Outbreak of viral gastroenteritis due to a contaminated well - International consequences
Outbreak of viral gastroenteritis due to a contaminated well - International consequences
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DOI：
10.1001/jama.278.7.563
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发表时间：
1997-08-20
影响因子：
120.7
通讯作者：
Spika, JS
中科院分区：
文献类型：
--
作者：
Beller, M;Ellis, A;Spika, JS
背景.-已知小圆形结构病毒 (SRSV) 会引起病毒性胃肠炎，但迄今为止尚未在爆发的相关车辆中得到证实。目的.-胃肠炎爆发的调查。设计.-应用流行病学方法定位爆发源后，我们进行了环境和实验室调查以阐明原因。背景.-乘坐巴士穿越阿拉斯加和育空地区的游客加拿大.参与者.-与疫情源有关的商业综合体的一家餐厅的工作人员、停在那里的公共汽车上人员的便利样本以及公共汽车员工。主要结果指标.-与暴露相关的疾病的比值比 (OR)。使用逆转录聚合酶链反应和病毒扩增产物测序对餐厅的水样以及游客和餐厅工作人员的粪便标本进行核酸扩增检查。结果-出现呕吐或腹泻的游客群体的行程可追溯到巴士在33至36小时前停靠的餐厅，饮水量与疾病相关（OR，5.3；95％置信区间[CI]，2.3-12.6）。该商业综合体 26 名员工中有 18 人生病；尽管不是指示病例，但在疫情爆发前不久，一名生病的员工住在与化粪池相连的建筑物中，该化粪池被发现污染了为餐厅供水的水井，在 2 名游客和 1 名餐厅员工的粪便样本中发现了基因型 2/P2B SRSV。粪便和水样产生了相同的扩增产物序列。结论。-调查记录了车辆中的 SRSV，其流行病学上与胃肠炎爆发有关。研究结果证明了分子检测和识别的力量，并强调了基本公共卫生实践的重要性，例如餐厅检查、保证安全供水和疾病监测。
Context.-Small round-structured viruses (SRSVs) are known to cause viral gastroenteritis, but until now have not been confirmed in the implicated Vehicle in outbreaks.Objective.-Investigation of a gastroenteritis outbreak.Design.-After applying epidemiologic methods to locate the outbreak source, we conducted environmental and laboratory investigations to elucidate the cause.Setting.-Tourists traveling by bus through Alaska and the Yukon Territory of Canada.Participants.-Staff of a restaurant at a business complex implicated as the outbreak source, convenience sample of persons on buses that had stopped there, and bus employees.Main Outcome Measures.-Odds ratios (ORs) for illness associated with exposures. Water samples from the restaurant and stool specimens from tourists and restaurant staff were examined by nucleic acid amplification using reverse transcription polymerase chain reaction and sequencing of viral amplification products.Results.-The itineraries of groups of tourists manifesting vomiting or diarrhea were traced back to a restaurant where buses had stopped 33 to 36 hours previously, Water consumption was associated with illness (OR, 5.3; 95% confidence interval [CI], 2.3-12.6). Eighteen of 26 employees of the business complex were ill; although not the index case, an employee ill shortly before the outbreak lived in a building connected to a septic pit, which was found to contaminate the well supplying the restaurant's water, Genotype 2/P2B SRSV was identified in stool specimens of 2 tourists and 1 restaurant employee. Stools and water samples yielded identical amplification product sequences.Conclusions.-The investigation documented SRSVs in a vehicle epidemiologically linked to a gastroenteritis outbreak. The findings demonstrate the power of molecular detection and identification and underscore the importance of fundamental public health practices such as restaurant inspection, assurance of a safe water supply, and disease surveillance.