5 岁以下儿童中，社区发病率为 21.4/100 人年（95%可信度区间：15.9，27.7），而因诺如病毒相关 IID 到全科医生处就诊的发病率为 3.2/100 人年（95%可信度区间：2.6，3.8），每年有 10 万名儿童因诺如病毒相关 IID 看全科医生。诺如病毒是英格兰社区中最常见的 IID 病原体，导致的儿科初级保健就诊次数与轮状病毒相似。
