Hellenic Centre for Diseases Control and Prevention, Department of Surveillance and Intervention,Athens,Greece.
Department of Hygiene and Epidemiology,Medical School, University of Thessaly,Larissa,Greece.
Epidemiol Infect. 2019 Jan;147:e227. doi: 10.1017/S0950268819000852.
Noroviruses, along with rotaviruses, are among the leading causes of gastroenteritis worldwide and novel strains are periodically emerging. In August 2015, an unusual increase of gastroenteritis cases occurred in a touristic district in Kassandra peninsula, Chalkidiki, Northern Greece. Seven stool specimens from cases were tested positive for norovirus. Molecular investigation and phylogenetic analysis identified that there was co-circulation of norovirus GI.P2_GI.2 and the recombinant strain GII.P16_GII.13. A 1:1 case-control study conducted and showed that tap water consumption significantly associated with developing symptoms of gastroenteritis (odds ratio = 36.9, P = 0.018). The results of the epidemiological investigation, the co-circulation of two different norovirus strains, the information of a pipeline breakage at the water supply system before the onset of cases, and reports on flooded wells and sewage overflow, indicated the possibility of water contamination by sewage during the pipeline breakage leading to a large outbreak with a peak at 10 August and a possible secondary person-to-person transmission after the 16th of August. Norovirus GI.P2_GI.2 strains are rarely reported in Europe, while it is the first time that infection from the recombinant strain GII.P16_GII.13 is recorded in Greece.
诺如病毒和轮状病毒是全球导致肠胃炎的主要病原体之一，新的病毒株也在不断出现。2015 年 8 月，希腊北部哈尔基季基半岛卡西半岛的一个旅游区发生了一起不寻常的肠胃炎病例增加事件。从 7 例病例的粪便样本中检测到诺如病毒呈阳性。分子调查和系统进化分析表明，同时存在诺如病毒 GI.P2_GI.2 和重组株 GII.P16_GII.13。进行了 1:1 的病例对照研究，结果表明饮用自来水与肠胃炎症状的发展显著相关（比值比=36.9，P=0.018）。流行病学调查的结果、两种不同诺如病毒株的同时流行、供水系统在病例发生前的管道破裂信息以及关于水井泛滥和污水溢出的报告表明，在管道破裂期间，污水有可能污染自来水，导致 8 月 10 日达到高峰的大规模爆发，并可能在 8 月 16 日后发生二次人际传播。在欧洲，GI.P2_GI.2 型诺如病毒株很少被报道，而感染 GII.P16_GII.13 重组株则是希腊首例。
