BACKGROUND Environmental surfaces are a potential vehicle for the transmission of norovirus outbreaks in closed and semi-closed settings. Testing of environmental samples may help control outbreaks. AIM To assess the level of environmental contamination by norovirus in acute gastroenteritis outbreaks in closed or semi-closed settings (nursing homes, schools, kindergartens, youth accommodations, hospitals and social health centres) in the Barcelona region between January 2017 and March 2019. METHODS A prospective surveillance study was carried out. Environmental samples (529) were collected in 46 of the 50 outbreaks of acute norovirus gastroenteritis from environmental surfaces of common areas, bathrooms and kitchens in closed and semi-closed settings when the outbreak was notified and 10 days later. Instructions for taking environmental samples were distributed to public health inspectors. Norovirus was detected by reverse transcription polymerase chain reaction. FINDINGS Environmental samples were positive for norovirus in 31 (67.4%) outbreaks. Norovirus was most frequently detected on elevator buttons (4/17, 24%), toilet handles (16/66, 24%) and handrail bars (7/34, 21%). Positive samples from the first sampling were mainly found in bathrooms and greater viral persistence in the second sampling was found on elevator buttons and TV remote controls. Nursing homes were the setting with the most types of environmental surfaces contaminated (82% in first samples and 55% in second samples). CONCLUSION The probability of virus detection is independent of the time between notification of the outbreak or symptom onset and sample collection. Our results suggest possible defects in cleaning protocols and disinfection in closed and semi-closed settings.

中文翻译：

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在封闭和半封闭环境下，在诺如病毒爆发的环境样本中检测诺如病毒。

背景技术环境表面是在封闭和半封闭环境中传播诺如病毒暴发的潜在媒介。对环境样品进行测试可能有助于控制爆发。目的评估2017年1月至2019年3月在巴塞罗那地区封闭或半封闭环境（疗养院，学校，幼儿园，青年旅馆，医院和社会卫生中心）中急性胃肠炎暴发中诺如病毒对环境的污染程度。进行了一项前瞻性监测研究。接到疫情通报后以及十天后，在封闭和半封闭环境下的公共区域，浴室和厨房的环境表面中，从50例急性诺如病毒性胃肠炎暴发中的46例中收集了环境样本。收集环境样品的说明已分发给公共卫生检查员。通过逆转录聚合酶链反应检测到诺如病毒。结果在31例（67.4％）暴发中，环境样本中的诺如病毒呈阳性。在电梯按钮（4/17，24％），马桶把手（16/66，24％）和扶手栏（7/34，21％）上最常检测到诺如病毒。第一次采样中的阳性样本主要在浴室中发现，第二次采样中的病毒持久性更高，在电梯按钮和电视遥控器上发现。疗养院是环境表面类型受污染最多的环境（第一样本中82％，第二样本中55％）。结论病毒检测的可能性与爆发或症状发作通知与样本收集之间的时间无关。