The Rise in Norovirus-Related Acute Gastroenteritis During the Fight Against the COVID-19 Pandemic in Southern China

Ying Lu,Huaping Xie,Wenzhe Su,Hui Wang,Zhoubin Zhang,Dahu Wang,Jianyun Lu

doi:10.3389/fpubh.2021.785373

Ying Lu, Huaping Xie + Show 5 more

Open Access

https://doi.org/10.3389/fpubh.2021.785373

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Abstract

Background: There has been a significant decline in the morbidity of almost all infectious diseases during the COVID-19 pandemic. However, while the incidence of norovirus-related acute gastroenteritis declined in Guangzhou, China during the initial period of the pandemic, incidence increased significantly once the new school year began in September 2020.Methods: Norovirus-related acute gastroenteritis clusters and outbreaks were assessed in Guangzhou from 2015 to 2020. Medians and interquartile ranges were compared between groups using the Mann–Whitney U-test, and attack rates were calculated.Results: While 78,579 cases of infectious diarrhea were reported from 2015 to 2019, with an average of 15,716 cases per year, only 12,065 cases of infectious diarrhea were reported in 2020. The numbers of sporadic cases and outbreaks reported from January to August 2020 were lower than the average numbers reported during the same time period each year from 2015 to 2019 but began to increase in September 2020. The number of cases in each reported cluster ranged from 10 to 70 in 2020, with a total of 1,280 cases and an average attack rate of 5.85%. The median number of reported cases, the cumulative number of cases, and the attack rate were higher than the average number reported each year from 2015 to 2019. The intervention time in 2020 was also higher than the average intervention time reported during 2015–2019. The main norovirus genotypes circulating in Guangzhou during 2015–2020 included genogroup 2 type 2 (GII.2) (n = 79, 26.69%), GII.17 (n = 36, 12.16%), GII.3 (n = 27, 9.12%), GII.6 (n = 8, 2.7%), GII.4 Sydney_2012 (n = 7, 2.36%), and GII.4 (n = 6, 2.03%).Conclusions: Our findings illustrate the importance of maintaining epidemiological surveillance for viral gastroenteritis during the COVID-19 pandemic. Local disease prevention and control institutions need to devote sufficient human resources to control norovirus clusters.

Highlights

There has been a significant decline in the morbidity of almost all infectious diseases during the COVID-19 pandemic
Noroviruses are responsible for a considerable burden of viral gastroenteritis in China, especially in people < 2 and over ≥ 65 years of age [3]
Data on reported cases of infectious diarrhea was obtained from Notifiable Infectious Disease Reporting Information System (NIDRIS), and information on norovirus clusters was obtained through ongoing daily surveillance

Summary

Introduction

There has been a significant decline in the morbidity of almost all infectious diseases during the COVID-19 pandemic. While the incidence of norovirus-related acute gastroenteritis declined in Guangzhou, China during the initial period of the pandemic, incidence increased significantly once the new school year began in September 2020. A series of public social distancing interventions were implemented [1] that may have implications for the management of non-COVID19 diseases. Called the “winter vomiting bug,” is the leading cause of non-bacterial gastroenteritis outbreaks worldwide [2], affecting individuals of all ages. The majority of reported outbreaks in China from 2014 to 2017 occurred in school settings including primary schools, childcare facilities, and secondary schools [6]

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