Existence of multiple outbreaks of viral gastroenteritis among infants in a day care center in Japan
Existence of multiple outbreaks of viral gastroenteritis among infants in a day care center in Japan
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DOI：
10.1007/s00705-005-0540-y
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发表时间：
2005-10-01
影响因子：
2.7
通讯作者：
Ushijima, H
中科院分区：
文献类型：
--
作者：
Akihara, S;Phan, TG;Ushijima, H
从1999年6月至2000年7月在日本东京的一家日托中心（DCC）收集了44名婴儿的921份粪便标本，通过逆转录-多重聚合酶链反应（RT-多重PCR）和序列分析检测了轮状病毒、诺如病毒、痘病毒、星状病毒和腺病毒的存在。在88份急性胃肠炎患儿粪便标本中，检出肠道病毒阳性45份，阳性率为51.1%。星状病毒最常见（15.9%，14/88），其次是诺如病毒GII（14.8%，13/88）、腺病毒（12.5%，11/88）和沙波病毒（2.3%，2/88）。病毒混合感染占5.7%（5/88）。有趣的是，从无症状婴儿中收集的833份粪便标本中有230份（27.6%）也感染了麻疹病毒。其中，在53份、46份、96份和22份粪便标本中鉴定出星状病毒、诺如病毒GII、腺病毒和沙波病毒（分别为23%、20%、41.7%和9.6%）。此外，833例正常标本中有13例（1.6%）显示混合病毒感染。令人惊讶的是，在这些受试者中没有检测到轮状病毒（已知为DCC中急性胃肠炎的最常见病原体）。另一个有趣的特点是，在一个单一的DCC中发现了五个独立的急性胃肠炎爆发。爆发A与星状病毒血清型1和诺如病毒GII/3（称为多伦多病毒簇）两者相关;爆发B与腺病毒12相关;爆发C与诺如病毒GII/4（Lordsdale病毒簇）相关;爆发D与沙波病毒GIV相关，爆发E与星状病毒血清型1相关。据我们所知，这是首次证明日本婴儿在一个DCC中多次爆发病毒性胃肠炎。我们的研究结果证实了这些病毒的存在和重要性，并警告它们构成的威胁。
A total of 921 fecal specimens collected from 44 infants in a day care center (DCC) in Tokyo, Japan during June 1999 to July 2000 were tested for the presence of rotavirus, norovirus, sapovirus, astrovirus and adenovirus by reverse-transcription-multiplex polymerase chain reaction (RT-multiplex PCR) and sequence analysis. Of 88 fecal specimens from infants with acute gastroenteritis, 51.1% (45) were found to be positive for diarrheal viruses. Astrovirus was the most prevalent (15.9%, 14 of 88), followed by norovirus GII (14.8%, 13 of 88), adenovirus (12.5%, 11 of 88), and sapovirus (2.3%, 2 of 88). Viral mixed infection accounted for 5.7% (5 of 88). Interestingly, 230 of 833 (27.6%) fecal specimens collected from asymptomatic infants were also infected with diarrheal viruses. Of these, astrovirus, norovirus GII, adenovirus and sapovirus were identified in 53, 46, 96 and 22 fecal specimens (23%, 20%, 41.7%, and 9.6%, respectively). Moreover, 13 of 833 (1.6%) normal specimens showed mixed viral infections. Surprisingly, no rotavirus (known as the most common causative agent of acute gastroenteritis in DCCs) was detected in those subjects. Another interesting feature was the demonstration of five separate outbreaks of acute gastroenteritis identified in a single DCC. Outbreak A was associated with both astrovirus serotype 1 and norovirus GII/3 (known as Toronto virus cluster); Outbreak B with adenovirus 12; Outbreak C with norovirus GII/4 (Lordsdale virus cluster); Outbreak D with sapovirus GIV and Outbreak E with astrovirus serotype 1. To our knowledge, this is the first proof of multiple outbreaks of viral gastroenteritis in Japanese infants in a single DCC. Our results confirm the presence as well as the importance of these viruses and warn of the threat they pose.