Duan Xiaojian, Wang Jing, Wang Yi, He Zhaokai, Ren Xiaobin, Wang Zhe, Kao Qingjun, Song Kai, Huo Liangliang
Hangzhou Center for Disease Control and Prevention (Hangzhou Health Supervision Institution) Institute of Infectious Disease Control and Prevention, Hangzhou, China.
Front Public Health. 2025 Jul 24;13:1631091. doi: 10.3389/fpubh.2025.1631091. eCollection 2025.
While nosocomial norovirus transmission in hospitalized patients is well characterized, its transmission dynamics among HCWs remain poorly documented. This investigation of HCW-focused norovirus transmission provides critical epidemiological evidence to refine infection control protocols for gastroenteritis in healthcare settings. This study utilized a retrospective case-control design to systematically analyze outbreak transmission dynamics. Structured questionnaires were implemented ≤72 h post-symptom onset to capture dietary exposures during the three-day exposure window, minimizing recall bias. Potential high-risk dining periods and food items were further analyzed via a case-control study. The outbreak investigation identified 52 cases, including 48 HCWs and 4 cafeteria staff, yielding an overall attack rate of 2.21% (52/2352). Epidemiological evidence supports a point-source origin, as demonstrated by the single-peak epidemic curve. Case-control analysis revealed the lunch on 19th June as the primary exposure window (statistically significant OR = 25.21; 95% CI: 3.35-189.69), with the "red bean cake" served in the implicated meal being the significantly associated food item (OR = 1248.75; 95% CI: 170.64-9138.33). RT-qPCR confirmed norovirus GII RNA in clinical specimens from cases and the implicated "red bean cake" food sample. These findings definitively established the "red bean cake" as the outbreak's etiological source.
虽然医院内住院患者之间的诺如病毒传播情况已得到充分描述，但其在医护人员中的传播动态仍记录甚少。这项针对医护人员的诺如病毒传播调查提供了关键的流行病学证据，以完善医疗机构中胃肠炎的感染控制方案。本研究采用回顾性病例对照设计，系统分析疫情传播动态。在症状出现后≤72小时内实施结构化问卷，以获取三天暴露窗口期内的饮食暴露情况，尽量减少回忆偏倚。通过病例对照研究进一步分析潜在的高风险用餐时段和食物项目。疫情调查确定了52例病例，包括48名医护人员和4名食堂工作人员，总体发病率为2.21%（52/2352）。流行病学证据支持点源起源，单峰流行曲线证明了这一点。病例对照分析显示，6月19日午餐是主要暴露窗口（统计学显著的比值比=25.21；95%置信区间：3.35-189.69），涉事餐食中供应的“红豆糕”是显著相关的食物项目（比值比=1248.75；95%置信区间：170.64-9138.33）。逆转录定量聚合酶链反应在病例的临床标本和涉事“红豆糕”食物样本中确认了诺如病毒GII型RNA。这些发现明确确定“红豆糕”是此次疫情的病原来源。
