Luchs Adriana, Madalosso Geraldine, Cilli Audrey, Morillo Simone Guadagnucci, Martins Sandra Regina, de Souza Karen Aparecida Farias, Namiyama Gislene Mitsue, Gonçalves Cláudia Regina, Carmona Rita de Cássia Compagnoli, Timenetsky Maria do Carmo Sampaio Tavares
Enteric Disease Laboratory, Virology Center, Adolfo Lutz Institute, São Paulo, Brazil.
Foodboorne Diseases Epidemiological Surveillance, Center for Disease Control, Health Surveillance Management, Municipal Department of São Paulo Health, São Paulo, Brazil.
Geriatr Nurs. 2017 Jul-Aug;38(4):283-290. doi: 10.1016/j.gerinurse.2016.11.004. Epub 2016 Dec 10.
The present study described a group A rotavirus (RVA) outbreak in an age-care facility in Brazil, using epidemiologic and molecular diagnostic methods. A descriptive clinical, epidemiological and environmental investigation was conducted. Stool samples were collected and screened for RVA, Norovirus (NoV), Enteric Adenovirus 40/41 (AdV 40/41) and Astrovirus (AstV) using ELISA, RT-PCR, qRT-PCR, electron microscopy and sequencing methods. Outbreak occurred during 26th-29th October, 2015; 28 individuals affected (22 residents; 6 staff). The attack rate was 25.9% and 8.5% among residents (median-age: 85.5 years) and staff (median-age: 28 years), respectively. Female staff was identified as the index case. RVA G2P[4] genotype was detected in 87.5% (7/8). Genetic analysis demonstrated that the outbreak involved one single strain, suggesting a common-source infection. RVA should be considered during outbreaks investigations in residential facilities, and raise the question if the current licensed RVA vaccines for children could also be helpful for the elderly.
本研究运用流行病学和分子诊断方法，描述了巴西一家老年护理机构中发生的A组轮状病毒（RVA）暴发情况。开展了描述性临床、流行病学和环境调查。采集粪便样本，采用酶联免疫吸附测定（ELISA）、逆转录聚合酶链反应（RT-PCR）、定量逆转录聚合酶链反应（qRT-PCR）、电子显微镜检查和测序方法，对样本进行RVA、诺如病毒（NoV）、肠道腺病毒40/41（AdV 40/41）和星状病毒（AstV）筛查。暴发发生在2015年10月26日至29日期间；28人受到影响（22名居民；6名工作人员）。居民（中位年龄：85.5岁）和工作人员（中位年龄：28岁）的罹患率分别为25.9%和8.5%。女性工作人员被确定为首例病例。在87.5%（7/8）的病例中检测到RVA G2P[4]基因型。基因分析表明，此次暴发涉及单一菌株，提示为共同来源感染。在对住宿机构暴发事件进行调查时应考虑RVA，并引发了关于目前已获许可的儿童RVA疫苗对老年人是否也有帮助的问题。
