25 KB106 KB22 KB192920262003Barlič-Maganja, DarjaLanjšček, MajdaPetraš, TeodoraPoljšak-Prijatelj, MatejaŠtrumbelj, IztokZimšek, Janetštevilka:5letnik:72str. 279-282ISSN:1318-0347COBISSID:16299225URN:URN:NBN:SI:doc-6IFTBE1WslSlovensko zdravniško društvoZdravniški vestnikCaliciviridaeCaliciviridae InfectionsDiagnosisDisease Outbreaksdomovi za stare ljudiDomovi za starostnikeepidemijaEpidemijeEpidemiologyEtiologyGastroenteritisHomes For The AgedIsolation And PurificationKaliciviridne infekcijeMicroscopy, ElectronMikroskopija elektronskaPolimerazna, verižna reakcijaPolymerase Chain ReactionPrevention And Controlvirusne infekcijeS kalicivirusi povzročena epidemija gastroenteritisa v domu za starejše osebe| Human calicivirus outbreak of acute gastroenteritis in an aged-care facility|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 2002already 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 questionnaireand 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 detectcaliciviruses. 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 Hawaiivirus) andgenetic cluster 4 (closely related to thelordsdale virus)Izhodišča. Človeški kalicivirusi, povzročitelji črevesnih okužb, predstavljajogenetsko 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 virusnegagastroenteritisa, povzročenega s kalicivirusi. Do novembra 2002 je bilo potrjenih že 574 primerov. Do sedaj so bili kalicivirusi pri nas dokazanipredvsem 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 kasnejein 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)TEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo