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An outbreak of norovirus gastroenteritis in a county in Turkey

Year 2014, , 26 - 29, 01.03.2014
https://doi.org/10.5799/ahinjs.02.2014.01.0119

Abstract

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.

References

  • Widdowson MA, Monroe SS, Glass RI. Are noroviruses emerging? Emerg Infect Dis 2005; 11:735-737.
  • Altay A, Bozdayı G. Norovirüsün gnomik yapısı, replikasyonu ve epidemiyolojisi. Flora 2012; 17:1-10.
  • Koo HL, Ajami N, Atmar RL, Dupont HL. Noroviruses: the leading cause of gastroenteritis worldwide. Discov Med 2010;10:61-70.
  • Ahmed SF, Klena JD, Mostafa M, et al. Viral gastroenteritis associated with genogroup II norovirus among U.S. military personnel in Turkey, 2009. PLOS One. 2012;7:e35791.
  • Gonen I. Management of a large outbreak caused by Norovi- rus and Campylobacter jejuni occured in a rural area in Tur- key. Nobel Medicus 2013;9:47-51.
  • Ozkul AA, Kocazeybek BS, Turan N, et al. Frequency and phy- logeny of norovirus in diarrheic children in Istanbul, Turkey. J Clin Virol 2011;51:160-164.
  • Altay A, Bozdayı G, Meral M, et al. Investigation of norovirus infection incidence among 0-5 years old children with acute gastroenteritis admitted to two different hospitals in Ankara, Turkey. Mikrobiyol Bul 2013;47:98-108.
  • Altindis M, Bányai K, Kalayci R, et al. Frequency of norovirus in stool samples from hospitalized children due to acute gas- troenteritis in Anatolia, Turkey, 2006-2007. Scand J Infect Dis 2009;41:685-688.
  • URL- http://tuikapp.tuik.gov.tr/adnksdagitapp/- (21 May 2012)
  • Scarcella C, Carasi S, Cadoria F, et al. An outbreak of viral gastroenteritis linked to municipal water supply, Lombardy, Italy, June 2009. Eurosurveillance 2009;14:1-3.
  • Uyar Y, Çarhan A, Özkaya E, Ertek M. Türkiyede 2008 yılında ortaya çıkan ilk norovirüs salgınının laboratuvar sonuçlarının değerlendirilmesi. Mikrobiyol Bul 2008;42:608-615.
  • Arias C, Sala MR, Dominguez A, et al. Epidemiological and clinical features of norovirus gastroenteritis in outbreaks: a population-based study. Clin Microbiol Infect 2010;16:39-44.
  • Parashar U, Quiroz ES, Mounts AW, et al. Norwalk-like virus- es. Public health consequences and outbreak management. MMWR Recomm Rep 2001;50:1-17.
  • Papadopoulos VP, Vlachos O, Isidoridou E, et al. A gastroen- teritis Outbreak due to Norovirus Infection in Xanthi, North- ern Greece: Management and Public Health Consequences. J Gastrointest Liver Dis 2006;15:27-30.
  • Centers for Disease Control and Prevention. “Norwalk-like viruses”: public health consequences and outbreak manage- ment. MMWR 2001;50(No. RR-9):1-17.
  • Koo HL, Ajami NJ, Jiang ZD, Atmar RL, DuPont HL. Norovi- rus infection as a cause of sporadic healthcare associated diarrhea. J Hosp Infect 2009;72;185-187.
  • Atmar RL, Estes MK. The epidemiologic and clinical impor- tance of norovirus infection. Gastroenterol Clin North Am 2006;35:275-290.
  • Thornton AC, Jennings-Conklin KS, McCormick MI. Norovi- ruses: agents in outbreaks of acute gastroenteritis. Disaster Manage Response 2004;2:4-9.
  • Gallay A, De Valk H, Cournot M, et al. A large multi-pathogen waterborne community outbreak linked to faecal contamina- tion of a groundwater system, France, 2000. Clin Microbiol Infect 2006;12:561-570.

An outbreak of norovirus gastroenteritis in a county in Turkey

Year 2014, , 26 - 29, 01.03.2014
https://doi.org/10.5799/ahinjs.02.2014.01.0119

Abstract

Amaç: Bu çalışmada içme suyu kaynaklı bir norovirüs salgınının epidemiyolojik özelliklerini ve salgın kontrol çalışmalarını sunmayı amaçladık.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 saptanmıyorsa, salgın etkeni olarak norovirüs öncelikle düşünülmeli ve buna yönelik incelemeler yapılmalıdır

References

  • Widdowson MA, Monroe SS, Glass RI. Are noroviruses emerging? Emerg Infect Dis 2005; 11:735-737.
  • Altay A, Bozdayı G. Norovirüsün gnomik yapısı, replikasyonu ve epidemiyolojisi. Flora 2012; 17:1-10.
  • Koo HL, Ajami N, Atmar RL, Dupont HL. Noroviruses: the leading cause of gastroenteritis worldwide. Discov Med 2010;10:61-70.
  • Ahmed SF, Klena JD, Mostafa M, et al. Viral gastroenteritis associated with genogroup II norovirus among U.S. military personnel in Turkey, 2009. PLOS One. 2012;7:e35791.
  • Gonen I. Management of a large outbreak caused by Norovi- rus and Campylobacter jejuni occured in a rural area in Tur- key. Nobel Medicus 2013;9:47-51.
  • Ozkul AA, Kocazeybek BS, Turan N, et al. Frequency and phy- logeny of norovirus in diarrheic children in Istanbul, Turkey. J Clin Virol 2011;51:160-164.
  • Altay A, Bozdayı G, Meral M, et al. Investigation of norovirus infection incidence among 0-5 years old children with acute gastroenteritis admitted to two different hospitals in Ankara, Turkey. Mikrobiyol Bul 2013;47:98-108.
  • Altindis M, Bányai K, Kalayci R, et al. Frequency of norovirus in stool samples from hospitalized children due to acute gas- troenteritis in Anatolia, Turkey, 2006-2007. Scand J Infect Dis 2009;41:685-688.
  • URL- http://tuikapp.tuik.gov.tr/adnksdagitapp/- (21 May 2012)
  • Scarcella C, Carasi S, Cadoria F, et al. An outbreak of viral gastroenteritis linked to municipal water supply, Lombardy, Italy, June 2009. Eurosurveillance 2009;14:1-3.
  • Uyar Y, Çarhan A, Özkaya E, Ertek M. Türkiyede 2008 yılında ortaya çıkan ilk norovirüs salgınının laboratuvar sonuçlarının değerlendirilmesi. Mikrobiyol Bul 2008;42:608-615.
  • Arias C, Sala MR, Dominguez A, et al. Epidemiological and clinical features of norovirus gastroenteritis in outbreaks: a population-based study. Clin Microbiol Infect 2010;16:39-44.
  • Parashar U, Quiroz ES, Mounts AW, et al. Norwalk-like virus- es. Public health consequences and outbreak management. MMWR Recomm Rep 2001;50:1-17.
  • Papadopoulos VP, Vlachos O, Isidoridou E, et al. A gastroen- teritis Outbreak due to Norovirus Infection in Xanthi, North- ern Greece: Management and Public Health Consequences. J Gastrointest Liver Dis 2006;15:27-30.
  • Centers for Disease Control and Prevention. “Norwalk-like viruses”: public health consequences and outbreak manage- ment. MMWR 2001;50(No. RR-9):1-17.
  • Koo HL, Ajami NJ, Jiang ZD, Atmar RL, DuPont HL. Norovi- rus infection as a cause of sporadic healthcare associated diarrhea. J Hosp Infect 2009;72;185-187.
  • Atmar RL, Estes MK. The epidemiologic and clinical impor- tance of norovirus infection. Gastroenterol Clin North Am 2006;35:275-290.
  • Thornton AC, Jennings-Conklin KS, McCormick MI. Norovi- ruses: agents in outbreaks of acute gastroenteritis. Disaster Manage Response 2004;2:4-9.
  • Gallay A, De Valk H, Cournot M, et al. A large multi-pathogen waterborne community outbreak linked to faecal contamina- tion of a groundwater system, France, 2000. Clin Microbiol Infect 2006;12:561-570.
There are 19 citations in total.

Details

Primary Language English
Journal Section ART
Authors

Hamdi Sözen This is me

İbak Gönen This is me

Halil Beydilli This is me

Publication Date March 1, 2014
Published in Issue Year 2014

Cite

APA Sözen, H., Gönen, İ., & Beydilli, H. (2014). An outbreak of norovirus gastroenteritis in a county in Turkey. Journal of Microbiology and Infectious Diseases, 4(01), 26-29. https://doi.org/10.5799/ahinjs.02.2014.01.0119
AMA Sözen H, Gönen İ, Beydilli H. An outbreak of norovirus gastroenteritis in a county in Turkey. J Microbil Infect Dis. March 2014;4(01):26-29. doi:10.5799/ahinjs.02.2014.01.0119
Chicago Sözen, Hamdi, İbak Gönen, and Halil Beydilli. “An Outbreak of Norovirus Gastroenteritis in a County in Turkey”. Journal of Microbiology and Infectious Diseases 4, no. 01 (March 2014): 26-29. https://doi.org/10.5799/ahinjs.02.2014.01.0119.
EndNote Sözen H, Gönen İ, Beydilli H (March 1, 2014) An outbreak of norovirus gastroenteritis in a county in Turkey. Journal of Microbiology and Infectious Diseases 4 01 26–29.
IEEE H. Sözen, İ. Gönen, and H. Beydilli, “An outbreak of norovirus gastroenteritis in a county in Turkey”, J Microbil Infect Dis, vol. 4, no. 01, pp. 26–29, 2014, doi: 10.5799/ahinjs.02.2014.01.0119.
ISNAD Sözen, Hamdi et al. “An Outbreak of Norovirus Gastroenteritis in a County in Turkey”. Journal of Microbiology and Infectious Diseases 4/01 (March 2014), 26-29. https://doi.org/10.5799/ahinjs.02.2014.01.0119.
JAMA Sözen H, Gönen İ, Beydilli H. An outbreak of norovirus gastroenteritis in a county in Turkey. J Microbil Infect Dis. 2014;4:26–29.
MLA Sözen, Hamdi et al. “An Outbreak of Norovirus Gastroenteritis in a County in Turkey”. Journal of Microbiology and Infectious Diseases, vol. 4, no. 01, 2014, pp. 26-29, doi:10.5799/ahinjs.02.2014.01.0119.
Vancouver Sözen H, Gönen İ, Beydilli H. An outbreak of norovirus gastroenteritis in a county in Turkey. J Microbil Infect Dis. 2014;4(01):26-9.