Norovirus on Swabs Taken from Hands Illustrate Route of Transmission: A Case Study
Norovirus on Swabs Taken from Hands Illustrate Route of Transmission: A Case Study
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DOI：
10.4315/0362-028x-72.8.1753
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发表时间：
2009-08-01
影响因子：
2
通讯作者：
Koopmans, Marion
中科院分区：
文献类型：
--
作者：
Boxman, Ingeborg;Dijkman, Remco;Koopmans, Marion
最近，厨房和浴室表面的环境拭子被描述为在爆发环境中检测诺如病毒的额外工具。本文描述了一个爆发调查，以回应胃肠炎的报告，在三个不相关的组6，12和13名成年人约30小时后，在同一家餐馆吃饭。从13名患者和6名食品处理人员中收集粪便样本，并从肥皂分配器、工作台、橱柜门把手、厨房和浴室的刀柄以及检查当天三名员工的手中采集环境拭子。通过实时逆转录PCR分别在时间和位置上分析临床和环境样品中诺如病毒的存在。有组织的面谈显示，所有工作人员都相继患上肠胃炎。在19份粪便样本中的17份以及4份环境样本中检测到诺如病毒RNA（GGI.6），其中包括一名正在准备即食食品的工作人员手中的拭子样本。从临床和环境样品中获得的序列显示出100%的同一性（235个核苷酸）。据我们所知，这是第一个直接证明在爆发环境中食物处理者手上存在诺如病毒RNA的案例研究。这一发现为诺沃克病毒通过食物处理人员传播到食物的可行性提供了直接证据。我们强烈建议教育食物从业员有关诺如病毒的传染性，并更新卫生守则。
Recently, environmental swabs from kitchen and bathroom surfaces have been described as an additional tool for the detection of norovirus in outbreak settings. This article describes an outbreak investigation in response to the reporting of gastroenteritis in three unrelated groups of 6, 12, and 13 adults approximately 30 h after having meals in the same restaurant. Fecal samples were collected from 13 patients and six food handlers, and environmental swabs were taken from the soap dispenser, working bench, doorknobs of cupboards, and the grip of a knife in the kitchen and in bathrooms as well as from the hands of each of three employees on the day of inspection. Clinical and environmental samples were analyzed separately in time and location for the presence of norovirus by real-time reverse transcription PCR. Structured interviews revealed that all staff members had suffered from gastroenteritis, one after the other. Norovirus RNA (GGI.6) was detected in 17 of 19 fecal samples as well as in 4 environmental samples, including a swab sample from the hands of a staff member who was preparing ready-to-eat food. Sequences obtained from clinical and environmental samples showed an identity of 100% (235 nucleotides). To our knowledge, this is the first case study to directly demonstrate the presence of norovirus RNA on a food handler's hands in an outbreak setting. This finding provides direct evidence for the feasibility of transmission of norovirus by a food handler to food. Education of food handlers on the infectivity of norovirus and updating of hygienic codes are strongly recommended.