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Country-wide surveillance of norovirus outbreaks in the Portuguese Army, 2015-2017

2018-11Journal article Restricted access
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dc.contributor.authorLopes-João, A.
dc.contributor.authorMesquita, J.R.
dc.contributor.authorde Sousa, R.
dc.contributor.authorOleastro, M.
dc.contributor.authorSilva, C.
dc.contributor.authorPenha-Gonçalves, C.
dc.contributor.authorNascimento, M.S.J.
dc.date.accessioned2018-11-16T16:03:31Z
dc.date.available2018-11-16T16:03:31Z
dc.date.issued2018-11
dc.description.abstractINTRODUCTION: Gastrointestinal infections are among the most common foodborne and waterborne diseases in military populations, with direct implications in operational efficiency and force readiness. Through the surveillance system of reportable acute gastrointestinal illness in the Portuguese Army, four norovirus outbreaks were identified between October 2015 and October 2017 in mainland Portugal and the Azores archipelago. The present study documents the epidemiological, clinical and laboratory investigations of these norovirus outbreaks. METHODS: Cases were investigated and epidemiological questionnaires were distributed to all soldiers in each military setting where the outbreaks occurred. Stool samples from soldiers with acute gastroenteritis illness were collected and screened for common enteropathogenic agents. Food and water samples served on the settings were also collected for microbiological investigation. Norovirus-positive samples were further characterised by sequence analysis using a public automated genotyping tool. RESULTS: The four outbreaks affected a total of 99 soldiers among the 618 stationed on base units and in a military exercise. A total of 27 soldiers provided a stool sample, of which 20 were positive for norovirus by real-time PCR. Phylogenetic analysis showed that the noroviruses involved were all genogroup II, namely GII.17, GII.Pe-GII.4 Sydney 2012, GII.P2-GII.2 and GII.P16-GII.2. Of note, 30 soldiers had to receive treatment at the military hospital due to severity of symptoms. CONCLUSION: In this short, two-year surveillance period, a total of four norovirus gastroenteritis outbreaks were detected in the Portuguese Army which caused a considerable morbidity, showing once again the impact of norovirus on Army effectiveness and force readiness.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ R Army Med Corps. 2018 Nov;164(6):419-422. doi: 10.1136/jramc-2018-000991. Epub 2018 Aug 3.pt_PT
dc.identifier.doi10.1136/jramc-2018-000991pt_PT
dc.identifier.issn0035-8665
dc.identifier.urihttp://hdl.handle.net/10400.18/5657
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMJ Publishing Grouppt_PT
dc.relation.publisherversionhttp://dx.doi.org/10.1136/jramc-2018-000991pt_PT
dc.subjectGastrointestinal Infectionspt_PT
dc.subjectCaliciviridae Infectionspt_PT
dc.subjectDisease Outbreakspt_PT
dc.subjectGastroenteritispt_PT
dc.subjectGenotype
dc.subjectNorovirus
dc.subjectPortuguese Army
dc.subjectMilitary Personnel
dc.subjectEpidemiology
dc.subjectPublic Health
dc.subjectInfecções Gastrointestinais
dc.subjectPortugal
dc.titleCountry-wide surveillance of norovirus outbreaks in the Portuguese Army, 2015-2017pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage422pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage419pt_PT
oaire.citation.titleJournal of the Royal Army Medical Corpspt_PT
oaire.citation.volume164pt_PT
rcaap.rightsembargoedAccesspt_PT
rcaap.typearticlept_PT

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