Fu Zhongyan, Wu Changjing, Yu Yinghui, Zhao Jian, Dong Yan, Liu Wei, Dou Huixin, Shi Xuezhen, Cai Chengzhi, Jiao Baihai, Liu Tiantian, Jiao Boyan
Department of Infectious Disease Control, Shandong Center for Disease Control and Prevention, Jinan, China.
Shandong Provincial Key Laboratory of Intelligent Monitoring, Early Warning, Prevention and Control for Infectious Diseases, Jinan, China.
Front Microbiol. 2025 Apr 30;16:1570161. doi: 10.3389/fmicb.2025.1570161. eCollection 2025.
Diarrhea poses a serious threat to human health, and rainfall is known to increase the incidence of diarrheal diseases. On July 7, 2024, a diarrhea outbreak occurred in a school in Sishui County, Jining City, Shandong Province, China, following heavy rainfall. This study aimed to identify the pathogens responsible for the outbreak and characterize their whole genomes.
On July 8, 2024, a total of 21 stool samples from diarrhea cases, 2 water samples from private wells, and 1 drinking water sample from the school cafeteria were collected. Real-time quantitative PCR was used to detect Rotavirus A (RV-A), Norovirus genogroup I (NV GI), Norovirus genogroup II (NV GII), Sapovirus (SaV), Human Astrovirus (HAstV), and Human Adenovirus (HAdV). Whole-genome sequencing was performed for NV GI and SaV-positive samples to determine their genotypes, construct phylogenetic trees, and analyze amino acid variation sites in encoded proteins.
Among the 21 case stool samples, 7 tested positive for both NV GI and SaV, 10 were positive for NV GI only, and 1 was positive for SaV only. Of the 2 private well water samples, one was positive for NV GI and the other for SaV. Whole-genome sequences were obtained for 11 NV GI strains and 2 SaV strains. The 11 NV GI sequences from the outbreak exhibited high homology, with whole-genome similarity ranging from 99.96% to 100%, and were all identified as the NV GI.6 [P11] genotype. Phylogenetic analysis showed that these 11 sequences clustered within the same evolutionary branch. Similarly, the 2 SaV sequences were highly homologous, with 99.97% similarity, and were identified as the SaV GI.6 genotype, clustering within the same phylogenetic branch.
This diarrhea outbreak was caused by the combined presence of NV GI and SaV following heavy rainfall. These findings provide valuable reference data for the prevention and control of diarrhea outbreaks caused by heavy rainfall or multiple pathogens.
腹泻对人类健康构成严重威胁，已知降雨会增加腹泻疾病的发病率。2024年7月7日，在中国山东省济宁市泗水县的一所学校，暴雨过后发生了腹泻疫情。本研究旨在确定引发此次疫情的病原体并对其全基因组进行特征分析。
2024年7月8日，共采集了21份腹泻病例的粪便样本、2份私人井水样本以及1份学校食堂的饮用水样本。采用实时定量PCR检测A组轮状病毒（RV - A）、诺如病毒I基因组（NV GI）、诺如病毒II基因组（NV GII）、札幌病毒（SaV）、人星状病毒（HAstV）和人腺病毒（HAdV）。对NV GI和SaV阳性样本进行全基因组测序，以确定其基因型、构建系统发育树并分析编码蛋白中的氨基酸变异位点。
在21份病例粪便样本中，7份同时检测出NV GI和SaV呈阳性，10份仅NV GI呈阳性，1份仅SaV呈阳性。2份私人井水样本中，1份NV GI呈阳性，另1份SaV呈阳性。获得了11株NV GI毒株和2株SaV毒株的全基因组序列。此次疫情中的11条NV GI序列具有高度同源性，全基因组相似度在99.96%至100%之间，均被鉴定为NV GI.6 [P11]基因型。系统发育分析表明，这11条序列聚集在同一进化分支内。同样，2条SaV序列高度同源，相似度为99.97%，被鉴定为SaV GI.6基因型，聚集在同一系统发育分支内。
此次腹泻疫情是由暴雨后NV GI和SaV共同存在引起的。这些发现为预防和控制由暴雨或多种病原体引起的腹泻疫情提供了有价值的参考数据。
