Norovirus shedding among symptomatic and asymptomatic employees in outbreak settings in Shanghai, China
Abstract Background Norovirus (NoV) is recognized as a leading cause of acute gastroenteritis (AGE) outbreaks in settings globally. Studies have shown that employees played an important role in the transmission mode during some NoV outbreaks. This study aimed to investigate the prevalence of NoV inf...
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-019-4205-y |
| _version_ | 1811270361589743616 |
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| author | Qiang-song Wu Ze-liang Xuan Jing-yi Liu Xue-tao Zhao Yuan-fang Chen Chen-xi Wang Xiao-ting Shen Ya-xin Wang Lan Wang Yi Hu |
| author_facet | Qiang-song Wu Ze-liang Xuan Jing-yi Liu Xue-tao Zhao Yuan-fang Chen Chen-xi Wang Xiao-ting Shen Ya-xin Wang Lan Wang Yi Hu |
| author_sort | Qiang-song Wu |
| collection | DOAJ |
| description | Abstract Background Norovirus (NoV) is recognized as a leading cause of acute gastroenteritis (AGE) outbreaks in settings globally. Studies have shown that employees played an important role in the transmission mode during some NoV outbreaks. This study aimed to investigate the prevalence of NoV infection and duration of NoV shedding among employees during NoV outbreaks, as well as factors affecting shedding duration. Methods Specimens and epidemiological data were collected from employees who were suspected of being involved in the transmission or with AGE symptoms during NoV outbreaks in Xuhui District, Shanghai, from 2015 to 2017. Specimens were detected using real-time RT-PCR to determine whether or not employees had become infected with NoV. Specimens were collected every 3–7 days from NoV-infected employees until specimens became negative for NoV. Results A total of 421 employees were sampled from 49 NoV outbreaks, and nearly 90% of them (377/421) were asymptomatic. Symptomatic employees showed significantly higher prevalence of NoV infection than asymptomatic ones (70.5% vs. 17.0%, P < 0.01). The average duration of NoV shedding was 6.9 days (95% confidence interval: 6.1–7.7 days) among 88 NoV-infected individuals, and was significantly longer in symptomatic individuals than in asymptomatic ones (9.8 days vs. 5.6 days, P < 0.01). In Cox proportional-hazards model, after adjusting age and gender, symptoms was the only factor associated with duration of NoV shedding. Conclusions Compared with asymptomatic employees, symptomatic employees had higher prevalence of NoV infection and longer durations of NoV shedding. Since NoV shedding duration among NoV-infected employees tends to be longer than their isolation time during outbreaks, reinforcement of hygiene practices among these employees is especially necessary to reduce the risk of virus secondary transmissions after their return to work. |
| first_indexed | 2024-04-12T22:00:27Z |
| format | Article |
| id | doaj.art-5c027e5b70854d5f9d81982c3d2bbeaa |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-12T22:00:27Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-5c027e5b70854d5f9d81982c3d2bbeaa2022-12-22T03:15:08ZengBMCBMC Infectious Diseases1471-23342019-07-011911810.1186/s12879-019-4205-yNorovirus shedding among symptomatic and asymptomatic employees in outbreak settings in Shanghai, ChinaQiang-song Wu0Ze-liang Xuan1Jing-yi Liu2Xue-tao Zhao3Yuan-fang Chen4Chen-xi Wang5Xiao-ting Shen6Ya-xin Wang7Lan Wang8Yi Hu9Xuhui Center for Disease Control and PreventionXuhui Center for Disease Control and PreventionXuhui Center for Disease Control and PreventionXuhui Center for Disease Control and PreventionXuhui Center for Disease Control and PreventionXuhui Center for Disease Control and PreventionXuhui Center for Disease Control and PreventionXuhui Center for Disease Control and PreventionXuhui District Health and Family Planning CommissionDepartment of Epidemiology, China and Key Laboratory of Public Health Safety, (Fudan University), School of Public Health, Fudan University, Ministry of EducationAbstract Background Norovirus (NoV) is recognized as a leading cause of acute gastroenteritis (AGE) outbreaks in settings globally. Studies have shown that employees played an important role in the transmission mode during some NoV outbreaks. This study aimed to investigate the prevalence of NoV infection and duration of NoV shedding among employees during NoV outbreaks, as well as factors affecting shedding duration. Methods Specimens and epidemiological data were collected from employees who were suspected of being involved in the transmission or with AGE symptoms during NoV outbreaks in Xuhui District, Shanghai, from 2015 to 2017. Specimens were detected using real-time RT-PCR to determine whether or not employees had become infected with NoV. Specimens were collected every 3–7 days from NoV-infected employees until specimens became negative for NoV. Results A total of 421 employees were sampled from 49 NoV outbreaks, and nearly 90% of them (377/421) were asymptomatic. Symptomatic employees showed significantly higher prevalence of NoV infection than asymptomatic ones (70.5% vs. 17.0%, P < 0.01). The average duration of NoV shedding was 6.9 days (95% confidence interval: 6.1–7.7 days) among 88 NoV-infected individuals, and was significantly longer in symptomatic individuals than in asymptomatic ones (9.8 days vs. 5.6 days, P < 0.01). In Cox proportional-hazards model, after adjusting age and gender, symptoms was the only factor associated with duration of NoV shedding. Conclusions Compared with asymptomatic employees, symptomatic employees had higher prevalence of NoV infection and longer durations of NoV shedding. Since NoV shedding duration among NoV-infected employees tends to be longer than their isolation time during outbreaks, reinforcement of hygiene practices among these employees is especially necessary to reduce the risk of virus secondary transmissions after their return to work.http://link.springer.com/article/10.1186/s12879-019-4205-yNorovirusAcute gastroenteritisEmployeesSheddingAsymptomatic infection |
| spellingShingle | Qiang-song Wu Ze-liang Xuan Jing-yi Liu Xue-tao Zhao Yuan-fang Chen Chen-xi Wang Xiao-ting Shen Ya-xin Wang Lan Wang Yi Hu Norovirus shedding among symptomatic and asymptomatic employees in outbreak settings in Shanghai, China BMC Infectious Diseases Norovirus Acute gastroenteritis Employees Shedding Asymptomatic infection |
| title | Norovirus shedding among symptomatic and asymptomatic employees in outbreak settings in Shanghai, China |
| title_full | Norovirus shedding among symptomatic and asymptomatic employees in outbreak settings in Shanghai, China |
| title_fullStr | Norovirus shedding among symptomatic and asymptomatic employees in outbreak settings in Shanghai, China |
| title_full_unstemmed | Norovirus shedding among symptomatic and asymptomatic employees in outbreak settings in Shanghai, China |
| title_short | Norovirus shedding among symptomatic and asymptomatic employees in outbreak settings in Shanghai, China |
| title_sort | norovirus shedding among symptomatic and asymptomatic employees in outbreak settings in shanghai china |
| topic | Norovirus Acute gastroenteritis Employees Shedding Asymptomatic infection |
| url | http://link.springer.com/article/10.1186/s12879-019-4205-y |
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