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- Title
Evidence-Based interventions of Norovirus outbreaks in China.
- Authors
Chen, Tianmu; Gu, Haogao; Leung, Ross Ka-Kit; Liu, Ruchun; Chen, Qiuping; Wu, Ying; Li, Yaman
- Abstract
<bold>Background: </bold>In resource-limited settings where laboratory capacity is limited and response strategy is non-specific, delayed or inappropriate intervention against outbreaks of Norovirus (NoV) are common. Here we report interventions of two norovirus outbreaks, which highlight the importance of evidence-based modeling and assessment to identify infection sources and formulate effective response strategies.<bold>Methods: </bold>Spatiotemporal scanning, mathematical and random walk modeling predicted the modes of transmission in the two incidents, which were supported by laboratory results and intervention outcomes.<bold>Results: </bold>Simulation results indicated that contaminated water was 14 to 500 fold more infectious than infected individuals. Asymptomatic individuals were not effective transmitters. School closure for up to a week still could not contain the outbreak unless the duration was extended to 10 or more days. The total attack rates (TARs) for waterborne NoV outbreaks reported in China (n = 3, median = 4.37) were significantly (p < 0.05) lower than worldwide (n = 14, median = 41.34). The low TARs are likely due to the high number of the affected population.<bold>Conclusions: </bold>We found that school closure alone could not contain Norovirus outbreaks. Overlooked personal hygiene may serve as a hotbed for infectious disease transmission. Our results reveal that evidence-based investigations can facilitate timely interventions of Norovirus transmission.
- Subjects
CHINA; NOROVIRUS diseases; DISEASE outbreaks; STIMULUS &; response (Biology); MEDICAL needs assessment; MEDICAL model
- Publication
BMC Public Health, 2016, Vol 16, Issue 1, p1072
- ISSN
1471-2458
- Publication type
journal article
- DOI
10.1186/s12889-016-3716-3