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本帖最后由 jerkran 于 2024-6-19 09:01 编辑
Norovirus infections generally have a shorter incubation period and are characterised by acute onset of nausea, vomiting, abdominal pain and diarrhoea [96]. The mean duration of symptoms is two-three days.
诺如病毒感染的潜伏期通常较短，其特征是急性发作的恶心、呕吐、腹痛和腹泻[96]。症状的平均持续时间为两到三天。
Maximum viral shedding occurs between 24 and 48 hours after exposure, so it is good practice for healthcare workers to be excluded for 48 hours after the resolution of symptoms. Clearance of norovirus is not practical or beneficial as viral excretion can persist for multiple days.
病毒脱落最多发生在暴露后 24 至 48 小时之间，因此医护人员在症状消退后 48 小时内被排除在外是一种很好的做法。清除诺如病毒既不切实际也不有益，因为病毒排泄可以持续数天。
There is evidence to suggest that shedding of norovirus may continue to occur for more than 21 days after the resolution of symptoms. However, no data has been reported on ongoing transmission or secondary cases.
有证据表明，诺如病毒的脱落可能在症状消退后持续发生超过 21 天。然而，目前尚无关于持续传播或继发病例的数据报告。
Norovirus epidemiology 诺如病毒流行病学
Norovirus is the most frequently occurring cause of community-acquired acute gastroenteritis in people of all ages. It is one of the most common causes of outbreaks in healthcare settings, affecting both long-term care facilities and acute care hospitals [115].
诺如病毒是所有年龄段人群中社区获得性急性胃肠炎最常见的病因。它是医疗机构暴发的最常见原因之一，影响长期护理机构和急症护理医院[115]。
Norovirus belongs to the family Caliciviridae and are a single-stranded RNA, non-enveloped virus that can cause gastroenteritis in humans [118]. Noroviruses are divided into at least six genogroups (GI-GVI) and further subdivided into more than 38 genotypes based on phylogenetic analysis of the major capside protein [118] [122]. Currently, human noroviruses belong to one of three norovirus genogroups which are further divided into more than 25 genetic clusters [119].
诺如病毒属于杯状病毒科，是一种单链RNA、无包膜病毒，可引起人类胃肠炎[118]。诺如病毒被分为至少6个基因型（GI-GVI），并根据主要衣苷蛋白的系统发育分析进一步细分为超过38个基因型[118][122]。目前，人类诺如病毒属于三个诺如病毒基因群之一，这些基因群进一步分为超过25个基因簇[119]。
Human noroviruses cannot be grown in cell culture [123], therefore, diagnostic methods focus on detecting viral RNA or antigen. 人类诺如病毒不能在细胞培养中生长[123]，因此诊断方法侧重于检测病毒RNA或抗原。
Transmission pathways 传播途径
Transmission for norovirus infections in healthcare settings mainly occur by the faecal–oral route, either through person to person contact or through exposure to contaminated food. Whilst some observational studies have suggested there is a possibility of viral transmission via aerosols, there is no data or determination criteria to support this assumption. It appears that Genotype GII.4 is more often associated with transmission mediated by person-to‑person contact than with other types of transmission.
在医疗机构中，诺如病毒感染的传播主要通过粪-口途径传播，即通过人与人之间的接触或接触受污染的食物。虽然一些观察性研究表明病毒有可能通过气溶胶传播，但没有数据或确定标准支持这一假设。与其他类型的传播相比，基因型GII.4似乎更常与人与人接触介导的传播有关。
Individuals may shed norovirus more than 21 days after the resolution of symptoms, possibly acting as a possible source for nosocomial transmission. However no data has been reported on ongoing transmission or secondary cases.
个体可能在症状消退后 21 天以上排出诺如病毒，这可能是院内传播的可能来源。然而，没有关于持续传播或继发病例的数据报告。
Healthcare workers should not be at work from symptom onset until 48 hours after symptom resolution. On returning to the healthcare facility, healthcare workers should adhere to appropriate hand hygiene practices.
医护人员从症状出现到症状消退后 48 小时才应上班。返回医疗机构后，医护人员应遵守适当的手部卫生习惯。
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发表于 2024-6-19 08:58
发表于 2024-6-19 09:08
