1
|
Mattison CP, Calderwood LE, Marsh ZA, Wikswo ME, Balachandran N, Kambhampati AK, Gleason ME, Lawinger H, Mirza SA. Childcare and School Acute Gastroenteritis Outbreaks: 2009-2020. Pediatrics 2022; 150:e2021056002. [PMID: 36278284 PMCID: PMC10061552 DOI: 10.1542/peds.2021-056002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVES Acute gastroenteritis (AGE) outbreaks commonly occur in congregate settings, including schools and childcare facilities. These outbreaks disrupt institutions, causing absences and temporary facility closures. This study analyzed the epidemiology of school and childcare AGE outbreaks in the United States. METHODS We analyzed AGE outbreaks occurring in kindergarten to grade 12 schools and childcare facilities reported via the National Outbreak Reporting System in the United States from 2009 to 2019 and compared this information to 2020 data. Outbreak and case characteristics were compared using the Kruskal-Wallis rank sum test, χ2 goodness-of-fit test, and Fisher exact test. RESULTS From 2009 to 2019, there were 2623 school, 1972 childcare, and 38 school and childcare outbreaks. School outbreaks were larger (median, 29 cases) than childcare outbreaks (median, 10 cases). Childcare outbreaks were longer (median, 15 days) than school outbreaks (median, 9 days). Norovirus (2383 outbreaks; 110 190 illnesses) and Shigella spp. (756 outbreaks; 9123 illnesses) were the most reported etiologies. Norovirus was the leading etiology in schools; norovirus and Shigella spp. were dominant etiologies in childcare centers. Most (85.7%) outbreaks were spread via person-to-person contact. In 2020, 123 outbreaks were reported, 85% in the first quarter. CONCLUSIONS Schools and childcare centers are common AGE outbreak settings in the United States. Most outbreaks were caused by norovirus and Shigella spp. and spread via person-to-person transmission. Fewer outbreaks were reported in 2020 from the COVID-19 pandemic. Prevention and control efforts should focus on interrupting transmission, including environmental disinfection, proper handwashing, safe diapering, and exclusion of ill persons.
Collapse
Affiliation(s)
- Claire P. Mattison
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
- Cherokee Nation Assurance, Arlington, Virginia
| | - Laura E. Calderwood
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
- Cherokee Nation Assurance, Arlington, Virginia
| | - Zachary A. Marsh
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary E. Wikswo
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Neha Balachandran
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
- Cherokee Nation Assurance, Arlington, Virginia
| | - Anita K. Kambhampati
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Michelle E. Gleason
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hannah Lawinger
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sara A. Mirza
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| |
Collapse
|
2
|
Yuan K, Huang G, Wang L, Wang T, Liu W, Jiang H, Yang AC. Predicting Norovirus in the United States Using Google Trends: Infodemiology Study. J Med Internet Res 2021; 23:e24554. [PMID: 34586079 PMCID: PMC8515228 DOI: 10.2196/24554] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 02/26/2021] [Accepted: 07/05/2021] [Indexed: 12/23/2022] Open
Abstract
Background Norovirus is a contagious disease. The transmission of norovirus spreads quickly and easily in various ways. Because effective methods to prevent or treat norovirus have not been discovered, it is important to rapidly recognize and report norovirus outbreaks in the early phase. Internet search has been a useful method for people to access information immediately. With the precise record of internet search trends, internet search has been a useful tool to manifest infectious disease outbreaks. Objective In this study, we tried to discover the correlation between internet search terms and norovirus infection. Methods The internet search trend data of norovirus were obtained from Google Trends. We used cross-correlation analysis to discover the temporal correlation between norovirus and other terms. We also used multiple linear regression with the stepwise method to recognize the most important predictors of internet search trends and norovirus. In addition, we evaluated the temporal correlation between actual norovirus cases and internet search terms in New York, California, and the United States as a whole. Results Some Google search terms such as gastroenteritis, watery diarrhea, and stomach bug coincided with norovirus Google Trends. Some Google search terms such as contagious, travel, and party presented earlier than norovirus Google Trends. Some Google search terms such as dehydration, bar, and coronavirus presented several months later than norovirus Google Trends. We found that fever, gastroenteritis, poison, cruise, wedding, and watery diarrhea were important factors correlated with norovirus Google Trends. In actual norovirus cases from New York, California, and the United States as a whole, some Google search terms presented with, earlier, or later than actual norovirus cases. Conclusions Our study provides novel strategy-based internet search evidence regarding the epidemiology of norovirus.
Collapse
Affiliation(s)
- Kai Yuan
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Guangrui Huang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Lepeng Wang
- School of Humanities, Beijing University of Chinese Medicine, Beijing, China
| | - Ting Wang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Wenbin Liu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Haixu Jiang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Albert C Yang
- Digital Medicine Center, National Yang Ming Chiao Tung University, Taiwan, Republic of China.,Department of Medical Research, Taipei Veterans General Hospital, Taiwan, Republic of China.,Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, United States
| |
Collapse
|
3
|
Parrón I, Barrabeig I, Alseda M, Cornejo-Sánchez T, Guix S, Jané M, Izquierdo C, Rius C, Domínguez À. Involvement of Workers in Closed and Semiclosed Institutions in Outbreaks of Acute Gastroenteritis Due to Norovirus. Viruses 2020; 12:E1392. [PMID: 33291823 PMCID: PMC7762007 DOI: 10.3390/v12121392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 12/19/2022] Open
Abstract
Norovirus outbreaks frequently occur in closed or semiclosed institutions. Recent studies in Catalonia and various countries indicate that, during outbreaks in these institutions, norovirus is detected in between 23% and 60% of workers, and the prevalence of infection in asymptomatic workers involved in outbreaks ranges from 17% to 40%. In this work, we carried out a prospective study to investigate the involvement of workers in closed and semiclosed institutions during outbreaks. The attack rates (ARs) and the rate ratios (RRs) were calculated according to the type of transmission and occupational category. The RRs and 95% confidence intervals (CIs) between workers and users were calculated. The mean cycle of quantification (Cq) values were compared according to the genogroup and the presence of symptoms. ARs were higher in person-to-person transmission than in common vehicle outbreaks, and 38.8% of workers were symptomatic. The RR between workers and users was 0.46 (95% CI 0.41-0.52). The ARs in workers were high, particularly in workers with closer contact with users. The mean Cq was lower in patients than in asymptomatic infected persons, although the difference was only significant for genogroup I (GI). The frequency of asymptomatic infected persons suggests that personal hygiene measures should be followed by all workers in the centers affected.
Collapse
Affiliation(s)
- Ignacio Parrón
- Sub-Direcció Regional a Barcelona del Departament de Salut, 08005 Barcelona, Spain;
| | - Irene Barrabeig
- Sub-Direcció Regional a Barcelona del Departament de Salut, 08005 Barcelona, Spain;
- CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.J.); (C.R.); (À.D.)
| | - Miquel Alseda
- Sub-Direcció Regional a Lleida del Departament de Salut, 25006 Lleida, Spain;
| | | | - Susana Guix
- Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, School of Biology, Institute of Nutrition and Food Safety, University of Barcelona, 08028 Barcelona, Spain;
| | - Mireia Jané
- CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.J.); (C.R.); (À.D.)
- Sub-Direcció General de Vigilància i Resposta a Emergències de Salut Pública, 08005 Barcelona, Spain;
- Departament de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Conchita Izquierdo
- Sub-Direcció General de Vigilància i Resposta a Emergències de Salut Pública, 08005 Barcelona, Spain;
| | - Cristina Rius
- CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.J.); (C.R.); (À.D.)
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
| | - Àngela Domínguez
- CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.J.); (C.R.); (À.D.)
- Departament de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain
| | | |
Collapse
|
4
|
Fang X, Ai J, Liu W, Ji H, Zhang X, Peng Z, Wu Y, Shi Y, Shen W, Bao C. Epidemiology of infectious diarrhoea and the relationship with etiological and meteorological factors in Jiangsu Province, China. Sci Rep 2019; 9:19571. [PMID: 31862956 PMCID: PMC6925108 DOI: 10.1038/s41598-019-56207-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 12/04/2019] [Indexed: 11/24/2022] Open
Abstract
We depicted the epidemiological characteristics of infectious diarrhoea in Jiangsu Province, China. Generalized additive models were employed to evaluate the age-specific effects of etiological and meteorological factors on prevalence. A long-term increasing prevalence with strong seasonality was observed. In those aged 0–5 years, disease risk increased rapidly with the positive rate of virus (rotavirus, norovirus, sapovirus, astrovirus) in the 20–50% range. In those aged > 20 years, disease risk increased with the positive rate of adenovirus and bacteria (Vibrio parahaemolyticus, Salmonella, Escherichia coli, Campylobacter jejuni) until reaching 5%, and thereafter stayed stable. The mean temperature, relative humidity, temperature range, and rainfall were all related to two-month lag morbidity in the group aged 0–5 years. Disease risk increased with relative humidity between 67–78%. Synchronous climate affected the incidence in those aged >20 years. Mean temperature and rainfall showed U-shape associations with disease risk (with threshold 15 °C and 100 mm per month, respectively). Meanwhile, disease risk increased gradually with sunshine duration over 150 hours per month. However, no associations were found in the group aged 6–19 years. In brief, etiological and meteorological factors had age-specific effects on the prevalence of infectious diarrhoea in Jiangsu. Surveillance efforts are needed to prevent its spread.
Collapse
Affiliation(s)
- Xinyu Fang
- School of Public Health, Nanjing Medical University, Nanjing, 211166, China.,Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Jing Ai
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Wendong Liu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Hong Ji
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Xuefeng Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Zhihang Peng
- School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Ying Wu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Yingying Shi
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Wenqi Shen
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Changjun Bao
- School of Public Health, Nanjing Medical University, Nanjing, 211166, China. .,Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China. .,NHC Key laboratory of Enteric Pathogenic Microbiology, Nanjing, 210009, China.
| |
Collapse
|
5
|
Popovici ED, Negru DG, Olariu T, Nagy M, Dinu S, Oprisan G, Zota L, Baditoiu LM. Application of the susceptible-infected-recovered deterministic model in a GII.P17 emergent norovirus strain outbreak in Romania in 2015. Infect Drug Resist 2019; 12:2543-2551. [PMID: 31496766 PMCID: PMC6701636 DOI: 10.2147/idr.s204175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 06/17/2019] [Indexed: 01/08/2023] Open
Abstract
Purpose This study shows the epidemiological profile of the first gastroenteritis outbreak of GII.P17 in the Romanian territory. An outbreak with such large amplitude in a European territory was previously undocumented. Patients and methods Using a cross-sectional design, with the susceptible-infected-recovered (SIR) deterministic compartmental model for a fixed population, and the cluster method for establishing the high-incidence zones, we carried out our investigation by means of questionnaires containing personal data, affected collectivities, disease onset and duration, symptoms displayed, medical assistance provided, previous antibiotic intake where applicable, food consumption and water sources, and sanitation conditions. The confirmation of cases was done based on the typical norovirus gastroenteritis symptomatology and using three laboratory confirmations (by molecular diagnosis) for GII.P17-GII.17 genotype noroviruses from three patients. Results A gastroenteritis outbreak occurred in October-November 2015, affecting 328 people in Arad, a county in Western Romania, covering 44 neighbouring localities with a total population of 35,440 people. The study detected an inter-human transmission of the infection, with an intrafamilial risk of disease of 2.26 (95% CI 1.76 to 2.90) compared with the community transmission (in school collectivity). The basic reproduction number Ro dropped from 1.26 to 0.18 during weeks 43:44, after controlling the transmission by decontamination and isolation. Conclusion SIR made it possible to highlight the expansion of the emerging norovirus strain infection from community to family collectivities. This study provides practical solutions to limit disease cases, even in the absence of etiology, and shows the importance of sometimes underestimated traditional control methods.
Collapse
Affiliation(s)
- Emilian Damian Popovici
- Epidemiology Department, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania.,National Institute of Public Health, Regional Public Health Centre, Timişoara, Romania
| | | | | | - Mariana Nagy
- Department of Mathematics and Computer Science, "Aurel Vlaicu" University of Arad, Arad, Romania
| | - Sorin Dinu
- Molecular Epidemiology Laboratory, Cantacuzino National Medical - Military Institute of Research and Development, Bucharest, Romania
| | - Gabriela Oprisan
- Molecular Epidemiology Laboratory, Cantacuzino National Medical - Military Institute of Research and Development, Bucharest, Romania.,Faculty of Pharmacy, "Titu Maiorescu" University, Bucharest, Romania
| | - Lavinia Zota
- National Institute of Public Health, National Centre for Surveillance and Control of Communicable Diseases, Bucharest, Romania
| | | |
Collapse
|
6
|
Free RJ, Buss BF, Koirala S, Ulses M, Carlson A, Loeck B, Safranek T. Successive Norovirus Outbreaks at an Event Center - Nebraska, October-November, 2017. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2019; 68:627-630. [PMID: 31318854 PMCID: PMC6657769 DOI: 10.15585/mmwr.mm6828a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|