Thames Valley Health Protection Unit, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency, Chilton, Didcot, Oxon OX11 0RQ, UK.
J Public Health (Oxf). 2011 Jun;33(2):205-11. doi: 10.1093/pubmed/fdq089. Epub 2010 Oct 27.
We present the investigation of an outbreak of gastroenteritis at a UK restaurant incorporating both epidemiological and microbiological analysis.
Structured postal questionnaires were sent to 30 diners who ate at the restaurant during the outbreak period (5-7 February 2010). Stool specimens collected from staff and diners were submitted for bacterial culture and norovirus testing, and 15 Pacific oysters (Crassostrea gigas) from the batch served during the outbreak period were tested for norovirus.
A strong association was observed between illness and oyster consumption (odds ratio undefined, confidence interval: 11.7 to infinity, P = 0.00001). Multiple different sequences of norovirus RNA were present in both stool and oyster specimens, typical of a shellfish origin. Several contemporaneous norovirus outbreaks throughout the UK were linked to oysters, particularly, though not exclusively, those sourced from Carlingford Lough in Ireland (as in this study), which were subsequently withdrawn from distribution.
Despite the risk to human health, there is significant uncertainty surrounding the quantitative correlation between oyster norovirus levels and consumer illness. Continued research should help further our understanding of this crucial correlation and identify ways in which viral depuration of oysters can be enhanced.
我们对一起在英国餐厅暴发的胃肠炎疫情进行了流行病学和微生物学分析。
对在暴发期间（2010 年 2 月 5 日至 7 日）在该餐厅就餐的 30 名食客进行了结构化邮寄问卷调查。采集员工和食客的粪便标本进行细菌培养和诺如病毒检测，对暴发期间供应的 15 个太平洋牡蛎（Crassostrea gigas）进行诺如病毒检测。
观察到发病与食用牡蛎之间存在强烈关联（比值比未定义，置信区间：11.7 至无穷大，P=0.00001）。粪便和牡蛎标本中均存在多种不同序列的诺如病毒 RNA，这是贝类来源的典型特征。英国同期发生的多起诺如病毒暴发与牡蛎有关，尤其是源自爱尔兰卡林福德湖的牡蛎（如本研究），随后这些牡蛎被撤出市场。
尽管对人类健康存在风险，但牡蛎中诺如病毒水平与消费者发病之间的定量相关性仍存在很大的不确定性。持续的研究应该有助于我们进一步了解这一关键的相关性，并确定增强牡蛎病毒净化的方法。
