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. 2019 Oct 29;19(1):910.
doi: 10.1186/s12879-019-4570-6.

A foodborne outbreak of gastroenteritis caused by Norovirus and Bacillus cereus at a university in the Shunyi District of Beijing, China 2018: a retrospective cohort study

Dongwan Chen  1 , Yongjin Li  2 , Jinchang Lv  2 , Xiufeng Liu  2 , Peng Gao  2 , Guoxin Zhen  2 , Wenzeng Zhang  2 , Dan Wu  2 , Hongbo Jing  2 , Ying Li  2 , Yao Zhao  3 , Xiaochen Ma  3 , Huilai Ma  4 , Lijie Zhang  4
Affiliations

A foodborne outbreak of gastroenteritis caused by Norovirus and Bacillus cereus at a university in the Shunyi District of Beijing, China 2018: a retrospective cohort study

Dongwan Chen et al. BMC Infect Dis. .

Abstract

Background: On September 4, 2018, a boarding school in the Shunyi District of Beijing, China reported an outbreak of acute gastroenteritis. At least 209 suspected students caused of diarrhea and vomiting. The case was investigated, and control measures were taken to prevent further spread.

Methods: A retrospective cohort study was conducted among the school students and staff in order to test hypothesis that high risk of food served at the school canteen. We collected information on demographics, refectory records, person to person transmission by uniform epidemiological questionnaire. Risk ratios (RR) and 95% confidence intervals (CI) were calculated. Stool specimens of cases and canteen employees, retained food, water, and environmental swabs were investigated by laboratory analysis.

Results: We identified 209 cases (including 28 laboratory-confirmed cases) which occurred from August 29 to September 10. All cases were students, and the average age was 20, 52% were male. The outbreak lasted for 13 days, and peaked on September 5. Consumption of Drinks stall and Rice flour stall on September 1 (RR:3.4, 95%CI:1.5-7.8, and RR:7.6, 95%CI:2.8-20.2), Rice flour stall and Fish meal stall on September 2 (RR:4.0, 95%CI:1.2-13.6, and RR:4.6, 95%CI:1.7-12.5), muslim meal stall on September 4 (RR:2.7, 95%CI:1.3-5.4), Barbeque stall on September 5 (RR:3.0, 95%CI:1.2-7.0) were independently associated with increased risk of disease within the following 2 days. Among 35 specimens of rectal swabs or feces from students, 28 specimens were positive. Norovirus GI.6 alone was detected in 23 specimens, Bacillus cereus alone in 3 specimens and both norovirus GI.6 and Bacillus cereus in 2 specimens. Ten specimens of rectal swabs from canteen employees were positive for norovirus GI, and 2 specimens were positive for Bacillus cereus. Four retained food specimens were positive for Bacillus cereus, and environmental samples were negative for any viruses or bacteria.

Conclusion: Our investigation indicated that canteen employees were infected by two pathogens (norovirus and Bacillus cereus) and transmission may have been possible due to unhygienic practices. Student consumption of food or drink at high-risk stalls was determined as the probable cause of the outbreak.

Keywords: Bacillus cereus; Cohort study; Foodborne; Gastroenteritis; Norovirus; Outbreak.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Epidemic curve for probable outbreak cases of acute gastroenteritis by 24 h intervals at a university—Shunyi, Beijing, China, 2018
See this image and copyright information in PMC

References

    1. Zhang S, Chen TH, Wang J, Dong C, Pan J, Moe C, Chen W, Yang L, Wang X, Tang H, Li X, Liu P. Symptomatic and asymptomatic infections of rotavirus, norovirus, and adenovirus among hospitalized children in Xi’an, China. J Med Virol. 2011;83(8):1476–1484. doi: 10.1002/jmv.22108. - DOI - PubMed
    1. Gallimore CI, Cubitt D, du Plessis N, Gray JJ. Asymptomatic and symptomatic excretion of noroviruses during a hospital outbreak of gastroenteritis. J Clin Microbiol. 2004;42(5):2271–2274. doi: 10.1128/JCM.42.5.2271-2274.2004. - DOI - PMC - PubMed
    1. Vinjé J. Advances in laboratory methods for detection and typing of norovirus. J Clin Microbiol. 2015;53(2):373–381. doi: 10.1128/JCM.01535-14. - DOI - PMC - PubMed
    1. Vega E, Barclay L, Gregoricus N, Shirley SH, Lee D, Vinjé J. Genotypic and epidemiologic trends of norovirus outbreaks in the United States, 2009 to 2013. J Clin Microbiol. 2014;52(1):147–155. doi: 10.1128/JCM.02680-13. - DOI - PMC - PubMed
    1. Yu Y, Yan S, Li B, Pan Y, Wang Y. Genetic diversity and distribution of human norovirus in China (1999–2011) Biomed Res Int. 2014;2014:1–10. - PMC - PubMed

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