Two Rotavirus Outbreaks Caused by Genotype G2P[4] at Large Retirement Communities Cohort Studies
Two Rotavirus Outbreaks Caused by Genotype G2P[4] at Large Retirement Communities Cohort Studies
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DOI：
10.7326/0003-4819-157-9-201211060-00006
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发表时间：
2012-11-06
影响因子：
39.2
通讯作者：
Gerber, Susan I.
中科院分区：
文献类型：
--
作者：
Cardemil, Cristina V.;Cortese, Margaret M.;Gerber, Susan I.
背景：老年人轮状病毒胃肠炎暴发的报道很少，但通常是由 G2P[4] 菌株引起。 2011 年，伊利诺伊州 2 个退休机构报告了疫情爆发。目标：实施控制措施，确定疾病的范围和严重程度，并评估居民和员工的疾病风险因素。设计：使用调查和病历摘要进行队列研究。地点：伊利诺伊州库克县的两个大型退休机构。患者：两个机构的居民和员工以及患有轮状病毒疾病的社区居民。测量：发病率、住院率和轮状病毒基因型。结果：在在 A 设施中，324 名居民中有 84 名 (26%) 被确诊患有临床或实验室确诊的轮状病毒胃肠炎（中位年龄为 84 岁），其中 11 名居民 (13%) 住院治疗。疫情持续了7周。在设施 B，855 名居民 (11%) 中发现了 90 名病例患者（中位年龄为 88 岁），其中 19 名居民 (21%) 住院治疗。 B设施爆发持续了9.3周。两个地点都发现了患病员工。在每个设施中，感染率似乎因居住环境而异，在较分散的环境中或感染控制措施基线水平较高的感染率最低。两次爆发的致病基因型都是 G2P[4]。通过酶免疫测定或基因分型逆转录聚合酶链式反应检测到，一些个体散发的病毒至少持续 35 天。 G2P[4]也在老年人社区的 19 个样本中的 17 个 (89%) 中被检测到，但在 40 个儿科样本中只有 15 个 (38%) 被检测到。局限性：居民的医疗或认知障碍限制了一些访谈的成功。结论：轮状病毒爆发可能发生在居住设施的老年人中，并可能导致相当大的发病率。对于老年人来说，G2P[4] 可能具有独特的重要性。卫生专业人员应将轮状病毒视为成人急性胃肠炎的原因。
Background: Outbreaks of rotavirus gastroenteritis in elderly adults are reported infrequently but are often caused by G2P[4] strains. In 2011, outbreaks were reported in 2 Illinois retirement facilities.Objective: To implement control measures, determine the extent and severity of illness, and assess risk factors for disease among residents and employees.Design: Cohort studies using surveys and medical chart abstraction.Setting: Two large retirement facilities in Cook County, Illinois.Patients: Residents and employees at both facilities and community residents with rotavirus disease.Measurements: Attack rates, hospitalization rates, and rotavirus genotype.Results: At facility A, 84 of 324 residents (26%) were identified with clinical or laboratory-confirmed rotavirus gastroenteritis (median age, 84 years) and 11 (13%) were hospitalized. The outbreak lasted 7 weeks. At facility B, 90 case patients among 855 residents (11%) were identified (median age, 88 years) and 19 (21%) were hospitalized. The facility B outbreak lasted 9.3 weeks. Ill employees were identified at both locations. In each facility, attack rates seemed to differ by residential setting, with the lowest rates among those in more separated settings or with high baseline level of infection control measures. The causative genotype for both outbreaks was G2P[4]. Some individuals shed virus detected by enzyme immunoassay or genotyping reverse transcription polymerase chain reaction for at least 35 days. G2P[4] was also identified in 17 of 19 (89%) samples from the older adult community but only 15 of 40 (38%) pediatric samples.Limitation: Medical or cognitive impairment among residents limited the success of some interviews.Conclusion: Rotavirus outbreaks can occur among elderly adults in residential facilities and can result in considerable morbidity. Among older adults, G2P[4] may be of unique importance. Health professionals should consider rotavirus as a cause of acute gastroenteritis in adults.