AN OUTBREAK OF ACUTE NONBACTERIAL GASTROENTERITIS IN A NURSING-HOME - DEMONSTRATION OF PERSON-TO-PERSON TRANSMISSION BY TEMPORAL CLUSTERING OF CASES
AN OUTBREAK OF ACUTE NONBACTERIAL GASTROENTERITIS IN A NURSING-HOME - DEMONSTRATION OF PERSON-TO-PERSON TRANSMISSION BY TEMPORAL CLUSTERING OF CASES
复制标题
DOI：
10.1093/oxfordjournals.aje.a113496
复制
发表时间：
1982-01-01
影响因子：
5
通讯作者：
GARY, GW
中科院分区：
文献类型：
--
作者：
KAPLAN, JE;SCHONBERGER, LB;GARY, GW
1980年12月，在马里兰州的巴尔的摩[美国]一家疗养院的居民和工作人员中爆发了急性非细菌性胃肠炎。共调查了101名居民和69名工作人员。各组的发作率（定义为急性呕吐发作或每24 h出现两次或两次以上稀便）均为46%。病情短暂而轻微;没有病人住院，也没有死亡。人与人之间的传播是通过病例的时间聚集来记录的（与患病室友接触的居民比没有接触的居民患病率高1或2天;相对危险度= 3.74），与居民有日常接触的员工患病率高于无此类接触的员工（57%对17%，P < 0.01）和通过与患病员工的家庭接触者的二次传播（二次发病率= 33%）。在11对来自患者的血清中，有3对在急性期和恢复期标本之间表现出诺瓦克病毒抗体滴度的4倍增加。对病例时间聚集性的分析在记录这次暴发中的人际传播方面特别有用，并可用于由诺瓦克或诺瓦克样病毒引起的其他暴发以及与其他传染性生物体有关的暴发。
An outbreak of acute nonbacterial gastroenteritis occurred among residents and staff in a nursing home in Baltimore, Maryland [USA], in Dec. 1980. A total of 101 residents and 69 staff members were surveyed by questionnaire. The attack rate (defined as acute onset of vomiting or two or more loose stools per 24 h) was 46% in each group. Illness was brief and mild; no patients were hospitalized, and there were no deaths. Person-to-person transmission was documented by temporal clustering of cases (the demonstration of a higher rate of illness among residents exposed to an ill roommate 1 or 2 days earlier than among those not similarly exposed; relative risk = 3.74), by a higher rate of illness among employees having daily contact with residents than among those without such contact (57 vs. 17%, P < 0.01) and by secondary transmission to household contacts of ill employees (secondary attack rate = 33%). Of 11 serum pairs from patients, 3 demonstrated a 4-fold increase in antibody titer to the Norwalk virus between acute- and convalescent-phase specimens. The analysis of temporal clustering of cases was particularly useful in documenting person-to-person transmission in this outbreak and might be used for this purpose in other outbreaks caused by Norwalk or Norwalk-like viruses, as well as in outbreaks associated with other infectious organisms.