Noroviruses: agents in outbreaks of acute gastroenteritis

Thornton, Alice; Jennings-Conklin, Karen S.; McCormick, Maggie

doi:10.1016/j.dmr.2003.11.001

Cited by 43 publications

(31 citation statements)

References 22 publications

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Section: Case Definitions and Laboratory Methods: Nec Was Staged Accomentioning

confidence: 99%

“…Generally, NV infections are mild and self-limiting and diarrheal stool during NV infection is non-bloody, lacks mucus, and may be loose or watery [4,6,27]. In contrast, four of our 8 newborn infants with NV infection (50%) had bloody stools and one of them 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 10 had NEC [6]. Human noroviruses are thought to have an enteric tropism limited to the upper intestinal tract, because intestinal biopsies from volunteers revealed villous broadening and atrophy, crypt cell hyperplasia and cytoplasmic vacuolization in the jejunum and duodenum and an infiltration of polymorphonuclear and mononuclear cells into the lamina propria [28][29][30][31].…”

Section: Case Definitions and Laboratory Methods: Nec Was Staged Accomentioning

confidence: 99%

“…NV and HAstV are usually associated with cases of mild and self-limiting GE in children [3][4][5][6].…”

Section: Answermentioning

confidence: 99%

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Clinical characteristics of viral intestinal infection in preterm and term neonates

Bağcı

Eis‐Hübinger

Yassin

et al. 2010

Eur J Clin Microbiol Infect Dis

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Objectives: The clinical presentation of the viral enteric pathogens in newborn infants has not been adequately examined. The aim of this study was to evaluate the clinical characteristics of viral intestinal infections in newborn infants. Methods: Clinical data of all term and preterm infants admitted to our tertiary neonatal intensive care unit from 1998 to 2007 with clinical signs of gastroenteritis (GE) or necrotizing enterocolitis (NEC) were retrospectively reviewed and compared between infants with different viral enteric pathogens in stool specimens. Results: In thirty-four infants with signs of GE or NEC, enteropathogenic viruses were found in stool specimens. Rotavirus was detected in 12 cases, of which 2 infants had NEC. Compared with infants with rotavirus or norovirus, infants with astrovirus more frequently suffered from NEC (p<0.05). In addition, an acute systemic inflammatory response was significantly more common in patients with astrovirus infection (astrovirus vs. rotavirus and astrovirus vs. norovirus p<0.01 and p<0.05, respectively). Of 8 children infected with norovirus, one infant had a systemic acute inflammatory response and NEC. Conclusions: This study demonstrates that in newborn infants, intestinal rotavirus, norovirus, and astrovirus infections may be associated with severe illness such as hemorrhagic enteritis resulting in bloody diarrhea or even NEC. We revised our manuscript "Clinical characteristics of viral intestinal infection in preterm and term neonates" according to the reviewers' comments. You may find our comments, additions and answers below (all changes made to the manuscript text are underlined).Reviewers' Comment 1: In the Abstract, under the Objectives paragraph it is stated that "The clinical presentation of viral intestinal infections in preterm and term neonates has not been adequately evaluated". This statement is not an objective in itself. It is an observation that could be included as background or as part of the introduction. The aims of the study should be better defined. Answer 1: According the reviewers' suggestions we revised the objectives in the abstract. Because of "200 words-limit in abstract" we revised the abstract, too (all changes made to the manuscript text are underlined).Reviewers' Comment 2: In the Results section (p.2, line 19) it should be mentioned that enteropathogenic viruses were found in 34 infants out of 220 (15.45%) infants with gastroenteritis (GE) and NEC (nectotizing enterocolitis). Answer 2: According the reviewers' suggestions we changed the sentence as recommended (Page 6, p.2).Reviewers' Comment 3: Among 112 infants with gastroenteritis, enteric viruses were detected in 22 patients (19.64%), and in 12 cases (11.11%) out of 108 infants with NEC. That means that approximately only in one case out of every 10 infants suffering of NEC was an enteric virus detected. The majority of cases with RV infection (10/12) were mild and self-limiting GE, but 2 preterm infants had signs of NEC. In this study, no enteric viruses were de...

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Section: Case Definitions and Laboratory Methods: Nec Was Staged Accomentioning

confidence: 99%

Section: Case Definitions and Laboratory Methods: Nec Was Staged Accomentioning

confidence: 99%

See 1 more Smart Citation

Clinical characteristics of viral intestinal infection in preterm and term neonates

Bağcı

Eis‐Hübinger

Yassin

et al. 2010

Eur J Clin Microbiol Infect Dis

View full text Add to dashboard Cite

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“…Although there is no specific treatment, patients who develop dehydration should be treated with oral or intravenous fluid replacement. 2,18 In this outbreak, all patients were treated on outpatient settings, if necessary intravenous fluids were given. No complications or deaths were seen.…”

Section: Discussionmentioning

confidence: 99%

An outbreak of norovirus gastroenteritis in a county in Turkey

Sözen¹

2014

Jmid

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Objective: The aim of our study was to present the epidemiologic features and the measures taken during a norovirus outbreak considered to be originating from contaminated water. Methods:Medical records of patients referred to the state hospital and health centers with gastroenteritis complaints in April 2010 were evaluated retrospectively. In addition, the data about the possible origin of the outbreak were also evaluated. Fifty patients were randomly selected, and a questionnaire containing epidemiological and clinical questions was applied.Results: During 13 days (between 6 and 17 April 2010), 1482 patients with acute gastroenteritis symptoms and findings presented to the healthcare facilities. Stool samples were obtained from nine patients and water samples were taken from four parts of the waterworks. Norovirus was detected in six of the stool samples. However, no norovirus was detected in the water samples. All patients were followed up at the outpatient clinics. None of the patients developed complications. Conclusion:Waterborne norovirus outbreaks can affect hundreds of people simultaneously. Early identification of the outbreak source and agent are important in the control of the outbreak, and for the treatment and follow up of the people affected. If leukocytes and erythrocytes are absent in the stool microscopy in gastroenteritis, norovirus should be considered in the first place as the cause, and appropriate investigation should be carried out. Yöntemler: Bu çalışmada Nisan 2010'da Isparta Keçiborlu ilçesinde yaşanan salgın esnasında ilçe devlet hastanesi ve bir aile hekimliği merkezine gastroenterit semptom ve bulgularıyla başvuran hastaların kayıtları incelendi. Ayrıca salgının kaynağını araştırmak için yapılan inceleme sonuçları retrospektif olarak değerlendirildi. Salgının ilk iki gününde rastgele seçilen 50 hastanın epidemiyolojik ve klinik özellikleri irdelendi.Bulgular: Salgının yaşandığı 6-17 Nisan 2010 tarihleri arasında akut gastroenterit semptom ve bulguları ile sağlık merkezlerine 1482 hasta başvurdu. Dokuz hastadan alınan dışkı örneklerinin altısında norovirüs tespit edildi. Şehir şebeke suyundan alınan örneklerde ise norovirüs tespit edilemedi Tüm hastalar ayaktan takip edildi ve semptomatik tedavi uygulandı. Herhangi bir komplikasyon gelişen hasta olmadı. Salgın, yapılan eğitim çalışmaları ve şehir şebeke suyunun temizliğinin sağlanması ile 13 günde kontrol altına alındı.Sonuç: Su kaynaklı norovirüs salgınları aynı anda yüzlerce kişiyi etkileyebilmektedir. Salgının kontrolü ve salgından etkilenen kişilerin takip ve tedavisi açısından salgının kaynağı ve etkenin erken tespiti önemlidir. Özellikle bulantı, kusma, karın ağrısı ve nadiren ateşin eşlik ettiği gastroenterit salgınlarında dışkı mikroskopisinde lökosit ve eritrosit saptanmı-yorsa, salgın etkeni olarak norovirüs öncelikle düşünülmeli ve buna yönelik incelemeler yapılmalıdır.

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“…Noroviruses possess highly infectious potential, with a small inoculum (as few as 10-100 virions) required for infection; furthermore, virions are relatively stable in the environment, with reported resistance to freezing, heating to 60°C, and disinfection with chlorine [16,23,24].…”

Section: Norovirusmentioning

confidence: 99%

Diagnosis of viral gastroenteritis: limits and potential of currently available procedures

Sidoti

Rittá

Costa

et al. 2015

J Infect Dev Ctries

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The diagnostic approaches to viral gastroenteritis have evolved substantially over the past decades because of the advances in detection methods, the emergence of new pathogens, and the increase in diarrhea hospitalizations attributed to viruses, especially in young children in non-industrialized countries. Overall, these factors have lead to a relevant improvement of types and operating characteristics of diagnostic methods (including sensitivity and specificity), as well as turnaround time. In this review, clinical and laboratory approaches to the diagnosis of viruses causing gastroenteritis are presented; in particular, specimen collection and detection methods are reviewed and discussed, taking into account performance and limitations.

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Noroviruses: agents in outbreaks of acute gastroenteritis

Cited by 43 publications

References 22 publications

Clinical characteristics of viral intestinal infection in preterm and term neonates

Clinical characteristics of viral intestinal infection in preterm and term neonates

An outbreak of norovirus gastroenteritis in a county in Turkey

Diagnosis of viral gastroenteritis: limits and potential of currently available procedures

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