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1.
J Gen Virol ; 97(7): 1500-1510, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27075118

RESUMO

Puumala hantavirus (PUUV) is the most common and widespread hantavirus in Europe and is associated with a mild form of haemorrhagic fever with renal syndrome in humans, called nephropathia epidemica. This study presents the molecular characterization of PUUV circulating in bank voles in two regions of the Netherlands. Most human cases of hantavirus infection are from these two regions. Phylogenetic analysis of the (partial) S, M and L-segments indicated that the Dutch strains belong to the CE lineage, which includes PUUV strains from France, Germany and Belgium. We have identified two distinct groups of PUUV, corresponding with their geographic origin and with adjoining regions in neighbouring countries.


Assuntos
Arvicolinae/virologia , Febre Hemorrágica com Síndrome Renal/virologia , Virus Puumala/classificação , Virus Puumala/genética , Animais , Sequência de Bases , Variação Genética/genética , Humanos , Países Baixos , RNA Viral/genética , Análise de Sequência de RNA
2.
Eur J Clin Microbiol Infect Dis ; 35(10): 1691-700, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27372926

RESUMO

Acute gastroenteritis (AGE) morbidity remains high amongst preschool children, posing a significant societal burden. Empirical data on AGE-causing agents is needed to gauge their clinical relevance and identify agent-specific targets for control. We assessed the prevalence, risk factors and association with symptoms for enteropathogens in households with preschool children. A monthly-repeated cross-sectional survey of enteropathogens in households with preschool children was performed. A parent-child pair per household (n = 907 households) provided faecal samples and reported their symptoms and potential risk exposures. Samples were tested by multiplex reverse transcription polymerase chain reaction (RT-PCR) for 19 enteropathogens. Associations were assessed using logistic regression. 28.3 % of children (n = 981) and 15.6 % of parents (n = 971) carried pathogenic bacteria and/or Escherichia coli-associated pathogenicity genes, and 6.5 % and 3.3 % carried viruses, respectively. Giardia lamblia (4.6 % of children, 2.5 % of parents) and Dientamoeba fragilis (36 %, 39 %, respectively) were the main parasites, and were associated with pet exposure. Living in rural areas was associated with carriage of pathogenic E. coli, norovirus I and D. fragilis. Pathogenic E. coli was associated with summertime and livestock exposure. Attending day-care centres increased the risk of carrying norovirus, sapovirus and G. lamblia. Viruses occurred mainly in winter and were associated with AGE symptoms. Child-parent associations were found for bacterial pathogenicity genes, viruses, G. lamblia and D. fragilis. Enteropathogens spread widely in households with preschool children, particularly viruses, which more often cause symptoms. While bacteria predominate during summer and in those exposed to livestock, viruses predominate in wintertime and, like G. lamblia, are widespread amongst day-care centre attendees.


Assuntos
Bactérias/isolamento & purificação , Saúde da Família , Gastroenterite/epidemiologia , Gastroenterite/etiologia , Parasitos/isolamento & purificação , Vírus/isolamento & purificação , Adulto , Animais , Bactérias/classificação , Pré-Escolar , Estudos Transversais , Transmissão de Doença Infecciosa , Características da Família , Fezes/microbiologia , Fezes/parasitologia , Fezes/virologia , Feminino , Humanos , Lactente , Masculino , Reação em Cadeia da Polimerase Multiplex , Parasitos/classificação , Prevalência , Fatores de Risco , Estações do Ano , Inquéritos e Questionários , Vírus/classificação
3.
Epidemiol Infect ; 144(12): 2527-39, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27483376

RESUMO

Insights into transmission dynamics of enteropathogens in children attending daycare are limited. Here we aimed at identifying daycare centre (DCC) characteristics associated with time-clustered occurrence of enteropathogens in DCC-attending children. For this purpose, we used the KIzSS network, which comprises 43 DCCs that participated in infectious disease surveillance in The Netherlands during February 2010-February 2013. Space-time scan statistics were used to identify clusters of rotavirus, norovirus, astrovirus, Giardia lamblia and Cryptosporidium spp. in a two-dimensional DCC characteristic space constructed using canonical correlation analysis. Logistic regression models were then used to further identify DCC characteristics associated with increased or decreased odds for clustering of enteropathogens. Factors associated with increased odds for enteropathogen clustering in DCCs were having indoor/outdoor paddling pools or sandpits, owning animals, high numbers of attending children, and reporting outbreaks to local health authorities. Factors associated with decreased odds for enteropathogen clustering in DCCs were cleaning child potties in designated waste disposal stations, cleaning vomit with chlorine-based products, daily cleaning of toys, extra cleaning of toys during a suspected outbreak, and excluding children with gastroenteritis. These factors provide targets for reducing the burden of gastrointestinal morbidity associated with time-clustered occurrence of major enteropathogens in DCC attendees.


Assuntos
Creches/estatística & dados numéricos , Surtos de Doenças , Gastroenterite/epidemiologia , Astroviridae/fisiologia , Infecções por Astroviridae/epidemiologia , Infecções por Astroviridae/virologia , Infecções por Caliciviridae/epidemiologia , Infecções por Caliciviridae/virologia , Creches/normas , Pré-Escolar , Análise por Conglomerados , Criptosporidiose/epidemiologia , Cryptosporidium/fisiologia , Gastroenterite/parasitologia , Gastroenterite/virologia , Giardia lamblia/fisiologia , Giardíase/epidemiologia , Humanos , Lactente , Países Baixos/epidemiologia , Norovirus/fisiologia , Prevalência , Fatores de Risco , Rotavirus/fisiologia , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/virologia
4.
Epidemiol Infect ; 143(8): 1710-7, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25336060

RESUMO

Norovirus is the most frequent cause of acute infectious gastroenteritis and it is difficult to control in crowded environments like hospitals and nursing homes. Transmission depends on oral intake of virus deposited in the environment by infectious subjects. Data from volunteer studies indicate that virus concentrations in stool are highly variable, but systematic studies of the time-course of shedding and its individual variation are lacking. This paper quantifies norovirus shedding in a large population of 102 subjects, including asymptomatic shedders, and uses a longitudinal model to generalize shedding patterns. Enhanced surveillance for studies of transmission of norovirus in hospital outbreaks has yielded a considerable number of faecal samples from symptomatic and asymptomatic shedders, both from patients and staff. Norovirus concentrations were determined by real-time PCR. A quantitative dynamic model was fitted to the shedding data, in a multilevel Bayesian framework, to study the time-course of shedding and its variation. The results indicate that shedding in asymptomatic subjects is similar to that in symptomatic infections, both showing considerable variation in peak levels (average 105-109 /g faeces) as well as duration of virus shedding (average 8-60 days). Patients appear to shed higher numbers of virus than staff, for slightly longer durations, but the differences are too small to be significant. Given equal shedding, the greater contribution of symptomatic cases to transmission must be caused by their higher efficiency in spreading these viruses. The results of this study will be helpful for risk studies that need to quantify the deposition of virus in the environment.


Assuntos
Infecções Assintomáticas , Infecções por Caliciviridae/virologia , Surtos de Doenças , Fezes/virologia , Gastroenterite/virologia , Norovirus/genética , RNA Viral/análise , Eliminação de Partículas Virais/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , Infecções por Caliciviridae/epidemiologia , Infecções por Caliciviridae/transmissão , Estudos de Coortes , Feminino , Gastroenterite/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Hospitais , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Transmissão de Doença Infecciosa do Profissional para o Paciente , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Análise Multinível , Casas de Saúde , Reação em Cadeia da Polimerase em Tempo Real , Adulto Jovem
5.
Euro Surveill ; 20(26)2015 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-26159308

RESUMO

In the winter of 2014/15 a novel GII.P17-GII.17 norovirus strain (GII.17 Kawasaki 2014) emerged, as a major cause of gastroenteritis outbreaks in China and Japan. Since their emergence these novel GII.P17-GII.17 viruses have replaced the previously dominant GII.4 genotype Sydney 2012 variant in some areas in Asia but were only detected in a limited number of cases on other continents. This perspective provides an overview of the available information on GII.17 viruses in order to gain insight in the viral and host characteristics of this norovirus genotype. We further discuss the emergence of this novel GII.P17-GII.17 norovirus in context of current knowledge on the epidemiology of noroviruses. It remains to be seen if the currently dominant norovirus strain GII.4 Sydney 2012 will be replaced in other parts of the world. Nevertheless, the public health community and surveillance systems need to be prepared in case of a potential increase of norovirus activity in the next seasons caused by this novel GII.P17-GII.17 norovirus.


Assuntos
Infecções por Caliciviridae/virologia , Doenças Transmissíveis Emergentes/virologia , Surtos de Doenças , Gastroenterite/virologia , Variação Genética , Norovirus/classificação , Norovirus/genética , Infecções por Caliciviridae/epidemiologia , China/epidemiologia , Doenças Transmissíveis Emergentes/genética , Feminino , Gastroenterite/epidemiologia , Genótipo , Humanos , Epidemiologia Molecular , Norovirus/isolamento & purificação , Filogenia , Estações do Ano
6.
Euro Surveill ; 20(29): 21192, 2015 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-26227370

RESUMO

In May 2013, Italy declared a national outbreak of hepatitis A, which also affected several foreign tourists who had recently visited the country. Molecular investigations identified some cases as infected with an identical strain of hepatitis A virus subgenotype IA. After additional European Union/European Economic Area (EU/EEA) countries reported locally acquired and travel-related cases associated with the same outbreak, an international outbreak investigation team was convened, a European outbreak case definition was issued and harmonisation of the national epidemiological and microbiological investigations was encouraged. From January 2013 to August 2014, 1,589 hepatitis A cases were reported associated with the multistate outbreak; 1,102 (70%) of the cases were hospitalised for a median time of six days; two related deaths were reported. Epidemiological and microbiological investigations implicated mixed frozen berries as the vehicle of infection of the outbreak. In order to control the spread of the outbreak, suspected or contaminated food batches were recalled, the public was recommended to heat-treat berries, and post-exposure prophylaxis of contacts was performed. The outbreak highlighted how large food-borne hepatitis A outbreaks may affect the increasingly susceptible EU/EEA general population and how, with the growing international food trade, frozen berries are a potential high-risk food.


Assuntos
Surtos de Doenças , Contaminação de Alimentos , Doenças Transmitidas por Alimentos/epidemiologia , Frutas/intoxicação , Vírus da Hepatite A/genética , Hepatite A/epidemiologia , Adolescente , Adulto , Pré-Escolar , Busca de Comunicante , Estudos Epidemiológicos , Europa (Continente)/epidemiologia , União Europeia , Feminino , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/virologia , Alimentos Congelados/intoxicação , Alimentos Congelados/virologia , Frutas/virologia , Hepatite A/virologia , Vírus da Hepatite A/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
7.
Euro Surveill ; 19(43)2014 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-25375899

RESUMO

An unexpected drop in rotavirus (RV) detections was observed in the Netherlands in 2014, without RV vaccination. The estimated decrease in RV detections and gastroenteritis consultations in under five year-olds, in January-April 2014, compared to the same months in previous years, was 72% and 36%, respectively. The low birth rate, mild winter, high RV incidence in the previous year and the introduction of RV vaccination in neighbouring countries may have contributed to this decrease.


Assuntos
Encaminhamento e Consulta/estatística & dados numéricos , Infecções por Rotavirus/epidemiologia , Rotavirus/isolamento & purificação , Pré-Escolar , Feminino , Gastroenterite/epidemiologia , Gastroenterite/virologia , Humanos , Incidência , Lactente , Masculino , Países Baixos/epidemiologia , Infecções por Rotavirus/diagnóstico , Infecções por Rotavirus/virologia , Vacinas contra Rotavirus , Estações do Ano , Vigilância de Evento Sentinela , Vacinação/estatística & dados numéricos
8.
Epidemiol Infect ; 141(3): 549-55, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22584109

RESUMO

Using polymerase chain reaction (PCR) to detect faecal hepatitis A virus (HAV) can be a useful tool for investigating HAV outbreaks, especially in low-endemic countries. We describe the use of faecal HAV PCR as a non-invasive tool for screening. Two Dutch children visiting different daycare centres were diagnosed with hepatitis A in 2011. A systematic contact investigation was started in the daycare centres and relevant contacts were screened. The faecal HAV PCR test was used to screen the children. The employees were screened with a serum IgM. The faecal HAV PCR test proved to be an appropriate tool for screening. The screening of a total of 135 children and employees in the daycare centres resulted in evidence of eight asymptomatic infections and transmission to three related daycare centres. Control measures were taken including immunization. Compared to an epidemiological investigation without screening, 144 extra contacts were vaccinated based on the screening results. This most likely led to improved prevention of expansion of the outbreak.


Assuntos
Busca de Comunicante , Surtos de Doenças/prevenção & controle , Vírus da Hepatite A Humana/isolamento & purificação , Hepatite A/diagnóstico , Hepatite A/epidemiologia , Reação em Cadeia da Polimerase , Adolescente , Adulto , Criança , Creches , Pré-Escolar , Fezes/virologia , Feminino , Hepatite A/virologia , Vírus da Hepatite A Humana/genética , Humanos , Lactente , Masculino , Programas de Rastreamento/métodos , Epidemiologia Molecular , Tipagem Molecular , Países Baixos/epidemiologia , Adulto Jovem
10.
Euro Surveill ; 18(4): 20387, 2013 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-23369392

RESUMO

Laboratory-based surveillance, one of the pillars of monitoring infectious disease trends, relies on data produced in clinical and/or public health laboratories. Currently, diagnostic laboratories worldwide submit strains or samples to a relatively small number of reference laboratories for characterisation and typing. However, with the introduction of molecular diagnostic methods and sequencing in most of the larger diagnostic and university hospital centres in high-income countries, the distinction between diagnostic and reference/public health laboratory functions has become less clear-cut. Given these developments, new ways of networking and data sharing are needed. Assuming that clinical and public health laboratories may be able to use the same data for their own purposes when sequence-based testing and typing are used, we explored ways to develop a collaborative approach and a jointly owned database (TYPENED) in the Netherlands. The rationale was that sequence data - whether produced to support clinical care or for surveillance -can be aggregated to meet both needs. Here we describe the development of the TYPENED approach and supporting infrastructure, and the implementation of a pilot laboratory network sharing enterovirus sequences and metadata.


Assuntos
Bases de Dados de Ácidos Nucleicos , Laboratórios , Vigilância da População/métodos , Saúde Pública , Sistemas de Informação em Laboratório Clínico , Controle de Doenças Transmissíveis/tendências , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/epidemiologia , Comportamento Cooperativo , Enterovirus/genética , Humanos , Disseminação de Informação , Dados de Sequência Molecular , Países Baixos , Projetos Piloto
11.
Vaccine ; 39(45): 6671-6681, 2021 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-34635375

RESUMO

BACKGROUND: Universal mass vaccination (UMV) against rotavirus has been implemented in many but not all European countries. This study investigated the impact of UMV on rotavirus incidence trends by comparing European countries with UMV: Belgium, England/Wales and Germany versus countries without UMV: Denmark and the Netherlands. METHODS: For this observational retrospective cohort study, time series data (2001-2016) on rotavirus detections, meteorological factors and population demographics were collected. For each country, several meteorological and population factors were investigated as possible predictors of rotavirus incidence. The final set of predictors were incorporated in negative binomial models accounting for seasonality and serial autocorrelation, and time-varying incidence rate ratios (IRR) were calculated for each age group and country separately. The overall vaccination impact two years after vaccine implementation was estimated by pooling the results using a random effects meta-analyses. Independent t-tests were used to compare annual epidemics in the pre-vaccination and post-vaccination era to explore any changes in the timing of rotavirus epidemics. RESULTS: The population size and several meteorological factors were predictors for the rotavirus epidemiology. Overall, we estimated a 42% (95%-CI 23;56%) reduction in rotavirus incidence attributable to UMV. Strongest reductions were observed for age-groups 0-, 1- and 2-years (IRR 0.47, 0.48 and 0.63, respectively). No herd effect induced by UMV in neighbouring countries was observed. In all UMV countries, the start and/or stop and corresponding peak of the rotavirus season was delayed by 4-7 weeks. CONCLUSIONS: The introduction of rotavirus UMV resulted in an overall reduction of 42% in rotavirus incidence in Western European countries two years after vaccine introduction and caused a change in seasonal pattern. No herd effect induced by UMV neighbouring countries was observed for Denmark and the Netherlands.


Assuntos
Gastroenterite , Infecções por Rotavirus , Vacinas contra Rotavirus , Rotavirus , Europa (Continente)/epidemiologia , Hospitalização , Humanos , Lactente , Recém-Nascido , Estudos Retrospectivos , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/prevenção & controle , Vacinação
12.
Euro Surveill ; 15(11)2010 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-20338146

RESUMO

As of 1 March 2010, a total of 11 primary cases with onset of symptoms between 31 December 2009 and 10 February 2010, have been identified with identical hepatitis A genotype IB strains in the Netherlands. A relation with Australian and French foodborne outbreaks occurring in 2009 and 2010 is suspected. Ten of the 11 primary cases indicated that they had consumed one or more products containing semi-dried tomatoes during their incubation period.


Assuntos
Contaminação de Alimentos/análise , Doenças Transmitidas por Alimentos/epidemiologia , Vírus da Hepatite A/isolamento & purificação , Hepatite A/epidemiologia , Hepatite A/etiologia , Adulto , Notificação de Doenças , Feminino , Genótipo , Vírus da Hepatite A/genética , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Vigilância da População , Adulto Jovem
13.
Euro Surveill ; 15(20)2010 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-20504389

RESUMO

Between 31 December 2009 and 10 February 2010, 13 patients were infected by an identical hepatitis A virus strain not previously detected in the Netherlands. They had not been abroad and were widely distributed over the Netherlands. A case-control study including 12 cases and 44 controls identified semi-dried tomatoes in oil as the source of the outbreak (odds ratio: 20.0; 95% confidence interval: 1.5-274). The virus was not detected in any of 81 tested food samples. International trace-back is still ongoing.


Assuntos
Contaminação de Alimentos/análise , Vírus da Hepatite A/isolamento & purificação , Hepatite A/epidemiologia , Solanum lycopersicum/microbiologia , Adulto , Estudos de Casos e Controles , Surtos de Doenças , Feminino , Hepatite A/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Inquéritos e Questionários , Adulto Jovem
14.
J Clin Virol ; 131: 104610, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32871544

RESUMO

BACKGROUND: We describe a patient who was planned to receive a kidney transplant from his wife. Both were infected with Hepatitis A virus (HAV) two weeks prior to the planned transplantation. Due to prolonged shedding of HAV (up until 126 days) we decided to postpone the kidney transplant in order to prevent long term complications. OBJECTIVES: The main question in this case was is there a higher risk of a complicated course of HAV-infection after kidney transplantation? We discuss the need for upscale of preventative measures of HAV infections in solid organ transplant candidates. STUDY DESIGN: We performed a literature study on risks of a complicated course of HAV in solid organ transplant recipients and performed a seroprevalence study on anti-HAV in a cohort of 106 hemodialysis patients. RESULTS: Little is known whether HAV infection in solid organ transplant patients causes a more aggressive course of diseases. However, HAV infections in these populations are associated with increased risk of liver failure. CONCLUSIONS: This case highlights the need of scaling up preventative measures against HAV infections in solid organ transplant candidates.


Assuntos
Hepatite A/complicações , Transplante de Rim , Hepatite A/virologia , Vírus da Hepatite A/imunologia , Vírus da Hepatite A/isolamento & purificação , Humanos , Diálise Renal/estatística & dados numéricos , Fatores de Risco , Estudos Soroepidemiológicos , Tempo para o Tratamento , Transplantados , Eliminação de Partículas Virais
15.
J Virol ; 82(12): 6078-83, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18400867

RESUMO

A longstanding enigmatic feature of the group 1 coronaviruses is the uncleaved phenotype of their spike protein, an exceptional property among class I fusion proteins. Here, however, we show that some group 1 coronavirus spike proteins carry a furin enzyme recognition motif and can actually be cleaved, as demonstrated for a feline coronavirus. Interestingly, this feature can be lost during cell culture adaptation by a single mutation in the cleavage motif; this, however, preserves a heparan sulfate binding motif and renders infection by the virus heparan sulfate dependent. We identified a similar cell culture adaptation for the human coronavirus OC43.


Assuntos
Adaptação Fisiológica , Furina/fisiologia , Heparitina Sulfato/metabolismo , Glicoproteínas de Membrana/metabolismo , Proteínas do Envelope Viral/metabolismo , Sequência de Aminoácidos , Animais , Gatos , Linhagem Celular , Humanos , Glicoproteínas de Membrana/química , Dados de Sequência Molecular , Glicoproteína da Espícula de Coronavírus , Proteínas do Envelope Viral/química
16.
J Hosp Infect ; 71(3): 199-205, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19147255

RESUMO

We report a retrospective analysis of norovirus (NoV) infections occurring in patients of a tertiary care hospital during five winter seasons (2002/03 to 2006/07). Data were compared with national surveillance data and with corresponding data for rotavirus. Between July 2002 and June 2007, faecal specimens from 221 (9.0%) of 2458 hospital patients with diarrhoea tested positive for NoV. The incidence in children varied from 2.52 per 1000 admissions in 2004/05 (when testing began to be performed routinely) to 11.9 per 1000 admissions in 2006/07, while the incidence in adults remained stable (mean: 1.49 per 1000 admissions). Two genotypes predominated during the study period: GIIb strains occurred mainly in children below the age of two-and-a-half years [odds ratio (OR): 14.7; P<0.0001] whereas GII.4 strains affected all age groups. Compared with rotavirus infections, NoV infections in children were more often hospital-acquired (59% vs 39%, OR: 2.29; P<0.01). Among these cases we identified 22 clusters of NoV infection among inpatients. Twelve of 53 patients from whom follow-up samples were available demonstrated long-term virus shedding. We report a dynamic pattern of sporadic NoV infections in large hospitals, with frequent nosocomial transmission and with the predominance of GIIb-related strains in children. Effective prevention strategies are required to reduce the impact of sporadic NoV infection in vulnerable patients.


Assuntos
Infecções por Caliciviridae/epidemiologia , Infecção Hospitalar/epidemiologia , Surtos de Doenças , Gastroenterite/epidemiologia , Norovirus/isolamento & purificação , Adolescente , Distribuição por Idade , Infecções por Caliciviridae/genética , Infecções por Caliciviridae/transmissão , Criança , Pré-Escolar , Infecção Hospitalar/transmissão , Infecção Hospitalar/virologia , Gastroenterite/virologia , Genótipo , Humanos , Incidência , Lactente , Recém-Nascido , Estudos Longitudinais , Países Baixos/epidemiologia , Norovirus/genética , Estudos Retrospectivos , Adulto Jovem
17.
Epidemiol Infect ; 137(12): 1722-33, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19426572

RESUMO

Effective infection control measures during norovirus outbreaks are urgently needed in places where vulnerable individuals gather. In the present study, the effect of a number of measures was investigated in daily practice. Forty-nine Dutch nursing homes were monitored prospectively for norovirus outbreaks during two winter seasons. A total of 37 norovirus outbreaks were registered. Control measures were most effective when implemented within 3 days after onset of disease of the first patient. Measures targeted at reduced transmission between persons, via aerosols, and via contaminated surfaces reduced illness in staff and in residents. Reducing illness in staff results in fewer costs for sick leave and substitution of staff and less disruption in the care of residents. The effect of control measures on outbreak duration was limited. This is the first intervention study examining the effect of control measures. Further research is needed to extend and refine the conclusions.


Assuntos
Infecções por Caliciviridae/epidemiologia , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Norovirus , Casas de Saúde , Surtos de Doenças/prevenção & controle , Pessoal de Saúde , Humanos , Estações do Ano , Visitas a Pacientes
18.
Euro Surveill ; 14(3)2009 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-19161728

RESUMO

An outbreak of hepatitis A has been ongoing in Latvia with 2,817 confirmed cases reported between 20 November 2007 and 31 December 2008. Initially the spread of infection was due to transmission among drug users and other high-risk groups, as well as several outbreaks in Riga (affecting a school and a restaurant), but in the second half of the year led to a community-wide increase in the number of cases. Molecular analysis of 100 strains showed that 95 belonged to genotype IA, of which 89 were identical and six were single nucleotide variants of the same sequence.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Hepatite A/epidemiologia , Vigilância da População , Medição de Risco/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Letônia/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
19.
Clin Microbiol Infect ; 25(8): 1039.e7-1039.e13, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30553029

RESUMO

OBJECTIVES: This study aimed to (i) determine risk factors for enteropathogen co-infections, (ii) determine whether enteropathogen co-infections influence gastroenteritis risk, and (iii) determine whether enteropathogen co-infection occurred randomly in preschool children. METHODS: A monthly-repeated cross-sectional survey in Dutch children aged 0-48 months was conducted during October 2012 to October 2014. A total of 981 stool samples were collected along with questionnaires collecting data on gastrointestinal symptoms and potential risk factors; 822 samples were successfully tested for 19 enteropathogens using real-time multiplex PCRs. Logistic regression analysis assessed co-infections in relation to gastroenteritis and potential risk factors. RESULTS: In all, 598/822 (72.7%) stool samples tested positive for at least one enteropathogen, of which 290 (48.5%) were positive for two or more enteropathogens. Risk factors for two or more enteropathogen co-infections were young age (<12 months, OR 1.9, 95% CI 1.1-3.3; 13-36 months, OR 1.7, 95% CI 1.1-2.5, versus 37-48 months), day-care attendance (OR 1.8, 95% CI 1.3-2.5), households with three or more children versus those with one child (OR 1.7, 95% CI 1.1-2.8). Stool samples collected in spring less often had two or more enteropathogens versus summer (OR 0.4, 95% CI 0.2-0.7). Food allergy was a risk factor for three or more enteropathogen co-infections (OR 3.2, 95% CI 1.1-8.9). The frequency of co-infection was higher than expected for norovirus GI/norovirus GII, Clostridium difficile/norovirus GI, C. difficile/rotavirus, astrovirus/Dientamoeba fragilis, atypical enteropathogenic Escherichia coli/adenovirus, typical enteropathogenic E. coli/adenovirus, and enteroaggregative E. coli/astrovirus. No co-infection was associated with increased gastroenteritis risk. CONCLUSIONS: Risk factors for enteropathogen co-infections were identified and specific enteropathogens co-occurred significantly more often than expected by chance. Enteropathogen co-infections were not associated with increased gastroenteritis risk, calling into question their clinical relevance in preschool children.


Assuntos
Coinfecção/epidemiologia , Gastroenterite/epidemiologia , Pré-Escolar , Estudos Transversais , Dientamebíase/epidemiologia , Escherichia coli Enteropatogênica , Infecções por Escherichia coli/epidemiologia , Características da Família , Fezes/microbiologia , Fezes/parasitologia , Fezes/virologia , Feminino , Gastroenterite/microbiologia , Gastroenterite/parasitologia , Gastroenterite/virologia , Humanos , Lactente , Recém-Nascido , Masculino , Países Baixos/epidemiologia , Fatores de Risco , Infecções por Rotavirus/epidemiologia
20.
J Clin Microbiol ; 46(9): 2959-65, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18650354

RESUMO

The Foodborne Viruses in Europe network has developed integrated epidemiological and virological outbreak reporting with aggregation and sharing of data through a joint database. We analyzed data from reported outbreaks of norovirus (NoV)-caused gastroenteritis from 13 European countries (July 2001 to July 2006) for trends in time and indications of different epidemiology of genotypes and variants. Of the 13 countries participating in this surveillance network, 11 were capable of collecting integrated epidemiological and virological surveillance data and 10 countries reported outbreaks throughout the entire period. Large differences in the numbers and rates of reported outbreaks per country were observed, reflecting the differences in the focus and coverage of national surveillance systems. GII.4 strains predominated throughout the 5-year surveillance period, but the proportion of outbreaks associated with GII.4 rose remarkably during years in which NoV activity was particularly high. Spring and summer peaks indicated the emergence of genetically distinct variants within GII.4 across Europe and were followed by increased NoV activity during the 2002-2003 and 2004-2005 winter seasons. GII.4 viruses predominated in health care settings and in person-to-person transmission. The consecutive emergence of new GII.4 variants is highly indicative of immune-driven selection. Their predominance in health care settings suggests properties that facilitate transmission in settings with a high concentration of people such as higher virus loads in excreta or a higher incidence of vomiting. Understanding the mechanisms driving the changes in epidemiology and clinical impact of these rapidly evolving RNA viruses is essential to design effective intervention and prevention measures.


Assuntos
Infecções por Caliciviridae/epidemiologia , Surtos de Doenças , Doenças Transmitidas por Alimentos/epidemiologia , Gastroenterite/epidemiologia , Norovirus , Infecções por Caliciviridae/transmissão , Infecções por Caliciviridae/virologia , Notificação de Doenças , Europa (Continente)/epidemiologia , Doenças Transmitidas por Alimentos/virologia , Gastroenterite/virologia , Genótipo , Humanos , Análise Multivariada , Norovirus/genética
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