Widespread outbreak of norovirus gastroenteritis among evacuees of Hurricane Katrina residing in a large "megashelter" in Houston, Texas: Lessons learned for prevention
Widespread outbreak of norovirus gastroenteritis among evacuees of Hurricane Katrina residing in a large "megashelter" in Houston, Texas: Lessons learned for prevention
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DOI：
10.1086/512195
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发表时间：
2007-04-15
影响因子：
11.8
通讯作者：
Glass, Roger I.
中科院分区：
文献类型：
--
作者：
Yee, Eileen L.;Palacio, Herminia;Glass, Roger I.
背景。卡特里娜飓风过后，估计有 200,000 人被疏散到休斯顿都会区，其中 127,000 人被安置在一个大型“巨型避难所”——Reliant Park Complex 内。我们调查了居住在 Reliant Park Complex 的撤离人员中报告的胃肠炎疫情，以评估传染源诺如病毒的传播情况，并实施和评估用于控制的干预措施的有效性。 2005 年 9 月 2 日至 12 日期间，公共卫生当局对在 Reliant Park 医疗诊所接受治疗的撤离人员进行了肠胃炎监测。记录了基本的人口统计和临床数据。收集粪便和呕吐物样本并检测细菌、寄生虫和病毒。庇护所普查数据用于估计疾病的每日发病率。结果。 11天内，超过1000名肠胃炎患者在诊所接受治疗，占所有就诊人数的17%。诺如病毒是唯一发现的肠道病原体，但涉及多种不同的菌株。在居住在 Reliant Park 综合体的疏散人员中，肠胃炎的发病率估计为每天每 1000 人 4.6 人次，而在居住在那里 9 天的疏散人员中，24 人中有 1 人（4%）患病。迅速采取了强化的公共卫生措施，但并没有明确减缓诺如病毒胃肠炎疫情的进展。结论。我们的调查强调了在拥挤环境中管理此类疫情的困难，以及需要快速、灵敏的实验室检测来检测诺如病毒。需要进行更多的研究来制定更有效的措施来控制和预防这种高度传染性的胃肠道疾病。
Background. After Hurricane Katrina, an estimated 200,000 persons were evacuated to the Houston metropolitan area, 127,000 of whom were housed in 1 large "megashelter," the Reliant Park Complex. We investigated an outbreak of gastroenteritis reported among the evacuees who resided in the Reliant Park Complex to assess the spread of the infectious agent, norovirus, and to implement and evaluate the effectiveness of interventions used for control.Methods. Public health authorities conducted surveillance of gastroenteritis among evacuees treated at the Reliant Park Medical Clinic during 2-12 September 2005. Basic demographic and clinical data were recorded. Specimens of stool and vomitus were collected and tested for bacteria, parasites, and viruses. Shelter census data were used to estimate the daily incidence of disease.Results. During a period of 11 days, > 1000 patients were treated at the clinic for gastroenteritis, which accounted for 17% of all clinic visits. Norovirus was the sole enteric pathogen identified, but multiple different strains were involved. Among the evacuees residing in the Reliant Park Complex, the incidence of gastroenteritis was estimated to be 4.6 visits per 1000 persons per day, and among the evacuees who resided there for 9 days, 1 (4%) of 24 persons would have been ill. Intensive public health measures were promptly instituted but did not definitively slow the progression of the outbreak of norovirus gastroenteritis.Conclusions. Our investigation underscores the difficulties in managing such outbreaks in crowded settings and the need for rapid, sensitive laboratory assays to detect norovirus. Additional research is needed to establish more effective measures to control and prevent this highly contagious gastrointestinal illness.