Sensorlux Norovirus surveillance in Luxembourg

Transcription

1 2 ème Colloque sur la sécurité de la chaîne alimentaire au Luxembourg et dans l'union européenne Sensorlux Norovirus surveillance in Luxembourg Jacques Kremer, PhD Institute of Immunology LNS-CRP-Santé, Luxembourg

2 Viruses with potential spread via foodborne route Poliovirus first recorded outbreak of food-borne (milk) disease (paralytic illness) Gastrointestinal disease - Norovirus - Astroviruses -Rotavirus -Sapoviruses - (Poliovirus first recorded outbreak of food Hepatitis - Hepatitis A - Hepatitis E

3 Epidemic gastroenteritis NoVs encount for >90% of outbreaks of viral gastroenteritis (~50% all cause outbreaks) Transmission typically through contaminated food, water, environment or person-to-person NoV = most common cause of outbreaks associated with fresh produce (i.e. fruits and vegetables) Food contamination: At the source (e.g. shellfish harvested from contaminated water or raspberries irrigated with sewage) By infectious food-handlers: Sandwiches, salads (handling without subsequent cooking)

4 Norovirus - Epidemiology Reported year round, they peak during months with cold wheather Mode of transmission: fecal-oral, droplets of vomitus, contaminated surfaces, contaminated food or water Low infectious dose Prolonged asymptomatic shedding High environmental stability Substantial strain diversity Lack of lasting immunity

5 Disease Acute-onset vomiting and diarrhea, typically after an incubation period of 12 to 48 h 30% of infections asymptomatic Symptoms: Vomiting, diarrhea, headaches, nausea, abdominal cramps, low grade fever Recovery ususally within 1 o 3 days NoV genome can be detected for 3 weeks after recovery in stools

6 Norovirus - Classification

7 Norovirus - Diagnosis Norovirus outbreak: Vomiting in >50% of affected persons Mean incubation period 24-48h Mean duration of illness 12-60h Absence of bacterial pathogen in stool culture Laboratory diagnosis EIA: insufficient sensitivity to detect wide range of NoV RT-PCR

8 NoV situation in Luxembourg? Relatively little information available since 2003, sentinel for influenza (seasonal flu) 16 doctors send swabs and clinical data from patients with influenza like illness(october april) Use existing structure for norovirus surveillance (stomach flu) Detection of Norovirus in surface water and wastewater at the CRP Gabriel Lippmann

9 SENSORLUX - projet pilote Financed by the Fonds National de Recherche 01/01/ /06/2010 Consortium between different institutions

10 Sensorlux - 5 Work Packages WP1: Enhanced surveillance of human gastroenteritis in several settings in Luxembourg Task leader: P. Weicherding WP2: Implementation and optimisation of norovirus detection methods in different matrices (food and stool samples) Task leader: Jos Even WP3: Testing for norovirus in human stool samples and shellfish Task leader: Jos Even WP4: Monitoring of noroviruses in wastewater and surface waters downstream infected populations Task Leader Henri- Michel Cauchie WP5: Determination of norovirus diversity and identification of epidemiological links between human cases and food and/or environmental sources Task leader: Claude Muller Coordination: Joel Mossong

11 Detection and characterisation of NoV Norovirus surveillance RT-PCR Detection Genotyping Wastewater treatment Children's day-care Environmental Human Nursing Homes Shellfish/high risk food Patients - sentinel GPs

12 Participants CRP GL Sylvain Skraber, Henri-Michel Cauchie, LNS Microbio Jos Even, Joël Mossong, Jérémie Langlet, Catherine Ragimbeau, Paul Reichert LNS Alimentaire Gilbert Moris Inspection Sanitaire Irène Demuth, John Schuh, Pierre Weicherding Institut d Immunologie Sébastien De Landtsheer, Jacques Kremer