Karagiannis Ioannis, Detsis Marios, Gkolfinopoulou Kassiani, Pervanidou Danai, Panagiotopoulos Takis, Bonovas Stefanos
Hellenic Centre for Diseases Control and Prevention, Athens, Greece.
Rural Remote Health. 2010 Oct-Dec;10(4):1507. Epub 2010 Oct 5.
Raw seafood consumption has frequently been linked to gastroenteritis and Norovirus is a common cause. In February and March 2010, there was an increase cases of gastroenteritis on the remote island of Agios Efstratios in the Northern Aegean Sea, Greece. A massive increase in seafood consumption associated with a religious festival a few days prior to the outbreak suggested seafood as the vehicle of transmission.
An outbreak investigation team visited the island in order to document the outbreak and find epidemiological evidence for its source. The whole island was used as a cohort in the retrospective cohort study that was conducted.
Sixty-four of the 181 participants reported having had symptoms of gastroenteritis, of which 34 were considered primary cases. People who consumed any raw seafood imported to the island were 21.5 times (95% CI: 8.95-51.8) more likely to develop symptoms of gastroenteritis in the 72 hours following exposure. Consumption of local seafood was not found to be a risk factor.
Despite the lack of laboratory evidence, all four Kaplan's criteria were met and the outbreak was thought to have been caused by Norovirus. The outbreak investigation demonstrates epidemiological methods for use in a remote setting, where the means for laboratory and environmental investigation may be absent or limited.
食用生海鲜常常与肠胃炎有关，诺如病毒是常见病因。2010年2月和3月，希腊北爱琴海的阿吉奥斯埃夫斯特拉蒂奥斯偏远岛屿上，肠胃炎病例有所增加。疫情爆发前几天，与一个宗教节日相关的海鲜消费量大幅增加，这表明海鲜是传播媒介。
一个疫情调查小组前往该岛，以便记录疫情并找到其源头的流行病学证据。在进行的回顾性队列研究中，整个岛屿被用作一个队列。
181名参与者中有64人报告有肠胃炎症状，其中34人被视为原发病例。食用任何进口到该岛的生海鲜的人在接触后72小时内出现肠胃炎症状的可能性高出21.5倍（95%置信区间：8.95 - 51.8）。未发现食用当地海鲜是一个风险因素。
尽管缺乏实验室证据，但卡普兰的所有四条标准均得到满足，疫情被认为是由诺如病毒引起的。这次疫情调查展示了在偏远地区使用的流行病学方法，在这些地区可能缺乏或限制实验室和环境调查手段。
