文摘大家译：医院内诺瓦克病毒感染爆发处理

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Clin Infect Dis. 2007 Sep 1;45(5):534-40. Epub 2007 Jul 18.  Links
Outbreak management and implications of a nosocomial norovirus outbreak.
Johnston CP, Qiu H, Ticehurst JR, Dickson C, Rosenbaum P, Lawson P, Stokes AB, Lowenstein CJ, Kaminsky M, Cosgrove SE, Green KY, Perl TM.
Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. cpark@jhmi.edu
BACKGROUND: Noroviruses are enterically transmitted and are a frequent cause of gastroenteritis, affecting 23 million people annually in the United States. We describe a norovirus outbreak and its control in a tertiary care hospital during February-May 2004. METHODS: Patients and health care workers met the case definition if they had new onset of vomiting and/or diarrhea during the outbreak period. Selected stool samples were tested for norovirus RNA. We also determined outbreak costs, including the estimated lost revenue associated with unit closures, sick leave, and cleaning expenses. RESULTS: We identified 355 cases that affected 90 patients and 265 health care workers and that were clustered in the coronary care unit and psychiatry units. Attack rates were 5.3% (7 of 133) for patients and 29.9% (29 of 97) for health care workers in the coronary care unit and 16.7% (39 of 233) for patients and 38.0% (76 of 200) for health care workers in the psychiatry units. Thirteen affected health care workers (4.9%) required emergency department visits or hospitalization. Detected noroviruses had 98%-99% sequence identity with representatives of a new genogroup II.4 variant that emerged during 2002-2004 in the United States (e.g., Farmington Hills and other strains) and Europe. Aggressive infection-control measures, including closure of units and thorough disinfection using sodium hypochlorite, were required to terminate the outbreak. Costs associated with this outbreak were estimated to be $657,644. CONCLUSIONS: The significant disruption of patient care and cost of this single nosocomial outbreak support aggressive efforts to prevent transmission of noroviruses in health care settings.

这是一篇发表在临床传染病杂志上的关于医院诺瓦克病毒感染爆发调查案例，欢迎大家参与翻译！

[ 本帖最后由 wzcdcyxh 于 2007-9-14 21:01 编辑 ]

David

ACKGROUND: Noroviruses are enterically transmitted and are a frequent cause of gastroenteritis, affecting 23 million people annually in the United States. (背景：诺如病毒通过肠道传播，是胃肠炎的常见病因，每年在美国有约230万人感染诺如病毒。)We describe a norovirus outbreak and its control in a tertiary care hospital during February-May 2004. （我们介绍一起2004年2月至5月发生在一家三级医院内的诺如病毒暴发以及相关的控制过程。）METHODS: Patients and health care workers met the case definition if they had new onset of vomiting and/or diarrhea during the outbreak period. （方法：凡在暴发期间有呕吐和/或腹泻症状的病人和医护人员均作为调查的病例。）Selected stool samples were tested for norovirus RNA. （选取粪便标本作诺如病毒RNA的检测。）We also determined outbreak costs, including the estimated lost revenue associated with unit closures, sick leave, and cleaning expenses. （我们也计算了由于感染暴发所带来的支出，包括因关闭病房，员工请病假和环境清洁的损失。）RESULTS: We identified 355 cases that affected 90 patients and 265 health care workers and that were clustered in the coronary care unit and psychiatry units. （结果：我们一共调查了355人，其中90个为病人，265个为医护人员，这些人都集中在冠心病监护室和精神病病房。）Attack rates were 5.3% (7 of 133) for patients and 29.9% (29 of 97) for health care workers in the coronary care unit and 16.7% (39 of 233) for patients and 38.0% (76 of 200) for health care workers in the psychiatry units. （在冠心病监护室内，有5.3%(133人中有7人)的病人，29.9%(97人中有29人)的医护人员感染；在精神病房内，有16.7%(233人中有39人)的病人，38.0%(200人中有76人)的医护人员感染）Thirteen affected health care workers (4.9%) required emergency department visits or hospitalization.（13名被感染的医护人员(4.9%)需要住院或由急诊科跟进。） Detected noroviruses had 98%-99% sequence identity with representatives of a new genogroup II.4 variant that emerged during 2002-2004 in the United States (e.g., Farmington Hills and other strains) and Europe. （检测出的诺如病毒有98~99%的基因序列与2002年至2004年发生在美国(例如：Farmington Hills菌株等)和欧洲的一种新的II.4型变异株相一致。）Aggressive infection-control measures, including closure of units and thorough disinfection using sodium hypochlorite, were required to terminate the outbreak. （积极的感控措施，包括关闭病房和用次氯酸钠彻底消毒，可以消除病毒暴发。）Costs associated with this outbreak were estimated to be $657,644. （这次感染暴发带来的损失估计达到657,644美元。）CONCLUSIONS: The significant disruption of patient care and cost of this single nosocomial outbreak support aggressive efforts to prevent transmission of noroviruses in health care settings.（结论：这次医院感染暴发所带来的损失以及给病人康复造成的扰乱都表明积极主动的措施才能避免医院环境中诺如病毒的传播。）:victory: :victory: :victory:

右手心

喜欢DAVID了,嘿嘿,清楚明了,谢谢!

phswany2007

大家进一步学习。