title: Norovirus prevention and the prevalence of asymptomatic norovirus infection in kindergartens and primary schools in Changzhou, China: Status of the knowledge, attitudes, behaviors, and requirements.
abstract: BACKGROUND
  We estimated the status of norovirus infection and prevention in kindergartens and primary schools and identified poor areas for which future education is needed. We evaluated the knowledge, attitude, behavior, requirements of outbreak prevention, and rate of asymptomatic carriers.
  
  
  METHODS
  Two self-administered questionnaires were conducted for data collection. Five hundred seventy-four teachers from kindergartens and primary schools and 3,114 students from primary schools in Changzhou city were sampled for questionnaire investigation. In addition, 511 rectal swabs from healthy children were taken for norovirus detection.
  
  
  RESULTS
  Twenty-one of 511 children were asymptomatically infected with norovirus. The rate of asymptomatic norovirus infection children in kindergartens was 2.7% and 4.7% in primary schools. Nineteen of 21 positive samples were GII strains, the other 2 were GI strains. In addition, we found that primary schools were less prepared to prevent norovirus outbreaks than kindergartens. Settings in the suburban counties needed more education on norovirus prevention.
  
  
  CONCLUSIONS
  The results of this study emphasize the need for training of primary schools and suburban schools about norovirus prevention. Asymptomatic norovirus infection should receive more attention.
authors.affiliation: Changzhou Center for Disease Control and Prevention, Changzhou, Jiangsu Province, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Qi
authors.affiliation: Center for Endemic Disease Control, Harbin Medical University, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Ye
authors.affiliation: Changzhou Center for Disease Control and Prevention, Changzhou, Jiangsu Province, China.
authors.forename: Cong
authors.initials: C
authors.lastname: Chen
authors.affiliation: Changzhou Center for Disease Control and Prevention, Changzhou, Jiangsu Province, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Yao
authors.affiliation: Changzhou Center for Disease Control and Prevention, Changzhou, Jiangsu Province, China.
authors.forename: Feifei
authors.initials: F
authors.lastname: Hu
authors.affiliation: Changzhou Center for Disease Control and Prevention, Changzhou, Jiangsu Province, China. Electronic address: czcdcjc@163.com.
authors.forename: Qin
authors.initials: Q
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases / Q000453:epidemiology*; D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000517:prevention & control*; D002656:Child Day Care Centers; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D029322:Norovirus / Q000302:isolation & purification*; D015995:Prevalence; D012574:Schools; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Asymptomatic infection; Education; Norovirus; Questionnaire; Rectal swab