Abstract
In April 2017, several travelers with acute gastroenteritis on a cruise ship were reported. We conducted an investigation to identify the pathogen, mode of transmission, and risk factors. We searched and classified case-patient according to structured case definition, and collect date of the onset, clinical manifestations, and demographic information of cases. A case-control study was implemented to compare foods consumption between cases and asymptomatic travelers. Samples such as feces, rectal swab, vomitus, and environment swab were collected for testing. The attack rate was 18.2% (101/555), four cold dishes served on 11th, April were independently associated with an increased risk of disease: cold potherb (odds ratio (OR): 14.4; 95% confidence interval (CI): 2.2–93.3) and cold garlic sprout (OR: 26.1; 95% CI: 4.9–138.0) served at lunch, cold broad bean (OR: 5.8; 95% CI: 1.3–26.2), and cold cucumber (OR: 13.9; 95% CI: 2.3–84.2) served at dinner. A total of 15 samples were positive for norovirus genogroup II (GII) by using reverse transcription polymerase chain reaction (RT-PCR). This outbreak that occurred on the cruise ship was caused by norovirus GII. The evidence indicated that norovirus was mainly transmitted through consumption of cold dishes on 11th, April, which might be contaminated by asymptomatic cold dish cook.
Highlights
Norovirus is known to be the major pathogen of acute gastroenteritis worldwide and it causes gastroenteritis outbreaks every year [1,2]
We investigated an outbreak of acute gastroenteritis that was caused by norovirus genogroup II (GII) that occurred on a cruise ship sailing on a four-day voyage along the Yangtze River, from Hubei Province to Chongqing Municipality, China, April 2017
A total of 101 acute diarrhea cases met the definition of the probable cases, including 15 cases with laboratory-confirmed norovirus infection
Summary
Norovirus is known to be the major pathogen of acute gastroenteritis worldwide and it causes gastroenteritis outbreaks every year [1,2]. The majority of human norovirus can be classified into two genogroups, I (GI) and II (GII), with the median incubation periods as 1.1 days (95% CI: 1.1–1.2). 1.2 days (95% CI: 1.1–1.2), respectively [3]. Norovirus infections are generally self-limited with mild to moderate symptoms, severe morbidity and occasional mortality have been reported in immunocompromised or elderly cases [4]. The symptoms of norovirus infection usually last for. No vaccines or antiviral therapies are available for preventing and controlling the norovirus infection. Res. Public Health 2018, 15, 2823; doi:10.3390/ijerph15122823 www.mdpi.com/journal/ijerph
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