An outbreak of acute norovirus gastroenteritis in a boarding school in Shanghai: a retrospective cohort study
More than 200 students and teachers at a boarding school in Shanghai developed acute gastroenteritis in December, 2012. The transmission mode remained largely unknown. An immediate epidemiological investigation was conducted to identify it. Using a retrospective cohort design, we investigated demogr...
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| Veröffentlicht in: | BMC public health 2014-10, Vol.14 (1), p.1092-1092, Article 1092 |
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| creator | Xue, Caoyi Fu, Yifei Zhu, Weiping Fei, Yi Zhu, Linying Zhang, Hong Pan, Lifeng Xu, Hongmei Wang, Yong Wang, Wenqin Sun, Qiao |
| description | More than 200 students and teachers at a boarding school in Shanghai developed acute gastroenteritis in December, 2012. The transmission mode remained largely unknown. An immediate epidemiological investigation was conducted to identify it.
Using a retrospective cohort design, we investigated demographic characteristics, school environment, and previous contacts with people who had diarrhea and/or vomiting, drinking water conditions, recalls of food consumption in the school cafeteria, hand-washing habits and eating habits. Rectal swabs of the new cases and food handlers as well as water and food samples were collected to test potential bacteria and viruses. Norovirus was detected by real-time reverse transcription-polymerase chain reaction (RT-PCR).
A total of 278 cases developed gastrointestinal symptoms in this outbreak, and the overall attack rate was 13.9%. The main symptoms included vomiting (50.0%), abdominal cramps (40.3%), nausea (27.0%), diarrhea (6.8%) and fever (6.8%). Twenty rectal swab samples were detected as Norovirus-positive, including 11 from student cases and 9 from asymptomatic food handlers (non-cases). Among environmental surface samples from the kitchen, 8 samples were also detected as Norovirus-positive. The genotypes of viral strains were the same (GII) in patients, asymptomatic food handlers and environmental surfaces. Other samples, including rectal swabs, water samples and food samples were negative for any bacteria and other tested viruses. Asymptomatic food handlers may have contaminated the cooked food during the food preparation.
The study detected that the outbreak was caused by Norovirus and should be controlled by thorough disinfection and excluding asymptomatic food handlers from food preparation. Early identification of the predominant mode of transmission in this outbreak was necessary to prevent new cases. Furthermore, good hygiene practices such as regular hand washing and efficient daily disinfection should be promoted to prevent such infection and outbreaks. |
| doi_str_mv | 10.1186/1471-2458-14-1092 |
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Using a retrospective cohort design, we investigated demographic characteristics, school environment, and previous contacts with people who had diarrhea and/or vomiting, drinking water conditions, recalls of food consumption in the school cafeteria, hand-washing habits and eating habits. Rectal swabs of the new cases and food handlers as well as water and food samples were collected to test potential bacteria and viruses. Norovirus was detected by real-time reverse transcription-polymerase chain reaction (RT-PCR).
A total of 278 cases developed gastrointestinal symptoms in this outbreak, and the overall attack rate was 13.9%. The main symptoms included vomiting (50.0%), abdominal cramps (40.3%), nausea (27.0%), diarrhea (6.8%) and fever (6.8%). Twenty rectal swab samples were detected as Norovirus-positive, including 11 from student cases and 9 from asymptomatic food handlers (non-cases). Among environmental surface samples from the kitchen, 8 samples were also detected as Norovirus-positive. The genotypes of viral strains were the same (GII) in patients, asymptomatic food handlers and environmental surfaces. Other samples, including rectal swabs, water samples and food samples were negative for any bacteria and other tested viruses. Asymptomatic food handlers may have contaminated the cooked food during the food preparation.
The study detected that the outbreak was caused by Norovirus and should be controlled by thorough disinfection and excluding asymptomatic food handlers from food preparation. Early identification of the predominant mode of transmission in this outbreak was necessary to prevent new cases. Furthermore, good hygiene practices such as regular hand washing and efficient daily disinfection should be promoted to prevent such infection and outbreaks.</description><identifier>ISSN: 1471-2458</identifier><identifier>EISSN: 1471-2458</identifier><identifier>DOI: 10.1186/1471-2458-14-1092</identifier><identifier>PMID: 25335780</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adolescent ; Adult ; Analysis ; Asymptomatic Diseases ; Bacteria ; Boarding ; Boarding schools ; Caliciviridae Infections - complications ; Caliciviridae Infections - epidemiology ; Care and treatment ; Carrier State - epidemiology ; Child ; Child, Preschool ; China ; Cohort analysis ; Cohort Studies ; Colic - etiology ; Cramps ; Data collection ; Demographics ; Development and progression ; Diarrhea ; Diarrhea - etiology ; Disease control ; Disease Outbreaks ; Disease prevention ; Disinfection ; Drinking water ; Eating behavior ; Epidemics ; Epidemiology ; FDA approval ; Feces ; Female ; Fever ; Fever - etiology ; Food ; Food consumption ; Food contamination ; Food contamination & poisoning ; Food handling ; Food Handling - statistics & numerical data ; Gastroenteritis ; Gastroenteritis - complications ; Gastroenteritis - epidemiology ; Gastroenteritis - virology ; Gastrointestinal symptoms ; Genotype ; Genotypes ; Hand Disinfection ; Handlers ; Health aspects ; Humans ; Hygiene ; Identification methods ; Infectious diseases ; Laboratories ; Male ; Meals ; Middle Aged ; Nausea ; Norovirus ; Norovirus - genetics ; Outbreaks ; Patient outcomes ; Polymerase chain reaction ; Public health ; Questionnaires ; Real-Time Polymerase Chain Reaction ; Rectum ; Retrospective Studies ; Reverse transcription ; Risk factors ; RNA, Viral - analysis ; Schools ; Students ; Systematic review ; Viruses ; Vomiting ; Washing ; Water analysis ; Water quality ; Water sampling ; Waterborne diseases</subject><ispartof>BMC public health, 2014-10, Vol.14 (1), p.1092-1092, Article 1092</ispartof><rights>COPYRIGHT 2014 BioMed Central Ltd.</rights><rights>2014 Xue et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.</rights><rights><![CDATA[2014. This work is licensed under https://s100.copyright.com/AppDispatchServlet?imprint=Nature&title=An%20outbreak%20of%20acute%20norovirus%20gastroenteritis%20in%20a%20boarding%20school%20in%20Shanghai%3A%20a%20retrospective%20cohort%20study&author=Caoyi%20Xue%20et%20al&contentID=10.1186%2F1471-2458-14-1092&publication=BMC%20Public%20Health&publicationDate=2014-10-22&publisherName=SpringerNature&orderBeanReset=true (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.]]></rights><rights>Xue et al.; licensee BioMed Central Ltd. 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c555t-db84b30f079f93b3bc4957021f03640962451629d9db0b4415505977140c34ae3</citedby><cites>FETCH-LOGICAL-c555t-db84b30f079f93b3bc4957021f03640962451629d9db0b4415505977140c34ae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221699/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221699/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25335780$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xue, Caoyi</creatorcontrib><creatorcontrib>Fu, Yifei</creatorcontrib><creatorcontrib>Zhu, Weiping</creatorcontrib><creatorcontrib>Fei, Yi</creatorcontrib><creatorcontrib>Zhu, Linying</creatorcontrib><creatorcontrib>Zhang, Hong</creatorcontrib><creatorcontrib>Pan, Lifeng</creatorcontrib><creatorcontrib>Xu, Hongmei</creatorcontrib><creatorcontrib>Wang, Yong</creatorcontrib><creatorcontrib>Wang, Wenqin</creatorcontrib><creatorcontrib>Sun, Qiao</creatorcontrib><title>An outbreak of acute norovirus gastroenteritis in a boarding school in Shanghai: a retrospective cohort study</title><title>BMC public health</title><addtitle>BMC Public Health</addtitle><description>More than 200 students and teachers at a boarding school in Shanghai developed acute gastroenteritis in December, 2012. The transmission mode remained largely unknown. An immediate epidemiological investigation was conducted to identify it.
Using a retrospective cohort design, we investigated demographic characteristics, school environment, and previous contacts with people who had diarrhea and/or vomiting, drinking water conditions, recalls of food consumption in the school cafeteria, hand-washing habits and eating habits. Rectal swabs of the new cases and food handlers as well as water and food samples were collected to test potential bacteria and viruses. Norovirus was detected by real-time reverse transcription-polymerase chain reaction (RT-PCR).
A total of 278 cases developed gastrointestinal symptoms in this outbreak, and the overall attack rate was 13.9%. The main symptoms included vomiting (50.0%), abdominal cramps (40.3%), nausea (27.0%), diarrhea (6.8%) and fever (6.8%). Twenty rectal swab samples were detected as Norovirus-positive, including 11 from student cases and 9 from asymptomatic food handlers (non-cases). Among environmental surface samples from the kitchen, 8 samples were also detected as Norovirus-positive. The genotypes of viral strains were the same (GII) in patients, asymptomatic food handlers and environmental surfaces. Other samples, including rectal swabs, water samples and food samples were negative for any bacteria and other tested viruses. Asymptomatic food handlers may have contaminated the cooked food during the food preparation.
The study detected that the outbreak was caused by Norovirus and should be controlled by thorough disinfection and excluding asymptomatic food handlers from food preparation. Early identification of the predominant mode of transmission in this outbreak was necessary to prevent new cases. Furthermore, good hygiene practices such as regular hand washing and efficient daily disinfection should be promoted to prevent such infection and outbreaks.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Analysis</subject><subject>Asymptomatic Diseases</subject><subject>Bacteria</subject><subject>Boarding</subject><subject>Boarding schools</subject><subject>Caliciviridae Infections - complications</subject><subject>Caliciviridae Infections - epidemiology</subject><subject>Care and treatment</subject><subject>Carrier State - epidemiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>China</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Colic - etiology</subject><subject>Cramps</subject><subject>Data collection</subject><subject>Demographics</subject><subject>Development and progression</subject><subject>Diarrhea</subject><subject>Diarrhea - etiology</subject><subject>Disease control</subject><subject>Disease Outbreaks</subject><subject>Disease prevention</subject><subject>Disinfection</subject><subject>Drinking water</subject><subject>Eating behavior</subject><subject>Epidemics</subject><subject>Epidemiology</subject><subject>FDA approval</subject><subject>Feces</subject><subject>Female</subject><subject>Fever</subject><subject>Fever - etiology</subject><subject>Food</subject><subject>Food consumption</subject><subject>Food contamination</subject><subject>Food contamination & poisoning</subject><subject>Food handling</subject><subject>Food Handling - statistics & numerical data</subject><subject>Gastroenteritis</subject><subject>Gastroenteritis - complications</subject><subject>Gastroenteritis - epidemiology</subject><subject>Gastroenteritis - virology</subject><subject>Gastrointestinal symptoms</subject><subject>Genotype</subject><subject>Genotypes</subject><subject>Hand Disinfection</subject><subject>Handlers</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Hygiene</subject><subject>Identification methods</subject><subject>Infectious diseases</subject><subject>Laboratories</subject><subject>Male</subject><subject>Meals</subject><subject>Middle Aged</subject><subject>Nausea</subject><subject>Norovirus</subject><subject>Norovirus - genetics</subject><subject>Outbreaks</subject><subject>Patient outcomes</subject><subject>Polymerase chain reaction</subject><subject>Public health</subject><subject>Questionnaires</subject><subject>Real-Time Polymerase Chain Reaction</subject><subject>Rectum</subject><subject>Retrospective Studies</subject><subject>Reverse transcription</subject><subject>Risk factors</subject><subject>RNA, Viral - analysis</subject><subject>Schools</subject><subject>Students</subject><subject>Systematic review</subject><subject>Viruses</subject><subject>Vomiting</subject><subject>Washing</subject><subject>Water analysis</subject><subject>Water quality</subject><subject>Water 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study</atitle><jtitle>BMC public health</jtitle><addtitle>BMC Public Health</addtitle><date>2014-10-22</date><risdate>2014</risdate><volume>14</volume><issue>1</issue><spage>1092</spage><epage>1092</epage><pages>1092-1092</pages><artnum>1092</artnum><issn>1471-2458</issn><eissn>1471-2458</eissn><abstract>More than 200 students and teachers at a boarding school in Shanghai developed acute gastroenteritis in December, 2012. The transmission mode remained largely unknown. An immediate epidemiological investigation was conducted to identify it.
Using a retrospective cohort design, we investigated demographic characteristics, school environment, and previous contacts with people who had diarrhea and/or vomiting, drinking water conditions, recalls of food consumption in the school cafeteria, hand-washing habits and eating habits. Rectal swabs of the new cases and food handlers as well as water and food samples were collected to test potential bacteria and viruses. Norovirus was detected by real-time reverse transcription-polymerase chain reaction (RT-PCR).
A total of 278 cases developed gastrointestinal symptoms in this outbreak, and the overall attack rate was 13.9%. The main symptoms included vomiting (50.0%), abdominal cramps (40.3%), nausea (27.0%), diarrhea (6.8%) and fever (6.8%). Twenty rectal swab samples were detected as Norovirus-positive, including 11 from student cases and 9 from asymptomatic food handlers (non-cases). Among environmental surface samples from the kitchen, 8 samples were also detected as Norovirus-positive. The genotypes of viral strains were the same (GII) in patients, asymptomatic food handlers and environmental surfaces. Other samples, including rectal swabs, water samples and food samples were negative for any bacteria and other tested viruses. Asymptomatic food handlers may have contaminated the cooked food during the food preparation.
The study detected that the outbreak was caused by Norovirus and should be controlled by thorough disinfection and excluding asymptomatic food handlers from food preparation. Early identification of the predominant mode of transmission in this outbreak was necessary to prevent new cases. Furthermore, good hygiene practices such as regular hand washing and efficient daily disinfection should be promoted to prevent such infection and outbreaks.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>25335780</pmid><doi>10.1186/1471-2458-14-1092</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4221699 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Springer Nature OA Free Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | Adolescent Adult Analysis Asymptomatic Diseases Bacteria Boarding Boarding schools Caliciviridae Infections - complications Caliciviridae Infections - epidemiology Care and treatment Carrier State - epidemiology Child Child, Preschool China Cohort analysis Cohort Studies Colic - etiology Cramps Data collection Demographics Development and progression Diarrhea Diarrhea - etiology Disease control Disease Outbreaks Disease prevention Disinfection Drinking water Eating behavior Epidemics Epidemiology FDA approval Feces Female Fever Fever - etiology Food Food consumption Food contamination Food contamination & poisoning Food handling Food Handling - statistics & numerical data Gastroenteritis Gastroenteritis - complications Gastroenteritis - epidemiology Gastroenteritis - virology Gastrointestinal symptoms Genotype Genotypes Hand Disinfection Handlers Health aspects Humans Hygiene Identification methods Infectious diseases Laboratories Male Meals Middle Aged Nausea Norovirus Norovirus - genetics Outbreaks Patient outcomes Polymerase chain reaction Public health Questionnaires Real-Time Polymerase Chain Reaction Rectum Retrospective Studies Reverse transcription Risk factors RNA, Viral - analysis Schools Students Systematic review Viruses Vomiting Washing Water analysis Water quality Water sampling Waterborne diseases |
| title | An outbreak of acute norovirus gastroenteritis in a boarding school in Shanghai: a retrospective cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T09%3A03%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=An%20outbreak%20of%20acute%20norovirus%20gastroenteritis%20in%20a%20boarding%20school%20in%20Shanghai:%20a%20retrospective%20cohort%20study&rft.jtitle=BMC%20public%20health&rft.au=Xue,%20Caoyi&rft.date=2014-10-22&rft.volume=14&rft.issue=1&rft.spage=1092&rft.epage=1092&rft.pages=1092-1092&rft.artnum=1092&rft.issn=1471-2458&rft.eissn=1471-2458&rft_id=info:doi/10.1186/1471-2458-14-1092&rft_dat=%3Cgale_pubme%3EA539591099%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1619636900&rft_id=info:pmid/25335780&rft_galeid=A539591099&rfr_iscdi=true |