Sub-Direcció Regional a Barcelona del Departament de Salut, Barcelona, Spain.
Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.
Sci Rep. 2021 Dec 1;11(1):23218. doi: 10.1038/s41598-021-02348-2.
Norovirus is the leading cause of outbreaks of acute viral gastroenteritis. We carried out this study to investigate outbreaks in long-term care facilities reported in 2017 and 2018 in Catalonia (Spain). The characteristics of the centers, exposed persons and the genogroups responsible were analyzed. Viral loads were estimated. The attack rate (AR) of the outbreaks studied, and the rate ratio (RR) and the odds ratio (OR) and their 95% confidence intervals as measures of association were calculated. The mean cycle thresholds were compared using the t-test for independent means. We included 30 outbreaks (4631 exposed people). The global AR was 25.93%. The RR of residents vs. staff was 2.28 (95% CI 2.0-2.6). The RR between AR in residents with total or severe dependence vs. residents with moderate, low or no-dependence was 1.23 (95% CI 1.05-1.45). The AR were higher in smaller centers than in larger ones (38.47% vs. 19.25% and RR 2; 95% CI 1.82-2.2). GII was responsible for 70% of outbreaks. No association was found between the genogroup and presenting symptoms (OR 0.96; 95% CI 0.41-2.26). Viral loads were higher in symptomatic than in asymptomatic patients (p = 0.001).
诺如病毒是急性病毒性胃肠炎暴发的主要原因。我们开展了这项研究，以调查 2017 年和 2018 年在加泰罗尼亚（西班牙）报告的长期护理机构暴发情况。分析了中心、暴露人员和负责的基因群的特征。估计了病毒载量。计算了研究暴发的发病率（AR）以及率比（RR）、比值比（OR）及其 95％置信区间作为关联的度量。使用独立均值 t 检验比较平均循环阈值。我们纳入了 30 起暴发（4631 名暴露人员）。总发病率为 25.93％。居民与工作人员的 RR 为 2.28（95％CI 2.0-2.6）。完全或严重依赖的居民与中度、低度或无依赖的居民之间的 AR 比值比为 1.23（95％CI 1.05-1.45）。较小的中心的发病率高于较大的中心（38.47％比 19.25％，RR 2；95％CI 1.82-2.2）。GII 负责 70％的暴发。基因群与出现的症状之间没有关联（OR 0.96；95％CI 0.41-2.26）。有症状患者的病毒载量高于无症状患者（p = 0.001）。
