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爆发性杯状病毒引起的急性胃肠炎病例:按年龄和病原体的临床差异。

Cases of acute gastroenteritis due to calicivirus in outbreaks: clinical differences by age and aetiological agent.

机构信息

Public Health Agency of Catalonia, Barcelona, Spain.

出版信息

Clin Microbiol Infect. 2014 Aug;20(8):793-8. doi: 10.1111/1469-0691.12522. Epub 2014 Jan 21.

Abstract

The Caliciviridae family includes norovirus and sapovirus, which both cause acute gastroenteritis (AGE). Currently, norovirus is the most common cause of AGE in all age groups in many countries. We analysed clinical differences in reported cases of acute gastroenteritis caused by caliciviruses (AGC) by age group and agent involved. We conducted a descriptive study of AGE outbreaks reported to the Public Health Agency of Catalonia (Spain) in 2010 and 2011. The odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated to estimate the association between clinical symptoms and age. Clinical differences between the <15 years and ≥15 years age groups were statistically significant: children more frequently presented with vomiting (OR, 3.25; 95% CI, 2.56-4.13), abdominal pain (OR, 3.27; 95% CI, 2.60-4.12), fever (OR, 1.51; 95% CI, 1.17-1.96) and nausea (OR, 1.49; 95% CI, 1.19-1.85). Comparing clinical manifestations of sapovirus and norovirus infection in children aged <15 years, cases caused by norovirus more frequently presented with vomiting and fever (p <0.001), and cases caused by sapovirus more frequently presented with diarrhoea (p 0.013). Determination of the clinical differences associated with cases in outbreaks according to the age of the majority of cases and the symptoms most frequently detected may aid decision making and guide aetiological investigations and the adoption of prevention and control measures.

摘要

杯状病毒科包括诺如病毒和札如病毒,均可引起急性肠胃炎(AGE)。目前,在许多国家,所有年龄段人群中,诺如病毒是 AGE 的最常见病因。我们分析了按年龄组和病原体报告的杯状病毒引起的急性肠胃炎(AGC)病例的临床差异。我们对 2010 年和 2011 年向加泰罗尼亚公共卫生署(西班牙)报告的 AGE 暴发进行了描述性研究。计算比值比(OR)和相应的 95%置信区间(CI)以估计临床症状与年龄之间的关联。<15 岁和≥15 岁年龄组之间的临床差异具有统计学意义:儿童更常出现呕吐(OR,3.25;95%CI,2.56-4.13)、腹痛(OR,3.27;95%CI,2.60-4.12)、发热(OR,1.51;95%CI,1.17-1.96)和恶心(OR,1.49;95%CI,1.19-1.85)。<15 岁儿童中比较札如病毒和诺如病毒感染的临床表现,诺如病毒感染更常出现呕吐和发热(p<0.001),而札如病毒感染更常出现腹泻(p<0.013)。根据大多数病例的年龄和最常检测到的症状确定与暴发相关的临床差异可能有助于决策制定,并指导病因学调查和采取预防控制措施。

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