A community outbreak of rotavirus diarrhea associated with exposures in a hospital outpatient department in South China

Pediatr Infect Dis J. 2011 Sep;30(9):745-8. doi: 10.1097/INF.0b013e31821fa542.

Abstract

Introduction: Between October 1 and December 10, 2006, Bao'an, China had a 5-fold increase in acute rotavirus gastroenteritis (ARGE) cases compared with the same time in 2005. To identify the risk factors for ARGE during this outbreak, we conducted a case-control study among children ≤ 24 months old from the most heavily affected area.

Methods: We defined an ARGE case as diarrhea, with group A rotavirus antigen detected from fecal samples by the enzyme-linked immunosorbent assay test. In the case-control study, 86 confirmed ARGE cases were identified. We enrolled 98 healthy control children matched by age. We administered questionnaires about exposures through telephone interviews.

Results: Of 8 general exposure types, we identified the following as being associated with ARGE: visiting outpatient services of hospital X, odds ratio (OR) = 7.1 (95% confidence interval [CI], 2.2-26); contact with other children with diarrhea, OR = 2.1 (95% CI, 1.1-3.7); and hand-washing before eating, OR = 0.48 (95% CI, 0.27-0.82). After improvements in the outpatient department of hospital X, ARGE incidence in the community during the ARGE transmission season (October through December) decreased from 4.3/10000 in 2006 to 1.4/10000 in 2009.

Conclusions: Outpatient services in hospital X may have contributed to the transmission of ARGE and improvements in infection control practices in this setting were associated a marked decrease incidence of ARGE in this community.

MeSH terms

  • Case-Control Studies
  • Child
  • Child, Preschool
  • China / epidemiology
  • Diarrhea / epidemiology*
  • Diarrhea / virology*
  • Disease Outbreaks*
  • Female
  • Hospitals
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Outpatients*
  • Residence Characteristics
  • Risk Factors
  • Rotavirus Infections / epidemiology*
  • Rotavirus Infections / transmission
  • Rotavirus Infections / virology