Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China.
Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester LE1 7RH, UK.
Int J Environ Res Public Health. 2017 Dec 14;14(12):1571. doi: 10.3390/ijerph14121571.
Norovirus infection, a highly prevalent condition associated with a high rate of morbidity, comprises a significant health issue. Although norovirus transmission mainly occurs via the fecal-oral and vomit-oral routes, airborne transmission has been proposed in recent decades. This paper re-examines a previously described norovirus outbreak in a hotel restaurant wherein airborne transmission was originally inferred. Specifically, the original evidence that suggested airborne transmission was re-analyzed by exploring an alternative hypothesis: could this outbreak instead have occurred via fomite transmission? This re-analysis was based on whether fomite transmission could have yielded similar attack rate distribution patterns. Seven representative serving pathways used by waiters were considered, and the infection risk distributions of the alternative fomite transmission routes were predicted using a multi-agent model. These distributions were compared to the reported attack rate distribution in the original study using a least square methods approach. The results show that with some reasonable assumptions of human behavior patterns and parameter values, the attack rate distribution corresponded well with that of the infection risk via the fomite route. This finding offers an alternative interpretation of the transmission routes that underlay this particular norovirus outbreak and an important consideration in the development of infection control guidelines and the investigation of similar norovirus outbreaks in future.
诺如病毒感染是一种高度普遍存在的疾病，发病率很高，是一个重大的健康问题。虽然诺如病毒主要通过粪-口和呕吐-口途径传播，但近几十年来已经提出了空气传播的可能性。本文重新审查了先前描述的在酒店餐厅发生的诺如病毒暴发事件，该事件最初推断为空气传播。具体来说，通过探索替代假设，重新分析了最初暗示空气传播的证据：这次暴发是否可能是通过接触传播引起的？这种重新分析是基于接触传播是否可以产生类似的发病率分布模式。考虑了服务员使用的七种有代表性的服务途径，并使用多主体模型预测了替代接触传播途径的感染风险分布。使用最小二乘法方法将这些分布与原始研究中报告的发病率分布进行了比较。结果表明，在对人类行为模式和参数值进行一些合理假设的情况下，发病率分布与接触传播途径的感染风险分布非常吻合。这一发现为该特定诺如病毒暴发的传播途径提供了另一种解释，也为制定感染控制指南和未来调查类似诺如病毒暴发提供了重要依据。
