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1.
BMC Public Health ; 20(1): 445, 2020 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-32248812

RESUMO

BACKGROUND: Acute gastroenteritis (AGE) is a highly transmissible condition spreading rapidly between individuals and within households. Rotavirus vaccination was introduced in the UK in 2013. The study objectives were to investigate how acute gastroenteritis incidence changed over 25 years and household incidence of AGE since 2013. METHODS: Repeated cross-sectional study of Royal College of General Practitioners Research and Surveillance Centre network. We used a negative binomial model to report incidence rate ratio (IRR) using the last 5 years data. We also conducted a retrospective cohort analysis, using a shared gamma frailty model (2013-2017). We explored the impact of child under 5- years, household size, socioeconomic status quintile, and rurality. RESULTS: In the cross-sectional analysis, the IRR of AGE in households with a child of under 5 years was 12.20 (95%CI 11.08-13.45-, p < 0.001) compared with households without; the IRR fell across IMD quintiles, for example there is a 37% decrease in incidence comparing IMD quintile 1 to quintile 5 (95%CI -0.52-0.76, p < 0.001), The cohort study revealed that the presence of an under 5 in the household was associated with a higher risk of household presentation (HR = 6.29, 95% CI 5.61-7.06, p < 0.001). In addition, we observe a reduction in risk of presentation from the most to the least deprived socioeconomic quintile (second quintile: HR = 0.74 (95%CI 0.59-0.92), to least deprived quintile, HR = 0.55 (95%CI 0.41-0.74). We saw a lower association with male gender, white ethnicity and living outside London, but an increased association with increasing household size. CONCLUSIONS: The incidence of AGE has changed over time: pre-school children, larger households, and living in London were associated with higher rates, and male gender and higher economic status associated with lower rates.


Assuntos
Características da Família , Gastroenterite/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Bases de Dados Factuais , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Londres , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
2.
Arch Virol ; 165(5): 1121-1128, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32221714

RESUMO

Since 2014, novel non-GII.4 norovirus (NoV) genotypes continue to be reported as the main cause of outbreaks worldwide. In this study, we analyzed the epidemiological and genetic features of NoV outbreaks from July 2014 to June 2018 in Huzhou, China. A total of 450 stool samples collected from 51 AGE outbreaks were tested for NoVs by real-time RT PCR. Partial polymerase and capsid sequences of NoV-positive samples were amplified and sequenced for phylogenetic analysis. NoVs were found to be responsible of 84.3% of AGE outbreaks in Huzhou over the past 5 years. Most NoV outbreaks were reported in the cool months (November-March) and occurred in primary schools and kindergartens. Changes in the diversity of genotypes and the distribution of predominant types were observed in recent years. At least eight genotypes were identified, and 91.9% of the genotyped outbreaks were caused by non-GII.4 strains. The top three circulating genotypes during the study period were GII.2[P16], GII.3[P12], and GII.17[P17]. The predominant NoV genotypes in outbreaks have changed from GII.4 variants to GII.17[P17] in 2014-2015, GII.3[P12] in 2015-2016, and then GII.2[P16] in 2016-2018. Non-GII.4 NoVs play an increasingly important role in outbreaks in Huzhou. Continuous surveillance is needed to monitor the emergence of novel NoV strains and help control NoV outbreaks in the next epidemic season.


Assuntos
Infecções por Caliciviridae/epidemiologia , Infecções por Caliciviridae/virologia , Surtos de Doenças , Gastroenterite/epidemiologia , Gastroenterite/virologia , Genótipo , Norovirus/classificação , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Fezes/virologia , Variação Genética , Técnicas de Genotipagem , Humanos , Epidemiologia Molecular , Norovirus/genética , Norovirus/isolamento & purificação , Prevalência
3.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(2): 226-230, 2020 Feb 10.
Artigo em Chinês | MEDLINE | ID: mdl-32164134

RESUMO

Objective: To investigate the epidemiological characteristics and clinic symptoms of an outbreak of infectious diarrhea caused by Sapovirus, in CT community, Zhaoqing, Guangdong province. Methods: Retrospective study of field epidemiology investigation was carried out and Chi-square test was used enteroviruses were detected by RT-PCR in swab, fecal specimens and water samples. Results: A total of 422 cases were identified in this outbreak, with the prevalence as 11.95%. Cases mainly concentrated between 21 and 24, December, with curves noticed by point- source and peaked on the 22(nd). Symptoms mainly appeared as vomiting, with watery stool. Patients were founded in every village, with the highest prevalence appeared in the elderly (25.20%) but involved in every age group. Sapovirus infection was most frequently seen in the population under 25 years of age, with overall prevalence as 16.41%. People older than 50 years of age took the second place (12.05%), and the lowest was seen between 25 to 49 years age group (8.42%). Sapovirus was detected in both swab and fecal specimens, with the positive rate as 38.78%. Both general and heat- resistant coliformed-bacteria were detected in the 24 monitored water samples, with the qualification rates as 95.83%, 45.83% and 50.00%, respectively. However, Sapovirus was not detected in any of the water samples. Conclusions: Our findings confirmed that an outbreak, caused by sapovirus infection in CT community was most likely related to the central water supply. The surveillance system for infectious diarrheal diseases should be improved and both public health awareness and surveillance programs on drinking water should be strengthened.


Assuntos
Infecções por Caliciviridae/epidemiologia , Surtos de Doenças , Gastroenterite/epidemiologia , Gastroenterite/virologia , Sapovirus/isolamento & purificação , Doença Aguda , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China/epidemiologia , Fezes/virologia , Humanos , Lactente , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
4.
Am J Psychiatry ; 177(4): 335-341, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32046532

RESUMO

OBJECTIVE: Previous studies have suggested that infections increase the risk of schizophrenia. In this study, the authors aimed to investigate 1) whether infections increase the risk of substance-induced psychosis, and 2) whether infections increase the risk of converting from substance-induced psychosis to schizophrenia. METHODS: The study data were drawn from the combined nationwide Danish registers and included all people born in Denmark since 1981. The authors used Cox proportional hazards regression with infections as time-varying covariates, estimating hazard ratios and 95% confidence intervals. Infections were operationalized both as any infection and by the site of infection. RESULTS: The study included 2,256,779 individuals, for whom 3,618 cases of incident substance-induced psychosis were recorded. Any infection increased the risk of substance-induced psychosis (hazard ratio=1.30, 95% CI=1.22-1.39). For the first 2 years, the risk was doubled. Hepatitis was the infection most strongly associated with substance-induced psychosis (hazard ratio=3.42, 95% CI=2.47-4.74). Different types of infections were linked with different types of substance-induced psychosis. Most associations remained significant after controlling for potential confounders, such as substance use disorders. Only hepatitis predicted conversion to schizophrenia after substance-induced psychosis (hazard ratio=1.87, 95% CI=1.07- 3.26). CONCLUSIONS: The study results support the hypothesis of an immunological component to psychosis.


Assuntos
Infecções/epidemiologia , Psicoses Induzidas por Substâncias/epidemiologia , Esquizofrenia/epidemiologia , Adolescente , Adulto , Infecções do Sistema Nervoso Central/epidemiologia , Dinamarca/epidemiologia , Progressão da Doença , Feminino , Gastroenterite/epidemiologia , Hepatite/epidemiologia , Humanos , Incidência , Masculino , Prognóstico , Modelos de Riscos Proporcionais , Infecções do Sistema Genital/epidemiologia , Infecções Respiratórias/epidemiologia , Fatores de Risco , Sepse/epidemiologia , Dermatopatias Infecciosas/epidemiologia , Infecções Urinárias/epidemiologia , Adulto Jovem
5.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(2): 169-174, 2020 Feb 06.
Artigo em Chinês | MEDLINE | ID: mdl-32074705

RESUMO

Objective: To analyze the etiology and epidemiological characteristics of gastroenteritis virus in foodborne diseases from three cities in Shandong. Methods: From January to December 2017, six sentinel hospitals in Jinan, Yantai and Linyi city of Shandong Province were selected as the research sites. Stool samples of 1 397 diarrhea patients were collected, as well as basic information and clinical symptoms. Duplex quantitative RT-PCR was used to detect Norovirus genogroupⅠ (Nov GⅠ) and genogroupⅡ (Nov GⅡ), Sapovirus (SAV) and Human astrovirus (HAstV), respectively, quantitative RT-PCR was used to detect group A Rotavirus (RVA), and quantitative PCR was used to detect Enteric adenovirus (EAdV). The specific gene of the virus were sequenced and typed. It was compared that the gastroenteritis virus rate in cases with different characteristics and the clinical symptoms difference between the virus positive and negative cases. Results: The median age (P(25), P(75)) was 23 (1, 42) , mainly male, 57.48% with 803 cased and children under 5 years old, 36.36% with 508 cases. The positive rate of gastroenteritis virus was 33.93% (474 cases), and that of Jinan, Linyi and Yantai City were 32.03% (147/459), 41.54% (189/455) and 28.57% (138/483), respectively (P<0.001). Nov GⅡ had the highest positive rate, 16.54% (231 cases), which, mainly GⅡ.P16/GⅡ.2 (48.28%, 56/116), peaked in May (24.75%, 50/202) and June (19.59%, 38/194). In patients of gastroenteritis virus positive, 44.51% (211/474) had vomiting symptoms, higher than that of patients of gastroenteritis virus negative (34.13%, 315/923). The difference was statistically significant (P<0.001). Conclusion: In Shandong Province, the majority of gastroenteritis patients were male and children under 5 years old. Nov GⅡ possessed highest epidemic intensity, and peaked in spring and summer. Viral gastroenteritis had atypical clinical symptoms.


Assuntos
Diarreia/epidemiologia , Diarreia/virologia , Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/virologia , Gastroenterite/epidemiologia , Gastroenterite/virologia , Adenoviridae/genética , Adenoviridae/isolamento & purificação , Adolescente , Adulto , Criança , Pré-Escolar , China/epidemiologia , Cidades , Enterovirus/genética , Enterovirus/isolamento & purificação , Feminino , Humanos , Lactente , Masculino , Rotavirus/genética , Rotavirus/isolamento & purificação , Adulto Jovem
6.
PLoS One ; 15(1): e0227890, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31935271

RESUMO

BACKGROUND: Norovirus is a leading cause of acute gastroenteritis (AGE) across the age spectrum; candidate vaccines are in clinical trials. While norovirus diagnostic testing is increasingly available, stool testing may not be performed routinely, which can hamper surveillance and burden of disease estimates. Additionally, lack of knowledge of the burden of disease may inhibit provider vaccine recommendations, which could affect coverage rates and ultimately the impact of the vaccine. Our objectives were to understand physicians' stool testing practices in outpatients with AGE, and physician knowledge of norovirus, in order to improve surveillance and prepare for vaccine introduction. METHODS: Internet and mail survey on AGE, norovirus, and future norovirus vaccines conducted January to March 2018 among national networks of primary care pediatricians, family practice and general internal medicine physicians. RESULTS: The response rate was 59% (820/1383). During peak AGE season, physicians estimated they ordered stool tests for a median of 15% (interquartile range: 5-33%) of their outpatients with AGE. Stool tests were reported as more often available for ova and parasites, Clostridioides difficile, and bacterial culture (>95% for all specialties) than for norovirus (6-33% across specialties); even when available, norovirus-specific tests were infrequently ordered. Most providers were unaware that norovirus is a leading cause of AGE across all age groups (Pediatricians 80%, Family Practice 86%, General Internal Medicine 89%) or that alcohol-based hand sanitizers are ineffective against norovirus (Pediatricians 51%, Family Practice 66%, General Internal Medicine 62%). Concerns cited as major barriers to implementing a future norovirus vaccine included if the vaccine is not covered by insurance (General Internal Medicine 64%, Pediatricians 67%, Family Practice 74%) and lack of adequate reimbursement for vaccination (Pediatricians 43%, General Internal Medicine 46%, Family Practice 50%). Factors that providers believed were 'not at all a barrier' or 'minor barrier' to new vaccine introduction included the belief that "my patients won't need this vaccine" (General Internal Medicine 78%, Family Practice 86%, Pediatricians 90%) and "my patients already get too many vaccines" (Family Practice 89%, General Internal Medicine 92%, Pediatricians 95%). CONCLUSIONS: Primary care physicians had few concerns regarding future norovirus vaccine introduction, but have knowledge gaps on norovirus prevalence and hand hygiene for prevention. Also, physicians infrequently order stool tests for outpatients with AGE, which limits surveillance estimates that rely on physician-ordered stool diagnostics. Closing physician knowledge gaps on norovirus burden and transmission can help support norovirus vaccine introduction.


Assuntos
Atitude do Pessoal de Saúde , Gastroenterite/epidemiologia , Norovirus/isolamento & purificação , Médicos de Atenção Primária/psicologia , Feminino , Gastroenterite/diagnóstico , Gastroenterite/patologia , Gastroenterite/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Norovirus/patogenicidade , Médicos/psicologia , Vacinas/uso terapêutico
7.
J Med Microbiol ; 69(3): 419-426, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31999240

RESUMO

Introduction. Current testing practices for yersiniosis mean that its true incidence and epidemiology are not well understood. In mid-2016, the introduction of testing via a multiplex gastrointestinal PCR panel at Portsmouth hospital laboratory in Hampshire, UK, resulted in a marked increase in the number of Yersinia cases identified locally.Aim. Here we describe the epidemiology and microbiology of Yersinia cases identified at Portsmouth laboratory following the introduction of PCR testing.Methodology. A case was defined as a person with a stool specimen in which Yersinia was detected by PCR and/or culture at Portsmouth NHS Trust laboratory between 1 January 2014 and 31 December 2018. A case list was created from laboratory data submitted by Portsmouth laboratory to Public Health England (PHE), updated with speciation and serotyping data from the PHE reference laboratory. Descriptive analysis was performed.Results. Over 30 months following introduction of PCR testing, 199 cases were confirmed with Yersinia, compared to two cases in the preceding 30 months. This corresponds to a rate of 13.8 and 0.1 per 100 000 population per year respectively (P<0.0001). In total, 85% of tested isolates were Y. enterocolitica, belonging to multiple serotypes, and the rest belonged to a range of Y. enterocolitica-like species.Conclusions. Introduction of PCR testing led to the identification of a previously unrecognized burden of yersiniosis in Hampshire. The diversity of species and serotypes suggests heterogeneity in sources and transmission routes. Further research on exposures, risk factors and clinical sequalae is needed to improve our understanding of the clinical and public health impact.


Assuntos
Surtos de Doenças , Gastroenterite/epidemiologia , Yersiniose/epidemiologia , Yersinia enterocolitica/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Inglaterra/epidemiologia , Feminino , Gastroenterite/microbiologia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Saúde Pública , Yersiniose/microbiologia , Yersinia enterocolitica/genética , Adulto Jovem
8.
BMC Public Health ; 20(1): 25, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31914962

RESUMO

BACKGROUND: A large number of students at a school in Guangzhou city developed a sudden onset of symptoms of diarrhea and vomiting. To help control the outbreak, we conducted an epidemiological investigation to determine the causative agent, sources, role of transmission and risk factors of the infections. METHODS: The study population consisted of probable and confirmed cases. An active search was conducted for cases among all students, teachers and other school staff members. A case control study was carried out using standardized online questionnaires. Data were obtained regarding demographic characteristics, gastrointestinal symptoms, personal hygiene habits, history of contact with a person who had diarrhea and/or vomiting and dining locations during the past 3 days. Rectal swabs or stool samples of the cases and, food handlers, as well as environmental samples were collected to detect potential intestinal viruses and bacteria. We calculated odds ratios and 95% confidence intervals (CIs). RESULTS: A total of 157 individuals fit the definition of a probable case, including 46 with laboratory-confirmed norovirus infection between March 8 and March 22, 2018. The proportion of students who had eaten delivery food 3 days before the onset of illness in the case group was 2.69 times that in the control group (95%CI: 1.88-3.85). Intake of take-out food 3 days earlier, and exposure to similar cases 72 h before onset and case in the same dormitory were risk factors. A total of 20 rectal swab samples from students, 10 rectal swabs from food handlers and 2 environmental swab samples from the out-campus restauranttested positive for norovirus (GII, genogroup II strain). CONCLUSIONS: We investigated an outbreak of norovirus infectious diarrhea. Food handling practices carry potential risk of acute gastroenteritis outbreaks owing to a lack of surveillance and supervision. Greater attention should be paid to the monitoring and supervision of food handlers in off campus restaurant to reduce the incidence of norovirus-related acute gastroenteritis associated with delivery food.


Assuntos
Infecções por Caliciviridae/epidemiologia , Surtos de Doenças , Doenças Transmitidas por Alimentos/epidemiologia , Gastroenterite/epidemiologia , Gastroenterite/virologia , Restaurantes , Instituições Acadêmicas , Adolescente , Estudos de Casos e Controles , China/epidemiologia , Diarreia/epidemiologia , Diarreia/virologia , Feminino , Manipulação de Alimentos , Genótipo , Humanos , Masculino , Norovirus/genética , Norovirus/isolamento & purificação , Estudantes/estatística & dados numéricos , Vômito/epidemiologia , Vômito/virologia , Adulto Jovem
10.
Food Microbiol ; 85: 103280, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31500706

RESUMO

Listeria monocytogenes causes severe diseases in humans, including febrile gastroenteritis and systemic infections that has a high mortality despite antibiotic treatment. This pathogen may cause massive outbreaks associated to the consumption of contaminated food products, which highlight its importance in public health. In the last decade, L. monocytogenes has emerged as a foodborne pathogen of major importance in Chile. A previous work showed that in Chile during 2008 and 2009, L. monocytogenes serotypes 1/2a, 1/2b and 4b were the most frequently identified in food and clinical strains. Here we report the molecular characterization of L. monocytogenes strains isolated from 2008 to 2017 in the country. Our results indicate that serotypes 1/2a, 1/2b and 4b continue to be the most commonly found in food products. In addition, we identify persistent and widespread PFGE subtypes. This study reports ten years of epidemiological surveillance ofL. monocytogenes in Chile.


Assuntos
Monitoramento Epidemiológico , Microbiologia de Alimentos , Doenças Transmitidas por Alimentos/epidemiologia , Listeria monocytogenes/genética , Listeriose/epidemiologia , Chile/epidemiologia , Contagem de Colônia Microbiana , DNA Bacteriano/genética , Surtos de Doenças , Doenças Transmitidas por Alimentos/microbiologia , Gastroenterite/epidemiologia , Gastroenterite/microbiologia , Variação Genética , Humanos , Listeria monocytogenes/patogenicidade , Produtos da Carne/microbiologia , Epidemiologia Molecular , Saúde Pública , Sorogrupo , Sorotipagem , Fatores de Virulência/genética
11.
Int J Hyg Environ Health ; 223(1): 281-288, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31523016

RESUMO

Water Safety Plans (WSPs), as recommended by the World Health Organization (WHO), can help drinking water suppliers to identify potential hazards related to drinking water and enable improvements in public health outcomes. In this study we propose a procedure to evaluate the health risk related to turbidity in finished water by determining the cases of drinking water-related gastrointestinal diseases. The results of several epidemiological studies and three-year time series turbidity data, coming from three different drinking water treatment plants (WTPs) located in Tuscany (Italy), have been used to determine the relationship between drinking water turbidity and gastroenteritis incidence and to assess the health risk attributable to the turbidity of tap water. The turbidity variation occurring in the treated water during the monitored period showed an incremental risk compared to the baseline value from 9% to 27% in the three WTPs. Risk reduction due to each treatment step was also evaluated and it was found that a complete treatment train (clari-flocculation, sand filtration, activated carbon filtration and multi-step disinfection) reduces risk by over 600 times. Our approach is a useful tool for water suppliers to quantify health risks by considering time series data on turbidity at WTPs and to make decisions regarding risk management measures.


Assuntos
Água Potável/microbiologia , Gastroenteropatias/epidemiologia , Purificação da Água/métodos , Desinfecção , Filtração , Gastroenterite/epidemiologia , Humanos , Itália , Medição de Risco , Gestão de Riscos , Qualidade da Água/normas , Abastecimento de Água
12.
BMC Infect Dis ; 19(1): 1021, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791261

RESUMO

BACKGROUND: Currently, norovirus (NoV) is associated with one-fifth of all acute gastroenteritis (AGE) cases worldwide. The NoV GII.17_2014 variant has been associated with gastroenteritis outbreaks in several Asian countries, replacing the previously dominant Sydney 2012 variant. There is limited data about circulation of this new strain in Brazil. This study aimed to describe the phylogenetic and evolutionary characteristics of the GII.17_2014 strains in the Northern region of Brazil. METHODS: NoV was detected by enzyme immunoassay (EIA) in 645 stool samples of AGE cases that were reported in Pará and Amazonas states during 2015-2016. All positive samples were tested for NoV GI and GII by reverse transcription polymerase chain reaction (RT-PCR) and the amplicons were subjected to genome sequencing. The GII.17-positive samples were retested by PCR using different sets of designed primers, which target a highly conserved capsid gene region. Next, the amplicons were sequenced and phylogenetically analyzed using Bayesian inferences. RESULTS: Of the 645 samples tested, 208 (32.2%) tested were positive for NoV by EIA, among which 95 (45.7%) were genotyped. Among the genotyped samples, 12 (12.6%) were characterized as GII.17_2014 with the first case detected in November 2015 (1/30, 3.3%) and the others in 2016 (11/65, 16.9%). All strains found in our study were clustered in clade D (epidemic strain). The uncorrelated log-normal model estimations calculated the rate of evolution for GII-17 strains as 1.95 × 10- 3 (1.28 × 10- 3-2.63 × 10- 3). In total, 36 nucleotide changes were observed after analyzing the VP1 sequence, among which 28 occurred in the P2 region. CONCLUSIONS: These data demonstrate the evolutionary dynamics in NoV GII.17_2014 strains, which indicated high mutation rates with nucleotide substitutions and indels that are related to the elevated levels of antigenic diversity. This partly explains the increase in viral prevalence.


Assuntos
Infecções por Caliciviridae/virologia , Evolução Molecular , Gastroenterite/virologia , Tipagem Molecular , Norovirus/classificação , Norovirus/genética , Brasil/epidemiologia , Infecções por Caliciviridae/epidemiologia , Proteínas do Capsídeo/genética , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/virologia , Surtos de Doenças , Epidemias , Fezes/virologia , Gastroenterite/epidemiologia , Genótipo , Humanos , Tipagem Molecular/métodos , Filogenia , Prevalência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Virologia/métodos
13.
BMC Infect Dis ; 19(1): 1018, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791267

RESUMO

BACKGROUND: Although, India has made steady progress in reducing deaths in children younger than 5 years, the proportional mortality accounted by diarrhoeal diseases still remains high. The present hospital based cross sectional study was carried out to understand the prevalence of various bacterial pathogens associated with the diarrhoea cases in under 5 years age group. METHODS: During, 1st September, 2015 to 30th November 2017, all the childhood diarrhoea cases (≤5 yrs) of SCB Medical College in Odisha, India were included in the study. Stool samples were collected and processed for the isolation of causative bacterial pathogen and the isolated bacterial pathogens were subjected to antibiotic sensitivity testing, molecular analysis of drug resistance. Clinical and demographic data were collected and analyzed. RESULTS: Three hundred twenty patients were enrolled in the study during the study period from whom 82 bacterial isolates were obtained indicating a proportional causality of 25.6% for bacterial diarrhoea among children in this region. Entero toxigenic E.coli (ETEC) accounted for majority of the cases and and more than 50% of the strains were found to be multi-drug resistant (resistant to more than 3 class of antibiotics). More than 50% of the strains were resistant to current choice of treatment like ciprofloxacin, ofloxacin and ceftriaxone and 2.4% being resistant to Imipenem. ESBL production was also observed in some of the strains and one isolate harboured the NDM-1 gene. Fluoroquinolone resistance was found to be linked with multiple mutations in the QRDR region followed by PMQR determinants. CONCLUSION: The current study, to the best of our knowledge is first of its kind which demonstrated the etiology of bacterial diarrhoea in children less than 5 years old and identified diarrheogenic E. coli as the predominant enteropathogen in Odisha. Majority of the isolates being multi-drug resistance calls for a continuous surveillance system in the region which will be helpfulin identifying emerging resistance pattern and for developing suitable intervention stategies.


Assuntos
Infecções Bacterianas/diagnóstico , Infecções Bacterianas/microbiologia , Diarreia/diagnóstico , Diarreia/etiologia , Resistência Microbiana a Medicamentos/genética , Tipagem Molecular/métodos , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/epidemiologia , Pré-Escolar , Ciprofloxacino/uso terapêutico , Estudos Transversais , Diarreia/epidemiologia , Diarreia/microbiologia , Resistência Microbiana a Medicamentos/efeitos dos fármacos , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Feminino , Fluoroquinolonas/uso terapêutico , Gastroenterite/diagnóstico , Gastroenterite/tratamento farmacológico , Gastroenterite/epidemiologia , Gastroenterite/microbiologia , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Testes de Sensibilidade Microbiana , Técnicas de Diagnóstico Molecular/métodos , Prevalência , Centros de Atenção Terciária
14.
Pan Afr Med J ; 33: 269, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693717

RESUMO

Rotaviruses are one of the leading etiological agents of gastroenteritis in young children, for which a monovalent G1P(8) vaccine has been provided for free in Kenyan since July 2014. The main objective was to estimate the post vaccine prevalence and seasonal distribution of rotavirus diarrhea in children less than 5 years in Nairobi County, Kenya. Rotavirus positive samples were collected from children below 5 years of age in two hospitals within Nairobi County where vaccination status was card-confirmed. The children were examined and the demographic and clinical profiles of the children were recorded. Fecal specimens were analyzed for rotavirus antigen using an ELISA kit, followed by characterization by PAGE. Out of the total 323 samples, 49 had detectable rotavirus infection, representing 15.2% prevalence. Age distribution of rotavirus prevalence was as follows: ≤ 6 months-8.5%, 7-12 months-27.4%, 13-24 months - 41.4%, 25-36 months - 16.4% while 36-65 months had 6.3%. Rotavirus diarrhea was more common in wet and cold months of the year, the highest prevalence being observed in August (24.5%), 12.3% in both July and March, while April scored a prevalence of 10.2%. Out of the 49 rotavirus positive children, 48 had vomiting and abdominal cramps while all had fever and watery stool. The prevalence of Rotaviral diarrhea in children less than 5 years in Nairobi County Kenya has greatly reduced following the vaccine introduction and is more common during the wet and cold seasons of the year.


Assuntos
Diarreia/epidemiologia , Gastroenterite/epidemiologia , Infecções por Rotavirus/epidemiologia , Vacinas contra Rotavirus/administração & dosagem , Distribuição por Idade , Pré-Escolar , Diarreia/virologia , Feminino , Gastroenterite/virologia , Humanos , Lactente , Quênia/epidemiologia , Masculino , Prevalência , Infecções por Rotavirus/prevenção & controle , Estações do Ano
15.
Pediatrics ; 144(6)2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31694979

RESUMO

BACKGROUND: Ondansetron is an effective antiemetic employed to prevent vomiting in children with gastroenteritis in high-income countries; data from low- and middle-income countries are sparse. METHODS: We conducted a randomized, double-blind, placebo-controlled superiority trial in 2 pediatric emergency departments in Pakistan. Dehydrated children aged 6 to 60 months with ≥1 diarrheal (ie, loose or liquid) stool and ≥1 vomiting episode within the preceding 4 hours were eligible to participate. Participants received a single weight-based dose of oral ondansetron (8-15 kg: 2 mg; >15 kg: 4 mg) or identical placebo. The primary outcome was intravenous administration of ≥20 mL/kg over 4 hours of an isotonic fluid within 72 hours of random assignment. RESULTS: All 918 (100%) randomly assigned children completed follow-up. Intravenous rehydration was administered to 14.7% (68 of 462) and 19.5% (89 of 456) of those administered ondansetron and placebo, respectively (difference: -4.8%; 95% confidence interval [CI], -9.7% to 0.0%). In multivariable logistic regression analysis adjusted for other antiemetic agents, antibiotics, zinc, and the number of vomiting episodes in the preceding 24 hours, children administered ondansetron had lower odds of the primary outcome (odds ratio: 0.70; 95% CI, 0.49 to 1.00). Fewer children in the ondansetron, relative to the placebo group vomited during the observation period (difference: -12.9%; 95% CI, -18.0% to -7.8%). The median number of vomiting episodes (P < .001) was lower in the ondansetron group. CONCLUSIONS: Among children with gastroenteritis-associated vomiting and dehydration, oral ondansetron administration reduced vomiting and intravenous rehydration use. Ondansetron use may be considered to promote oral rehydration therapy success among dehydrated children in low- and middle-income countries.


Assuntos
Antieméticos/administração & dosagem , Desidratação/tratamento farmacológico , Desidratação/epidemiologia , Serviço Hospitalar de Emergência , Ondansetron/administração & dosagem , Administração Oral , Pré-Escolar , Desidratação/diagnóstico , Método Duplo-Cego , Feminino , Hidratação/métodos , Gastroenterite/diagnóstico , Gastroenterite/tratamento farmacológico , Gastroenterite/epidemiologia , Humanos , Lactente , Masculino , Paquistão/epidemiologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-31610774

RESUMO

An outbreak of Salmonella enterica serovar Typhimurium with closely related Multiple Locus Variable-number Tandem Repeat Analysis (MLVA) patterns was detected by routine surveillance by the Australian Capital Territory Health Protection Service in May 2018. The outbreak consisted of three cases in 2018 (MLVA 03-10-10-09-496) and one in 2016 (MLVA 03-10-09-09-496), who reported eating home-cooked eggs from the same local producer. Environmental investigations found significant problems with egg cleaning, hand hygiene and documentation of food safety procedures on farm. Environmental samples collected from the farm were found to have the same MLVA pattern as the 2018 cases. Although poor farm practices most likely led to contamination of the eggs, this outbreak highlights the need for consumer education about safe handling of eggs in the home.


Assuntos
Ovos/microbiologia , Infecções por Salmonella/epidemiologia , Infecções por Salmonella/microbiologia , Adolescente , Adulto , Território da Capital Australiana/epidemiologia , Criança , Surtos de Doenças , Monitoramento Ambiental , Feminino , Microbiologia de Alimentos , Gastroenterite/epidemiologia , Gastroenterite/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Repetições Minissatélites , Saúde Pública , Salmonella typhimurium , Sorogrupo , Adulto Jovem
17.
Arch Virol ; 164(12): 2985-2993, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31570995

RESUMO

Human adenovirus (HAdV) and human astrovirus (HAstV) are common causes of gastroenteritis. Data on the prevalence and diversity of enteric viruses are important for control and preventive measures. However, epidemiological information regarding HAdV and HAstV infections in Ethiopia are limited. Fecal specimens were collected from 450 outpatient diarrheic infants and young children in Gondar and Bahir Dar from November 2015 to April 2016. Socio-demographic information was recorded. All fecal specimens were screened for the presence of HAdV and classical HAstV using PCR. Genotyping was performed by sequencing and phylogenetic analysis. Human HAdV and HAstV were detected in 144 (32%) and 16 (3.6%) of the children, respectively. Overall, 182 different adenovirus genotypes were detected, including mixed infections. Species F adenoviruses (HAdV-40, HAdV-41) were less common than other adenoviruses (HAdV-1, -2, -3, -5,-12, -16, -31, species D types) with a frequency of 32 versus 150, respectively. The HAstV genotypes were classified as HAstV-8 (n = 10), HAstV-1 (n = 3), HAstV-2 (n = 3), and HAstV-3 (n = 1). HAstV was detected only in Gondar. Thirty-eight coinfections HAdV and one HAstV coinfections were detected. There was no significant difference in the detection rate of HAdV and HAstV between boys and girls. The detection rates also did not differ between children from rural and urban areas. Children under 6 months of age, were less often infected with both viruses. These findings suggest that HAdV and HAstV are common in children with diarrhea in Ethiopia.


Assuntos
Infecções por Adenoviridae/virologia , Adenovírus Humanos/genética , Infecções por Astroviridae/virologia , Gastroenterite/virologia , Mamastrovirus/genética , Doença Aguda/epidemiologia , Infecções por Adenoviridae/epidemiologia , Adenovírus Humanos/classificação , Adenovírus Humanos/isolamento & purificação , Adolescente , Adulto , Infecções por Astroviridae/epidemiologia , Criança , Pré-Escolar , Etiópia/epidemiologia , Feminino , Gastroenterite/epidemiologia , Variação Genética , Genótipo , Humanos , Lactente , Masculino , Mamastrovirus/classificação , Mamastrovirus/isolamento & purificação , Pessoa de Meia-Idade , Filogenia , Adulto Jovem
18.
Medicine (Baltimore) ; 98(40): e17269, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577718

RESUMO

This study examined the characteristics of norovirus (NoV) gastroenteritis associated with convulsions in children and its molecular epidemiology. From July 2006 through December 2015, NoV infection was confirmed by the genome detection using reverse transcriptase polymerase chain reaction. Viral genotyping with strain validation was achieved using sequence analyses with Basic Local Alignment Search Tool genome identification. The patients' clinical features were assessed retrospectively, focusing on convulsive disorders. The diagnosis of encephalitis followed the International Encephalitis Consortium. Seizures occurred in 52 (20.9%) of 249 NoV infections. GII.4 Den_Haag_2006b (n = 22, 42.3%) and GII.4 Sydney 2012 (n = 10, 19.2%) were major variants correlated with convulsions. Patient with convulsions tend to have GII.4 genotype infection (P < .001), short vomiting (≤2 days) (P < .001), and no fever (P = .002). Compared to GII.4 Den_Haag_2006b, the GII.4 Sydney 2012-associated convulsions had similar manifestations except without significant winter preponderance (P = .049). The NoV infection with convulsions had less febrile course, specific genotype (GII.4) infections, and with shorter symptom of vomiting. Continuous surveillance is important for uncommon disease associated with emerging NoV strain infections. The prevention of NoV diseases requires the development of vaccines targeting highly virulent variants.


Assuntos
Infecções por Caliciviridae/epidemiologia , Infecções por Caliciviridae/genética , Gastroenterite/epidemiologia , Convulsões/epidemiologia , Adolescente , Criança , Pré-Escolar , Encefalite/epidemiologia , Feminino , Febre/epidemiologia , Gastroenterite/virologia , Genótipo , Humanos , Lactente , Masculino , Epidemiologia Molecular , RNA Viral/genética , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Estações do Ano , Análise de Sequência de DNA , Taiwan/epidemiologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-31627449

RESUMO

BACKGROUND: Food safety is a major public health consideration during athletic events. On 27 June 2019, the Hellenic National Public Health Organization was notified of a cluster of gastroenteritis cases among athletes of four of the 47 teams participating at the Panhellenic Handball Championship for children. METHODS: A retrospective cohort study among the members of the four teams was performed. The local public health authority visited the restaurants where common meals took place, amassed information on the preparation of meals, and collected samples of leftovers. Stool samples were tested for Salmonella spp. and Shigella spp. RESULTS: Consumption of minced beef had a statistically significant association with disease occurrence [RR:8.29 (95%CI 1,31-52,7)]. Samples of meat were found positive for Clostridium perfringens. It was documented that the meat was not stored and re-heated as indicated. Stool samples were negative for Salmonella spp. and Shigella spp. and were not tested for the Clostridium perfringens toxin. CONCLUSION: Specific standards should be kept to prevent outbreaks during athletic events. This was the first time that a foodborne outbreak due to Clostridium perfringens was investigated in the country. Laboratory investigation for toxins should be enhanced, especially in foodborne outbreaks where clinical manifestations of cases are found to be compatible with infection caused by a toxin.


Assuntos
Infecções por Clostridium/epidemiologia , Clostridium perfringens , Surtos de Doenças , Inocuidade dos Alimentos , Esportes , Animais , Bovinos , Criança , Fezes/microbiologia , Feminino , Doenças Transmitidas por Alimentos/epidemiologia , Gastroenterite/epidemiologia , Grécia/epidemiologia , Humanos , Masculino , Carne/microbiologia , Restaurantes , Estudos Retrospectivos
20.
BMC Infect Dis ; 19(1): 910, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664944

RESUMO

BACKGROUND: On September 4, 2018, a boarding school in the Shunyi District of Beijing, China reported an outbreak of acute gastroenteritis. At least 209 suspected students caused of diarrhea and vomiting. The case was investigated, and control measures were taken to prevent further spread. METHODS: A retrospective cohort study was conducted among the school students and staff in order to test hypothesis that high risk of food served at the school canteen. We collected information on demographics, refectory records, person to person transmission by uniform epidemiological questionnaire. Risk ratios (RR) and 95% confidence intervals (CI) were calculated. Stool specimens of cases and canteen employees, retained food, water, and environmental swabs were investigated by laboratory analysis. RESULTS: We identified 209 cases (including 28 laboratory-confirmed cases) which occurred from August 29 to September 10. All cases were students, and the average age was 20, 52% were male. The outbreak lasted for 13 days, and peaked on September 5. Consumption of Drinks stall and Rice flour stall on September 1 (RR:3.4, 95%CI:1.5-7.8, and RR:7.6, 95%CI:2.8-20.2), Rice flour stall and Fish meal stall on September 2 (RR:4.0, 95%CI:1.2-13.6, and RR:4.6, 95%CI:1.7-12.5), muslim meal stall on September 4 (RR:2.7, 95%CI:1.3-5.4), Barbeque stall on September 5 (RR:3.0, 95%CI:1.2-7.0) were independently associated with increased risk of disease within the following 2 days. Among 35 specimens of rectal swabs or feces from students, 28 specimens were positive. Norovirus GI.6 alone was detected in 23 specimens, Bacillus cereus alone in 3 specimens and both norovirus GI.6 and Bacillus cereus in 2 specimens. Ten specimens of rectal swabs from canteen employees were positive for norovirus GI, and 2 specimens were positive for Bacillus cereus. Four retained food specimens were positive for Bacillus cereus, and environmental samples were negative for any viruses or bacteria. CONCLUSION: Our investigation indicated that canteen employees were infected by two pathogens (norovirus and Bacillus cereus) and transmission may have been possible due to unhygienic practices. Student consumption of food or drink at high-risk stalls was determined as the probable cause of the outbreak.


Assuntos
Bacillus cereus/isolamento & purificação , Infecções por Caliciviridae/epidemiologia , Surtos de Doenças , Doenças Transmitidas por Alimentos/microbiologia , Gastroenterite/epidemiologia , Norovirus/isolamento & purificação , Adolescente , Pequim/epidemiologia , Infecções por Caliciviridae/complicações , Diarreia/complicações , Fezes/microbiologia , Fezes/virologia , Feminino , Contaminação de Alimentos , Doenças Transmitidas por Alimentos/virologia , Gastroenterite/complicações , Higiene das Mãos , Humanos , Masculino , Razão de Chances , Estudos Retrospectivos , Inquéritos e Questionários , Universidades , Vômito/complicações , Adulto Jovem
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