Waterborne norovirus outbreaks in China, 2000-2022: a systematic review.
Rev Environ HealthJul 17, 2026 (epub)
Ruihan Xu, Jingqi Yu, Jiamei Fu et al.
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In 30 seconds
This systematic review analyzed 112 waterborne norovirus outbreaks in China from 2000 to 2022, involving approximately 19,796 cases. The median number of cases per outbreak was 98, with a median attack rate of 6.09%. The findings highlight the significant impact of waterborne transmission despite its rarity.
Key findings
- 112 outbreaks reported, involving approximately 19,796 cases and 565,485 exposures.
- Median attack rate was 6.09%, with higher rates in winter and primary schools.
- Most outbreaks occurred in southern regions, particularly in coastal provinces.
- Contamination of barreled water and self-provided wells was the primary risk factor.
Why it matters
Understanding the epidemiological features of waterborne norovirus outbreaks is crucial for public health strategies. Effective monitoring and protection of water sources can help mitigate the risk of large-scale outbreaks.