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| Epidemiological investigation of an outbreak of acute gastroenteritis caused by GⅡ norovirus at a vocational and technical school |
| ZHANG Hui1, NIAN Yunpeng2,3, LI Hua2,3, ZHANG Leile1, LAN Ning1,2, LI Xiaohu2,4
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1. Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi 710054, China;
2. Training Program for Field Epidemiology of Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi 710054, China;
3. Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi 710054, China;
4. Fuping County Center for Disease Control and Prevention, Fuping, Shaanxi 711700, China |
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Abstract Objective To investigate an outbreak of acute gastroenteritis at a vocational and technical school in Shaanxi Province in 2024, ao as to provide the reference for the handling of school outbreaks. Methods The conducted case searches, individual case investigations, and on-site hygienic investigations were established in accordance with the Guidelines on outbreak investigation, prevention and control of Norovirus infection (2015). The potential risk factors were analyzed by case-control study. Anal swab samples from cases and all canteen staff, as well as environmental swab samples were collected to detect common intestinal pathogens. All reserved food samples in canteen were collected to test for common pathogenic bacteria. Results From October 26 to November 5, 2024, a cumulative total of 53 cases were reported, with an attack rate of 1.47%. The main clinical symptoms included vomiting (83.02%), abdominal pain (56.60%), diarrhea (30.19%), and fever (26.42%). The epidemic curve suggested an intermittent common-source outbreak, with no obvious clustering characteristics in terms of the population and spatial distribution of cases. The case-control analysis revealed that having dinner at the rice-with-dishes-on-top stall on the first floor of the canteen on October 28 was a risk factor for illness (OR=11.025, 95%CI: 2.186-55.601). GⅡ norovirus was detected as positive in anal swab samples from 6 cases and 2 asymptomatic infected canteen staff, as well as in 3 environmental swab samples from the rice-with-dishes-on-top stall. The test results for common pathogenic bacteria in the reserved food samples were all negative. Conclusions This outbreak was caused by an acute gastroenteritis epidemic induced by GⅡ norovirus infection, with a transmission pattern consistent with an intermittent homologous outbreak. The possible source of infection was asymptomatic infected canteen staff mainly through foodborne trasmission, and having meals at the rice-with-dishes-on-top stall was the primary risk factor for this outbreak.
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Received: 18 June 2025
Revised: 14 August 2025
Published: 16 September 2025
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[1] CHEN J L,CHENG Z C,CHEN J,et al.Advances in human norovirus research:vaccines,genotype distribution and antiviral strategies[J/OL].Virus Res,2024,350[2025-08-14].https://doi.org/10.1016/j.virusres.2024.199486.
[2] Centres for Disease Control and Prevention. Norovirus facts and stats [EB/OL].[2025-08-14].https://www.cdc.gov/norovirus/data-research/index.html.
[3] 余建兴,赖圣杰,王鑫,等.中国27省(市、自治区)2009—2013年门诊腹泻病例诺如病毒流行特征分析[J].中华流行病学杂志,2015,36(3):199-204.
YU J X,LAI S J,WANG X,et al.Analysis of epidemiology characteristics of norovirus among diarrheal outpatients in 27 provinces in China,2009-2013[J].Chin J Epidemiol,2015,36(3):199-204.(in Chinese)
[4] 廖巧红,冉陆,靳淼,等.诺如病毒感染暴发调查和预防控制技术指南(2015版)[J].中国病毒病杂志,2015,5(6):448-458.
LIAO Q H,RAN L,JIN M,et al.Guidelines on outbreak investigation,prevention and control of Norovirus infection(2015)[J].Chin J Viral Dis,2015,5(6):448-458.(in Chinese)
[5] WINDER N,GOHAR S,MUTHANA M.Norovirus:an overview of virology and preventative measures[J/OL].Viruses,2022,14(12)[2025-08-14].https://doi.org/10.3390/v14122811.
[6] 陆献蒿,田红艳,农智,等.一起诺如病毒感染引起的校园突发公共卫生事件的调查[J].微生物学免疫学进展,2024,52(4):56-60.
LU X H,TIAN H Y,NONG Z,et al.Epidemiological survey on a school public health emergency event caused by norovirus infection[J].Prog Vet Microbiol Immunol,2024,52(4):56-60.(in Chinese)
[7] LI T T,PENG J Y,LI Q,et al.Investigation of two norovirus outbreaks linked to drinking water contaminated with multiple GⅡ strains in a rural county-Chongqing,China,2021[J/OL].Front Public Health,2023,11[2025-08-14].https://doi.org/10.3389/fpubh.2023.1259584.
[8] 郑家乐,冯太聪,向伦辉,等.宝山区45起诺如病毒聚集性疫情分析[J].预防医学,2023,35(9):803-806.
ZHENG J L,FENG T C,XIANG L H,et al.Epidemiological characteristics of 45 norovirus clusters in Baoshan District[J].China Prev Med J,2023,35(9):803-806.(in Chinese)
[9] 邵云平,郭黎.海淀区中小学校和托幼机构诺如病毒感染疫情流行特征[J].预防医学,2021,33(12):1262-1264.
SHAO Y P,GUO L.Epidemiological characteristics of norovirus infection in primary and secondary schools and kindergartens in Haidian District[J].China Prev Med J,2021,33(12):1262-1264.(in Chinese)
[10] WANG J,JI Z H,ZHANG S B,et al.Asymptomatic norovirus infection during outbreaks in China:a systematic review and meta-analysis[J/OL].J Med Virol,2024,96(1)[2025-08-14].https://doi.org/10.1002/jmv.29393.
[11] 熊华威,魏惠平,吴云杰,等.深圳市某学校一起GⅡ型诺如病毒感染引发急性胃肠炎聚集性疫情调查[J].实用预防医学,2024,31(12):1490-1494.
XIONG H W,WEI H P,WU Y J,et al.A clustering outbreak of acute gastroenteritis caused by norovirus GⅡ infection in a school in Shenzhen City[J].Pract Prev Med,2024,31(12):1490-1494.(in Chinese)
[12] SHIODA K,BARCLAY L,BECKER-DREPS S,et al.Can use of viral load improve norovirus clinical diagnosis and disease attribution[J/OL].Open Forum Infect Dis,2017,4(3)[2025-08-14].https://doi.org/10.1093/ofid/ofx131.
[13] TEUNIS P M,SUKHRIE F A,VENNEMA H,et al.Shedding of norovirus in symptomatic and asymptomatic infections[J].Epidemiol Infect,2015,143(8):1710-1717.
[14] 黄艳红,刘潇潇,杨雄,等.2015—2018年北京市西城区诺如病毒胃肠炎聚集性疫情流行特征分析[J].现代预防医学,2019,46(24):4424-4426,4430.
HUANG Y H,LIU X X,YANG X,et al.Epidemiological characteristics of norovirus gastroenteritis at Xicheng District in Beijing from 2015 to 2018[J].Mod Prev Med,2019,46(24):4424-4426,4430.(in Chinese)
[15] 西安市教育局,西安市卫生健康委员会,西安市疾病预防控制中心.校园传染病防控——班主任手册[Z].西安:西安电子科技大学出版社,2024.
Xi'an Education Bureau,Xi'an Health Commission,Xi'an Center for Disease Control and Prevention.Manua for contagious disease prevention and control in schools:a guide for homeroom teachers[Z].Xi'an:Xidian University Press,2024.(in Chinese) |
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