Potential distribution of viable norovirus after simulated vomiting
Potential distribution of viable norovirus after simulated vomiting
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DOI：
10.1016/j.jhin.2019.02.010
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发表时间：
2019-07-01
影响因子：
6.9
通讯作者：
Frost, G.
中科院分区：
文献类型：
--
作者：
Booth, C. Makison;Frost, G.
背景：呕吐是人体迅速清除有害胃内容物的一种方式。虽然这一过程通常对呕吐者有利，但如果他们感染了高度传染性的病原体，如诺沃克病毒，它可能会带来严重的感染控制问题。目前尚不清楚诺沃克病毒在保持存活的同时通过呕吐传播到多远的程度，特别是在清洗过程中可能遗漏的深远的飞沫和飞溅中。目的：确定模拟呕吐后诺沃克病毒活着传播的潜在水平。方法：本研究使用一种名为“呕吐拉里”的系统来模拟呕吐，使用含有诺沃克病毒替代猫科杯状病毒(FCV)的感染介质作为病毒在模拟呕吐后分布和存活的最坏情况。在模拟呕吐后采集空气和地板样本，并通过空斑试验分析活病毒。协方差分析调查了不同样本体积和位置的FCV浓度的差异。发现：虽然在模拟呕吐后没有从任何空气样本中分离出活病毒，但从几乎所有从地面采集的样本中都回收了>；=10个菌斑形成单位/毫升的FCV浓度(88/90)。其中包括离开呕吐系统3米远的小液滴。有证据表明，FCV浓度取决于样本量和位置。结论：本研究表明，即使在能够引发感染的浓度下，诺沃克病毒即使在影响深远的小液滴中也能存活。这样的飞沫很容易在清理过程中被忽视，增加了控制诺沃克病毒爆发的挑战。皇冠版权(C)2019由爱思唯尔有限公司代表医疗感染学会出版。
Background: Vomiting is one way in which the body rids itself of harmful gastric contents rapidly. Whilst this process is generally beneficial for the emetic individual, it can pose significant infection control issues if they are infected with a highly communicable pathogen such as norovirus. It is not known how far norovirus could spread through vomiting while remaining viable, particularly in far-reaching droplets and splashes that might be missed during cleaning.Aim: To identify the potential level of dissemination of viable norovirus after simulated vomiting.Methods: This study used a system called 'Vomiting Larry' to simulate vomiting with infection medium containing the norovirus surrogate feline calicivirus (FCV) as a worst-case scenario for distribution and survival of viruses after simulated vomiting. Air and floor samples were taken after simulated vomiting, and analysed for viable virus via plaque assay. Analysis of covariance investigated differences in FCV concentration by sample volume and location.Findings: Whilst viable virus was not isolated from any air samples taken after simulated vomiting, FCV concentrations of >= 10 plaque-forming units/mL were recovered from almost all samples taken from the floor (88/90). These included small droplets of fluid that travelled 3 m away from the vomiting system. There was evidence that FCV concentration depended on both sample volume and location.Conclusion: This study suggests that norovirus can survive being ejected even within small far-reaching droplets at concentrations capable of eliciting infection. Such droplets could easily go unnoticed and be overlooked during cleaning, adding to the challenge of controlling norovirus outbreaks. Crown Copyright (C) 2019 Published by Elsevier Ltd on behalf of The Healthcare Infection Society.