An outbreak of multiple norovirus strains on a cruise ship in China, 2014.
OBJECTIVE
To determine the cause of an outbreak of acute gastroenteritis that occurred on a cruise ship sailing along the Yangzi River from Chongqing to Nanjing, China.


RESULTS
Noroviruses were identified by reverse transcription-PCR (RT-PCR) in rectal swabs from 34 of 54 subjects tested (63·0%). Sequencing and genotyping showed that noroviruses of up to seven different genotypes circulated in this outbreak: noroviruses GI.1, GI.2, GI.3, GI.4, GI.8, GI.9 and an uncommon strain GII.17. Common genotypes were not identified in this event. None of the food or water samples were tested positive for noroviruses.


CONCLUSIONS
We suspected that it was a point-source infection due to contaminated water or food harvested from contaminated water, taking account of the co-existence of diverse norovirus genotypes.


CONCLUSIONS
In this study, we presented the molecular investigation of a norovirus outbreak on a cruise in China. We revealed that the outbreak was caused by several different norovirus genotypes and analysed the possible source of infection as well, thus facilitating the evaluation of epidemiological issues regarding noroviruses in this area.
Nanjing Municipal Center for Disease Control and Prevention, Jiangsu, China.
X
X
Wang
Nanjing Municipal Center for Disease Control and Prevention, Jiangsu, China.
W
W
Yong
Nanjing Municipal Center for Disease Control and Prevention, Jiangsu, China.
L
L
Shi
Nanjing Municipal Center for Disease Control and Prevention, Jiangsu, China.
M
M
Qiao
Nanjing Municipal Center for Disease Control and Prevention, Jiangsu, China.
M
M
He
Nanjing Municipal Center for Disease Control and Prevention, Jiangsu, China.
H
H
Zhang
Nanjing Municipal Center for Disease Control and Prevention, Jiangsu, China.
B
B
Guo
Nanjing Municipal Center for Disease Control and Prevention, Jiangsu, China.
G
G
Xie
Gulou District Center for Disease Control and Prevention, Nanjing, Jiangsu, China.
M
M
Zhang
National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China.
M
M
Jin
Nanjing Municipal Center for Disease Control and Prevention, Jiangsu, China.
J
J
Ding
D000293:Adolescent; D000328:Adult; D017250:Caliciviridae Infections / Q000453:epidemiology / Q000821:virology*; D002681:China / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D005759:Gastroenteritis / Q000821:virology; D005838:Genotype; D006801:Humans; D008297:Male; D029322:Norovirus / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology; D012767:Ships; D014195:Travel; D055815:Young Adult
cruise ship; gastroenteritis; genetic diversity; norovirus; outbreak