Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK.
NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK.
BMJ Open. 2017 Nov 3;7(11):e018867. doi: 10.1136/bmjopen-2017-018867.
Noroviruses are the leading cause of acute gastroenteritis in all age groups, but illness is more severe and causes excess mortality in the elderly, particularly those in long-term care. The total burden of norovirus disease in the elderly in the UK is poorly defined; no current surveillance programmes systematically or accurately quantify norovirus infection in those living in care homes. The aim of this study is to evaluate an enhanced surveillance system for acute gastroenteritis among the elderly in care homes.
We will conduct this prospective cohort study in care homes in North West England; residents and staff at study care homes will be asked to participate. We will prospectively enrol a cohort of participants in an enhanced surveillance system to capture the incidence of acute gastroenteritis and use multiplex PCR to detect pathogens. We will sample symptomatic and non-symptomatic participants to understand characteristics of norovirus disease and susceptibility to infection. We will generate novel data on transmission dynamics by collecting data on the pattern of interactions within care homes using electronic proximity sensors. Comparisons of outbreak and non-outbreak periods will be used to quantify the impact of norovirus outbreaks on care homes.
The study has been approved by the North West-Greater Manchester South NHS Research Ethics Committee (REC Reference: 16/NW/0541). Study outputs will be disseminated through scientific conferences and peer-reviewed publications. This study will provide detailed insight on the burden and aetiology of acute gastroenteritis in care homes, in addition to generating novel data on transmission dynamics and risks. The study will identify areas for improving infection control practice and allow more accurate modelling of the introduction of interventions such as vaccination.
诺如病毒是所有年龄段人群急性胃肠炎的主要病因，但在老年人中，疾病更为严重，导致死亡率过高，尤其是在长期护理机构中。在英国，老年人中诺如病毒病的总负担定义不明确；目前没有监测方案系统或准确地量化了居住在护理院中的人群的诺如病毒感染情况。本研究旨在评估一种针对护理院中老年人急性胃肠炎的强化监测系统。
我们将在英格兰西北部的护理院进行这项前瞻性队列研究；研究护理院的居民和工作人员将被要求参与。我们将前瞻性地招募一个强化监测系统的参与者队列，以捕获急性胃肠炎的发病率，并使用多重 PCR 检测病原体。我们将对有症状和无症状的参与者进行采样，以了解诺如病毒病的特征和易感性。我们将通过使用电子接近传感器收集有关护理院内互动模式的数据，生成有关传播动态的新数据。通过比较暴发期和非暴发期，来量化诺如病毒暴发对护理院的影响。
该研究已获得西北-大曼彻斯特南 NHSE 研究伦理委员会的批准（REC 参考号：16/NW/0541）。研究结果将通过科学会议和同行评议出版物进行传播。该研究将提供有关护理院中急性胃肠炎的负担和病因的详细信息，同时还将生成有关传播动态和风险的新数据。该研究将确定改善感染控制实践的领域，并允许更准确地对疫苗接种等干预措施的引入进行建模。
