Karakteristike norovirusne infekcije u Srbiji

  • Tijana Relić Institute of Public Health of Belgrade, Belgrade, Serbia
  • Ivana Begović-Lazarević Institute of Public Health of Belgrade, Belgrade, Serbia
  • Nevenka Pavlović Institute of Public Health of Belgrade, Belgrade, Serbia
  • Nevenka Ilić Institute of Public Health of Kragujevac, Kragujevac, Serbia
  • Hranislav Kačarević Institute of Public Health of Belgrade, Belgrade, Serbia
  • Dara Jovanović Institute of Public Health of Belgrade, Belgrade, Serbia
  • Gordana Kostić Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia
  • Ivana Lazarević Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
DOI: https://doi.org/10.2298/5431
Ključne reči: norovirus||, ||norovirus, gastroenteritis||, ||gastroenteritis, incidence||, ||incidenca, risk assessment||, ||rizik, procena, disease outbreaks||, ||epidemije, serbia||, ||srbija,

Sažetak


Uvod/Cilj. Norovirus (NoV), raniji naziv virus koji je sličan Norwalk virusu, najčešći je uzročnik akutnog gastroenteritisa kod ljudi svih starosnih doba. Poznato je da je 90% virusnih gastroenteritisa i oko 60–85% svih epidemija gastroenteritisa uzrokovano ovim virusom, posebno na teritoriji Sjedinjenih Američkih Država, Evrope i Japana. Za zemlje severne hemisfere, norovirusne epidemije i pojedinačni slučajevi akutnog gastroenteritisa pokazuju sezonski obrazac pojavljivanja, uglavnom tokom zimskih meseci. Cilj ovog rada bio je da se opišu karakteristike akutnog gastroenteritisa sa utvrđenom norovirusnom etiologijom kod bolesnika u Srbiji. Metode. Studijskom grupom bilo je obuhvaćeno 88 bolesnika sa simptomima akutnog gastroenteritisa tokom 2010. i 2011. godine. Od svih bolesnika, uzimani su uzorci stolice najviše tri dana od pojave simptoma infekcije. Za otkrivanje NoV u uzorcima stolice korišćen je komercijalni kvalitativni imunohromatografski test. Za statističku obradu podataka korišćeni su χ2 test, Mann–Whitney U-test, Kruskal-Wallis test, Spirmanov test korelacije ranga i metode logističke regresije Rezultati. Slučajevi akutnog gastroenteritisa uzrokovanog NoV najčešće su zabaleženi kod dece, sa incidencijom od 50% u grupi od 0–15 godina starosti. Analizom simptoma kod bolesnika sa dokazanom norovirusnom infekcijom zaključeno je da je dijareja bila najčešći simptom, zatim, po učestalosti, sledilo je povraćanje, posebno kod manje dece, dok je abdominalni bol bio karakterističan za ispitanike starije od 65 godina. Prisustvo učestalog povraćanja, preko četiri puta dnevno, ukazivalo je na NoV infekciju kod žena, dok je kod muškaraca infekcija bila uvek manifestovana dijarejom. Zaključak. Rezultati istraživanja su potvrdili da su manja deca i starije osobe najosetljivije grupe za NoV infekciju i da su epidemije češće u zimskim mesecima. Bolesnici koji su se hranili u restoranima ili ustanovama za javnu ishranu nisu imali veći rizik od razvoja NoV infekcije.

Reference

Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention. Updated norovirus outbreak management and disease pre-vention guidelines. MMWR Recomm Rep 2011; 60(RR−3): 1−18.

Siebenga JJ, Vennema H, Zheng DP, Vinjé J, Lee BE, Pang XL, et al. Norovirus illness is a global problem: emergence and spread of norovirus GII.4 variants, 2001-2007. J Infect Dis 2009; 200(5): 802−12.

Patel MM, Hall AJ, Vinjé J, Parashar UD. Noroviruses: a comprehensive review. J Clin Virol 2009; 44(1): 1−8.

Vantarakis A, Mellou K, Spala G, Kokkinos P, Alamanos Y. A gastroenteritis outbreak caused by noroviruses in Greece. Int J Environ Res Public Health 2011; 8(8): 3468−78.

Lopman B, Armstrong B, Atchison C, Gray JJ. Host, weather and virological factors drive norovirus epidemiology: time-series analysis of laboratory surveillance data in England and Wales. PLoS One 2009; 4(8): e6671.

Phillips G, Tam CC, Rodrigues LC, Lopman B. Prevalence and characteristics of asymptomatic norovirus infection in the community in England. Epidemiol Infect 2010; 138(10): 1454−8.

Meakins SM, Adak GK, Lopman BA, O'Brien SJ. General outbreaks of infectious intestinal disease (IID) in hospitals, England and Wales, 1992-2000. J Hosp Infect 2003; 53(1): 1−5.

Kirk MD, Fullerton KE, Hall GV, Gregory J, Stafford R, Veitch MG, et al. Surveillance for outbreaks of gastroenteritis in long-term care facilities, Australia, 2002-2008. Clin Infect Dis 2010; 51(8): 907−14.

Atmar RL, Opekun AR, Gilger MA, Estes MK, Crawford SE, Neill FH, et al. Norwalk virus shedding after experimental human infection. Emerg Infect Dis 2008; 14(10): 1553–7.

Phillips G, Lopman B, Tam CC, Iturriza-Gomara M, Brown D, Gray J. Diagnosing norovirus-associated infectious intestinal disease using viral load. BMC Infect Dis 2009; 9: 63.

Phillips G, Tam CC, Conti S, Rodrigues LC, Brown D, Iturriza-Gomara M, et al. Community incidence of norovirus-associated infectious intestinal disease in England: improved estimates using viral load for norovirus diagnosis. Am J Epi-demiol 2010; 171(9): 1014–22.

Widdowson MA, Sulka A, Bulens SN, Beard RS, Chaves SS, Hammond R, et al. Norovirus and foodborne disease, United States, 1991–2000. Emerg Infect Dis 2005; 11(9): 95–102.

Hall AJ, Curns AT, McDonald LC, Parashar UD, Lopman BA. The roles of Clostridium difficile and norovirus among ga-stroenteritis-associated deaths in the United States, 1999-2007. Clin Infect Dis 2012; 55(2): 216−23.

Pombubpa K, Kittigul L. Assessment of a rapid immunochro-matographic test for the diagnosis of norovirus gastroenteri-tis. Eur J Clin Microbiol Infect Dis 2012; 31(9): 2379–83.

Mladenova Z, Korsun N, Geonova T, Di Bartolo I, Fiore L, Ruggeri FM. Prevalence and molecular epidemiology of noroviruses detected in outbreak and sporadic cases of acute gastroenteri-tis in Bulgaria. J Med Virol 2008; 80(12): 2161−8.

Arias C, Sala MR, Domínguez A, Torner N, Ruíz L, Martínez A, et al. Epidemiological and clinical features of norovirus ga-stroenteritis in outbreaks: a population-based study. Clin Mi-crobiol Infect 2010; 16(1): 39–44.

Bernard H, Höhne M, Niendorf S, Altmann D, Stark K. Epidemi-ology of norovirus gastroenteritis in Germany 2001-2009: eight seasons of routine surveillance. Epidemiol Infect 2014; 142(1): 63−74.

Lai CC, Wang YH, Wu CY, Hung CH, Jiang DD, Wu FT. A norovirus outbreak in a nursing home: norovirus shedding time associated with age. J Clin Virol 2013; 56(2): 96−101.

Wu HM, Fornek M, Schwab KJ, Chapin AR, Gibson K, Schwab E, et al. A norovirus outbreak at a long-term-care facility: the role of environmental surface contamination. Infect Control Hosp Epidemiol 2005; 26(10): 802−10.

Goller JL, Dimitriadis A, Tan A, Kelly H, Marshall JA. Long-term features of norovirus gastroenteritis in the elderly. J Hosp Infect 2004; 58(4): 286−91.

Estes MK, Prasad BV, Atmar RL. Noroviruses everywhere: has something changed? Curr Opin Infect Dis 2006; 19(5): 467–74.

Glass RI, Parashar UD, Estes MK. Norovirus gastroenteritis. N Engl J Med 2009; 361(11): 1776−85.

Payne DC, Vinjé J, Szilagyi PG, Edwards KM, Staat MA, Weinberg GA, et al. Norovirus and medically attended gastroenteritis in U.S. children. N Engl J Med 2013; 368(12): 1121−30.

Trivedi TK, DeSalvo T, Lee L, Palumbo A, Moll M, Curns A, et al. Hospitalizations and mortality associated norovirus outbreaks in nursing homes, 2009-2010. JAMA 2012; 308(16): 1668−75.

Rohayem J. Norovirus seasonality and the potential impact of climate change. Clin Microbiol Infect 2009; 15(6): 524–7.

Lopman BA, Adak GK, Reacher MH, Brown DW. Two epide-miologic patterns of norovirus outbreaks: surveillance in England and Wales, 1992-2000. Emerg Infect Dis 2003; 9(1): 71−7.

Cannon JL, Lindesmith LC, Donaldson EF, Saxe L, Baric RS, Vinjé J. Herd immunity to GII.4 noroviruses is supported by out-break patient sera. J Virol 2009; 83(11): 5363−74.

Objavljeno
2015/07/08
Broj časopisa
Vol. 72 Br. 4 (2015)
Rubrika
Originalni članak