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Xu Y, Zhu Y, Lei Z, Rui J, Zhao Z, Lin S, Wang Y, Xu J, Liu X, Yang M, Chen H, Pan X, Lu W, Du Y, Li H, Fang L, Zhang M, Zhou L, Yang F, Chen T. Investigation and analysis on an outbreak of norovirus infection in a health school in Guangdong Province, China. Infect Genet Evol 2021; 96:105135. [PMID: 34781036 DOI: 10.1016/j.meegid.2021.105135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/14/2021] [Accepted: 11/08/2021] [Indexed: 06/13/2023]
Abstract
Our objective was to describe the epidemiological features of an outbreak of norovirus infection in a health school in Guangdong province, China, to identify the cause of such a large scale outbreak of norovirus among older students, to simulate the transmission dynamics, and to evaluate the effect of intervention measures of GII.17 [P17] genotype norovirus infection. We identified all cases during the outbreak. Descriptive epidemiological, analytical epidemiological and hygiene survey methods were used to described the outbreak epidemic course and identify the cause of the outbreak of norovirus infection. We also used dynamical model to simulate the transmission dynamics of norovirus infection and evaluate the effect of intervention measures. Norovirus genotyping was assigned to the newly obtained strains, with a maximum likelihood phylogenetic analysis conducted. There were 360 cases of 42 classes in five grades with a 12.99% attack rate. Proportionally, more students were in contact with sick students and vomit in the suspected case group than the control group (χ2 = 5.535, P = 0.019 and χ2 = 5.549, P = 0.019, respectively). The basic reproduction number was 8.32 before and 0.49 after the intervention. Dynamical modeling showed that if the isolation rate was higher or case isolation began earlier, the total attack rate would decrease. Molecular characterization identified the GII.17 [P17] genotype in all stains obtained from the health school, which were clustered with high support in the phylogenetic tree. This was an outbreak of norovirus infection caused by contact transmission. The main reasons for the spread of the epidemic were the later control time, irregular treatment of vomit and no case isolation. The transmission dynamics of contact transmission was high, more efficient control measures should be employed.
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Affiliation(s)
- Yucheng Xu
- Futian District Center for Disease Control and Prevention, Shenzhen, People's Republic of China; Guangdong Field Epidemiology Training Program, Guangzhou, People's Republic of China
| | - Yuanzhao Zhu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City 361102, Fujian Province, People's Republic of China
| | - Zhao Lei
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City 361102, Fujian Province, People's Republic of China
| | - Jia Rui
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City 361102, Fujian Province, People's Republic of China
| | - Zeyu Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City 361102, Fujian Province, People's Republic of China
| | - Shengnan Lin
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City 361102, Fujian Province, People's Republic of China
| | - Yao Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City 361102, Fujian Province, People's Republic of China
| | - Jingwen Xu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City 361102, Fujian Province, People's Republic of China
| | - Xingchun Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City 361102, Fujian Province, People's Republic of China
| | - Meng Yang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City 361102, Fujian Province, People's Republic of China
| | - Hongsheng Chen
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People's Republic of China
| | - Xuemei Pan
- Lianzhou District Center for Disease Control and Prevention, Qingyuan, People's Republic of China
| | - Wentao Lu
- Qingyuan City Center for Disease Control and Prevention, Qingyuan, People's Republic of China
| | - Yuzhong Du
- Qingyuan City Center for Disease Control and Prevention, Qingyuan, People's Republic of China
| | - Hui Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People's Republic of China
| | - Ling Fang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People's Republic of China
| | - Meng Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People's Republic of China
| | - Lina Zhou
- Department of Nephrology, The second Hospital of Xiamen Medical college, Xiamen 361021, China
| | - Fen Yang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People's Republic of China.
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City 361102, Fujian Province, People's Republic of China.
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