A Community Outbreak of Rotavirus Diarrhea Associated With Exposures in a Hospital Outpatient Department in South China

INTRODUCTION:Between October 1 and December 10, 2006, Baoʼan, China had a 5-fold increase in acute rotavirus gastroenteritis (ARGE) cases compared with the same time in 2005. To identify the risk factors for ARGE during this outbreak, we conducted a case-control study among children ≤24 months old from the most heavily affected area. METHODS:We defined an ARGE case as diarrhea, with group A rotavirus antigen detected from fecal samples by the enzyme-linked immunosorbent assay test. In the case-control study, 86 confirmed ARGE cases were identified. We enrolled 98 healthy control children matched by age. We administered questionnaires about exposures through telephone interviews. RESULTS:Of 8 general exposure types, we identified the following as being associated with ARGEvisiting outpatient services of hospital X, odds ratio (OR) = 7.1 (95% confidence interval [CI], 2.2–26); contact with other children with diarrhea, OR = 2.1 (95% CI, 1.1–3.7); and hand-washing before eating, OR = 0.48 (95% CI, 0.27–0.82). After improvements in the outpatient department of hospital X, ARGE incidence in the community during the ARGE transmission season (October through December) decreased from 4.3/10000 in 2006 to 1.4/10000 in 2009. CONCLUSIONS:Outpatient services in hospital X may have contributed to the transmission of ARGE and improvements in infection control practices in this setting were associated a marked decrease incidence of ARGE in this community.