Study of Risk Factors for Total Attack Rate and Transmission Dynamics of Norovirus Outbreaks, Jiangsu Province, China, From 2012 to 2018

Jing Ai; Jing Ai; Yuanzhao Zhu; Jianguang Fu; Jianguang Fu; Xiaoqing Cheng; Xiaoqing Cheng; Xuefeng Zhang; Xuefeng Zhang; Hong Ji; Hong Ji; Wendong Liu; Wendong Liu; Jia Rui; Jingwen Xu; Tianlong Yang; Yao Wang; Xingchun Liu; Meng Yang; Shengnan Lin; Xiaohao Guo; Changjun Bao; Changjun Bao; Qun Li; Tianmu Chen

doi:10.3389/fmed.2021.786096

Frontiers in Medicine (Jan 2022)

Study of Risk Factors for Total Attack Rate and Transmission Dynamics of Norovirus Outbreaks, Jiangsu Province, China, From 2012 to 2018

Jing Ai,
Jing Ai,
Yuanzhao Zhu,
Jianguang Fu,
Jianguang Fu,
Xiaoqing Cheng,
Xiaoqing Cheng,
Xuefeng Zhang,
Xuefeng Zhang,
Hong Ji,
Hong Ji,
Wendong Liu,
Wendong Liu,
Jia Rui,
Jingwen Xu,
Tianlong Yang,
Yao Wang,
Xingchun Liu,
Meng Yang,
Shengnan Lin,
Xiaohao Guo,
Changjun Bao,
Changjun Bao,
Qun Li,
Tianmu Chen

Affiliations

Jing Ai: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Jing Ai: Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Yuanzhao Zhu: State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
Jianguang Fu: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Jianguang Fu: Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Xiaoqing Cheng: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Xiaoqing Cheng: Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Xuefeng Zhang: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Xuefeng Zhang: Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Hong Ji: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Hong Ji: Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Wendong Liu: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Wendong Liu: Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Jia Rui: State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
Jingwen Xu: State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
Tianlong Yang: State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
Yao Wang: State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
Xingchun Liu: State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
Meng Yang: State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
Shengnan Lin: State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
Xiaohao Guo: State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
Changjun Bao: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Changjun Bao: Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Qun Li: Public Health Emergency Center, Chinese Center for Disease Control and Prevention, Beijing, China
Tianmu Chen: State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China

DOI: https://doi.org/10.3389/fmed.2021.786096
Journal volume & issue: Vol. 8

Abstract

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Objective: To describe the epidemiological characteristics of norovirus outbreaks in Jiangsu Province, utilize the total attack rate (TAR) and transmissibility (Runc) as the measurement indicators of the outbreak, and a statistical difference in risk factors associated with TAR and transmissibility was compared. Ultimately, this study aimed to provide scientific suggestions to develop the most appropriate prevention and control measures.Method: We collected epidemiological data from investigation reports of all norovirus outbreaks in Jiangsu Province from 2012 to 2018 and performed epidemiological descriptions, sequenced the genes of the positive specimens collected that were eligible for sequencing, created a database and calculated the TAR, constructed SEIAR and SEIARW transmission dynamic models to calculate Runc, and performed statistical analyses of risk factors associated with the TAR and Runc.Results: We collected a total of 206 reported outbreaks, of which 145 could be used to calculate transmissibility. The mean TAR in was 2.6% and the mean Runc was 12.2. The epidemiological characteristics of norovirus outbreaks showed an overall increasing trend in the number of norovirus outbreaks from 2012 to 2018; more outbreaks in southern Jiangsu than northern Jiangsu; more outbreaks in urban areas than in rural areas; outbreaks occurred mostly in autumn and winter. Most of the sites where outbreaks occurred were schools, especially primary schools. Interpersonal transmission accounted for the majority. Analysis of the genotypes of noroviruses revealed that the major genotypes of the viruses changed every 3 years, with the GII.2 [P16] type of norovirus dominating from 2016 to 2018. Statistical analysis of TAR associated with risk factors found statistical differences in all risk factors, including time (year, month, season), location (geographic location, type of settlement, type of premises), population (total number of susceptible people at the outbreak site), transmission route, and genotype (P < 0.05). Statistical analysis of transmissibility associated with risk factors revealed that only transmissibility was statistically different between sites.Conclusions: The number of norovirus outbreaks in Jiangsu Province continues to increase during the follow-up period. Our findings highlight the impact of different factors on norovirus outbreaks and identify the key points of prevention and control in Jiangsu Province.

Published in Frontiers in Medicine

ISSN: 2296-858X (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Medicine (General)
Website: http://www.frontiersin.org/journals/medicine

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