诺罗病毒是流行性肠胃炎最常见的病因,在全球范围内,至少有50%的肠胃炎爆发,和食源性疾病的主要原因。在美国,据估计,每年约有2100万例由诺如病毒引起的疾病发生。自2001年以来,最新的诺如病毒建议发表(CDC。\"类似诺沃克的病毒。“公共卫生后果和疫情管理。MMWR2001;50[编号RR-9]),诺如病毒流行病学取得了实质性进展,免疫学,诊断方法,和感染控制。随着分子诊断技术性能的提高和越来越广泛的应用,诺如病毒爆发的检测和报告有所增加。尽管无法在体外培养人类诺如病毒阻碍了进展,新发现促进了对消毒剂性能的评估,人类诺如病毒的可培养替代品。此外,流行菌株的周期性出现(来自基因组II型4,GII.4)和特定人群的爆发(例如,养老院中的老年人)具有特色。本报告回顾了这些最新进展,并为疫情管理和疾病预防提供了指导方针。这些建议旨在供调查急性肠胃炎爆发的公共卫生专业人员使用,包括州和地方卫生当局,以及学术和研究机构。
Noroviruses are the most common cause of epidemic gastroenteritis, responsible for at least 50% of all gastroenteritis outbreaks worldwide, and a major cause of foodborne illness. In the United States, approximately 21 million illnesses attributable to
norovirus are estimated to occur annually. Since 2001, when the most recent
norovirus recommendations were published (CDC. \"Norwalk-like viruses.\" Public health consequences and outbreak management. MMWR 2001;50[No. RR-9]), substantial advances have been made in
norovirus epidemiology, immunology, diagnostic methods, and infection control. As molecular diagnostic techniques have improved in performance and become more widely available, detection and reporting of
norovirus outbreaks have increased. Although the inability to culture human noroviruses in vitro has hampered progress, assessment of the performance of disinfectants has been facilitated by the discovery of new, cultivable surrogates for human noroviruses. In addition, the periodic emergence of epidemic strains (from genogroup II type 4, GII.4) and outbreaks in specific populations (e.g., the elderly in nursing homes) have been characterized. This report reviews these recent advances and provides
guidelines for outbreak management and disease prevention. These recommendations are intended for use by public health professionals investigating outbreaks of acute gastroenteritis, including state and local health authorities, as well as academic and research institutions.