Abstract
Outbreaks of norovirus-associated gastroenteritis have been reported in schools in recent decades in China. For early warning and response to infectious disease outbreaks, the Shanghai Infectious Diseases Bud Event Surveillance System (IDBESS) was established in 2016. Bud event is a term used for the early sign of a potential infectious disease outbreak in public settings when the first few cases appear. This study aimed to describe the epidemiological characteristics of Norovirus-associated gastroenteritis bud events from June 2016 to December 2017 and to understand factors influencing the severity of events. Data were extracted from the IDBESS, supplemented by field investigations and school absence surveillance. In total, 189 bud events of Norovirus-associated gastroenteritis were reported in schools and kindergartens, affecting 3827 individuals and 52.38% happened in primary schools. The attack rate of Norovirus-associated gastroenteritis was 3.82% on average in students in the affected schools. In each event, case numbers varied between 5 and 148, with a median of 16. The duration of bud events lasted for 2 days on average. School absence happened in 47.93% (1797/3749) of affected students and the average duration of absence was 3.07 days. It was found that a longer delay before reporting was associated with a longer-lasting duration of bud event (OR = 2.25, 95% CI: 1.65, 3.07). In conclusion, ascribed to the sensitive threshold for alerting and the timely field investigation, the surveillance of bud events of Norovirus-associated gastroenteritis is effective in the control of Norovirus infection among preschool children and students in Shanghai.
Highlights
Norovirus (Norovirus), a member of the Caliciviridae family, is a highly contagious virus with a low infection dose of approximately 20 virus particles [1,2,3]
This study aimed to describe the epidemiological characteristics of the bud events of Norovirus-associated gastroenteritis and to understand factors influencing the spread and severity of the events based on data from the Infectious Diseases Bud Event Surveillance System (IDBESS), field investigations and surveillance system (SASS)
215 Norovirus-associated gastroenteritis bud events were reported from June 2016 to December 2017 in Shanghai; of these, 189 (87.91%) happened in schools and kindergartens
Summary
Norovirus (Norovirus), a member of the Caliciviridae family, is a highly contagious virus with a low infection dose of approximately 20 virus particles [1,2,3]. Norovirus can be divided into 10 genogroups [4], and GII, GI and GIV can cause human infection [5]. The illness of Norovirus infection is characterised by acute onset and an illness duration of 1–3 days and is self-limiting [9]. It causes vomiting, diarrhoea, mild fever and nausea. The diagnosis of Norovirus infection is mainly based on the detection of the nucleic acid of the virus by RT-PCR. The detection of Norovirus antigens by ELISA has been applied for diagnosis in China [5]
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