Author/Editor		Štrumbelj, Iztok; Poljšak-Prijatelj, Mateja; Petraš, Teodora; Zimšek, Janet; Lanjšček, Majda; Barlič-Maganja, Darja
Title		S kalcivirusi povzročena epidemija gastroenteritisa v domu za starejše osebe
Translated title		Human calcivirus outbreak of acute gastroenteritis in an aged-care facility
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. 5
Publication year		2003
Volume		str. 279-82
Language		slo
Abstract		Background. Human caliciviruses represent a genetically and antigenetically diverse group of single stranded RNA viruses associated with acute gastroenteritis in humans. In last two years the number of notified gastroenteric cases in Slovenia is increasing. From January till November 2002 already 574 calicivirus cases have been confirmed. Majority of cases were observed in preschool and school children but no cases were described in the aged-care facility. Methods. An outbreak of gastroenteritis in an aged-care facility occured. After onset of the outbreak an epidemiological questionnaire and inspection of local conditions were realized. Stool samples from home residents were analysed to find out bacteriological and/or viral aetiology. Direct electron microscopy and RT-PCR assay was performed to detect caliciviruses. Viral RNA was amplified using specific primers and PCR products were identified in hybridisation test. Results. The outbreak started suddenly on the second floor, where the attack rate was the highest On the other floors the illness started later and the attack rate was lower. Sixty-one (40,1%) residents from 152 became ill and additionally 15 (22, 4%) employees from 67. The outbreak ended after ten days. Electron microscopy or/and RT-PCR revealed Norovirus members of family Caliciviridae in 9 of 10 stool specimens. As determined by RT-PCR and hybridisation assay viruses corresponded to genogroup II, genetic cluster 1 (closely related to the Hawaii virus) andgenetic cluster 4 (closely related to thelordsdale virus).
Summary		Izhodišča. Človeški kalicivirusi, povzročitelji črevesnih okužb, predstavljajo genetsko in antigensko raznoliko skupino virusov s pozitivno usmerjeno enovijačno RNK Po podatkih lnštituta za varovanje zdravja v Sloveniji v zadnjih dveh letih narašča število prijavljenih epidemij virusnega gastroenteritisa, povzročenega s kalicivirusi. Do novembra 2002 je bilo potrjenih že 574 primerov. Do sedaj so bili kalicivirusi pri nas dokazani predvsem pri predšolskih in šolskih otrocih, epidemije pri starejših ljudeh v domovih za ostarele niso bile opisane. Metode. V prispevku prikazujemo epidemijo gastroenteritisa v domu za starejše osebe, ki smo jo obravnavali z epidemiološkimi metodami poizvedovanja, anketiranja in pregleda na kraju samem. Z bakteriološkimi in virološkimi metodami smo iskali različne povzročitelje. Kaliciviruse smo dokazovali z metodo neposredne elektronske mikroskopije, izvedli verižno reakcijo s polimerazo s predhodno reverzno transkripcijo (RTPCR) in produkte RT-PCR potrdili s hibridizacijo. Rezultati: Epidemija se je začela eksplozivno v drugem nadstropju doma, kjer je zbolelo največ oskrbovancev, v ostalih nadstropjih doma so se bolezni pojavile kasneje in v manjšem številu. Skupaj je zbolelo 61(40,1%) od 152 oskrbovancev doma in 15 (22,490) od 67 zaposlenih. Uvedeni so bili ukrepi za preprečevanje širjenja bolezni. Epidemija je bila zaključena deseti dan. Kaliciviruse (rod norovirusov) smo našli v devetih iztrebkih od desetih pregledanih. Z metodo RT-PCR in hibridizacije z gensko specifičnimi sondami smo potrdili noroviruse genske skupine GG 11, genskega svežnja 1 (virus Hawaii) in genskega svežnja 4 (virus Lordsdale).
Descriptors		HOMES FOR THE AGED GASTROENTERITIS DISEASE OUTBREAKS CALICIVIRIDAE INFECTIONS MICROSCOPY, ELECTRON CALICIVIRIDAE POLYMERASE CHAIN REACTION