HUMAN CALICIVIRUS OUTBREAK OF ACUTE GASTROENTERITIS IN AN AGED-CARE FACILITY
Abstract
Background. Human caliciviruses represent a genetically and antigenetically diverse group of single-stranded RNA viruses associated with acute gastroenteritis in humans. In last two years the number of notified gastroenteric cases in Slovenia is increasing. From January till November 2002 already 574 calicivirus cases have been confirmed. Majority of cases were observed in preschool and school children but no cases were described in the aged-care facility.
Methods. An outbreak of gastroenteritis in an aged-care facility occured. After onset of the outbreak an epidemiological questionnaire and inspection of local conditions were realized. Stool samples from home residents were analysed to find out bacteriological and/or viral aetiology. Direct electron microscopy and RT-PCR assay was performed to detect caliciviruses. Viral RNA was amplified using specific primers and PCR products were identified in hybridisation test.
Results. The outbreak started suddenly on the second floor, where the attack rate was the highest. On the other floors the illness started later and the attack rate was lower. Sixty-one (40,1%) residents from 152 became ill and additionally 15 (22,4%) employees from 67. The outbreak ended after ten days. Electron microscopy or/and RT-PCR revealed Norovirus members of family Caliciviridae in 9 of 10 stool specimens. As determined by RT-PCR and hybridisation assay viruses corresponded to genogroup II, genetic cluster 1 (closely related to the Hawaii virus) and genetic cluster 4 (closely related to the Lordsdale virus).
Conclusions. Presented data support a significant role for caliciviruses as causative agents of gastroenteritis in elderly persons in Slovenia.
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References
Centers for Disease Control and Prevention. Diagnosis and management of foodborne illnesses: a primer for physicians. MMWR 2001; 50 (No. RR-2): 1– 123.
Radšel-Medvešček A. Črevesne okužbe. In: Marolt-Gomišček M, RadšelMedvešček A. Infekcijske bolezni. Ljubljana: Tangram, 2002: 83–166.
Centers for Disease Control and Prevention. »Norwalk-like viruses:« public health consequences and outbreak management. MMWR 2001; 50 (No. RR-9): 1–17.
Pringle CR. Virus taxonomy. Arch Virol 1999; 144: 421–9.
Green KY, Ando T, Balayan MS et al. Taxonomy of caliciviruses. J Infect Dis 2000; 181: Suppl 2: S322–30.
Mead PS, Slutsker L, Dietz V. Food-related illness and death in the United States. Emerg Infect Dis 1999; 5: 607–25.
Lew JF, Glass RI, Gangarosa RE, Cohen IP, Bern C, Moe CL. Diarrheal deaths in the United States, 1979 through 1987: a special problem for the elderly. JAMA 1991; 265: 3280–4.
Green KY, Belliot G, Taylor JL et al. A predominant role for Norwalk-like viruses as agent of epidemic gastroenteritis in Maryland nursing homes for the elderly. J Infect Dis 2002; 185: 133–46.
Milazzo A, Tribe IG, Ratcliff R, Doherty C, Higgins G, Givney R. A large, prolonged outbreak of human calicivirus infection linked to an aged-care facility. Commun Dis Intell 2002; 26: 261–4.
Pravilnik o higieni živil. Ur. l. RS 60/02.
Pravilnik o posebnih ukrepih pri zastrupitvah in infekcijah oseb s hrano in o njihovem preprečevanju. Ur. l. SRS 24/81.
Collins HE, Lyne PM, Grange JM. Collins and Lyne’s microbiological methods. 7th ed. Oxford: Butterworth Heinemann, 1995: 270–410.
Vennema H, de Bruin E, Koopmans M. Rational optimisation of generic primers used for Norwalk-like viruses detection by reverse transcriptase polymerase chain reaction. J Clin Virol 2002; 25: 233–5.
Poljšak-Prijatelj M, Frelih T, Zimšek J, Berce I, Barlič-Maganja D. Kalicivirusi – povzročitelji epidemičnega gastroenteritisa pri otrocih – izkušnje v Sloveniji. Zdrav Vestn 2001; 70: 619–22.
Knapp RG, Miller MC. Clinical epidemiology and biostatistics. Baltimore: Williams Wilkins, 1992: 187–424.
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