An Acute Gastroenteritis Outbreak Caused by Astrovirus Serotype 4 in a School of Shenzhen City, China, 2017

Abstract

Background: In November of 2017, a school outbreak of acute gastroenteritis was reported from Shenzhen City. Methods: A cohort study was conducted to describe the epidemiological characteristics of the outbreak. Data on demographic details, onset of clinical symptoms, food and water intake history, contact with ill person prior to illness were obtained. Results: 98 student-cases were identified. The main symptoms included vomiting (69%), abdominal pain (59%), nausea (47%), diarrhea (43%) and cough (38%) with the median duration of illness of 2 days (range: 1-8 days). The AR was 3.2% and involved 63% of the classes with the median age of 10 years (range 6-15 years). Based on epidemiological investigation, multivariate analysis showed that touching with ill students (RR = 3.95, 95% CI = 2.18-5.58) and touching the handles of faucet (RR = 4.18, 95% CI = 1.50-8.37) were associated with illness. Astrovirus serotype 4 was detected in 6 ill students and 1 asymptomatic cleaning staff. Conclusions: This outbreak was caused by astrovirus. The main exposure mode was likely person to person and touching a contaminated water faucet. Recommendations included immediate isolation of cases and daily disinfecting the drinking water faucet. In the future, surveillance for astrovirus should be strengthened by laboratory testing after other common pathogens are ruled out.

Human Astrovirus Outbreak in a Daycare Center and Propagation among Household Contacts

“…We found a global AR of 20%, similar to the 17.6% (261/1479) described by Lui et al [27] in an outbreak in schoolchildren in the Chinese province of Guangxi in 2017 and less than the 70% (7/10) in children aged 7-18 months described by Taylor et al [26] in an outbreak in a South-African daycare center. Other reports have found smaller AR, ranging between 3.2% and 8.5% [28,29].…”