Improving knowledge, attitude and practice on norovirus infection diarrhea among staff of kindergartens and schools: a before-after study.

BACKGROUND: Norovirus gastroenteritis outbreaks were common in schools and kindergartens and were more related to faculty knowledge, attitude, and practice level. Gastroenteritis outbreaks caused by norovirus in educational institutions were the prominent cause of Public Health Emergency Events in China. This study aimed to explore the transformation in the contribution of KAP items related to outbreak prevention before and after intervention and the impact of demography factors on the intervention. METHODS: This study sampled 1095 kindergarten and 1028 school staff in Shenzhen, China. We created a questionnaire consisting of 35 items in 4 parts, and each item was rated on a scale of 1-5 according to the accuracy. Univariate analysis of non-parametric tests and binary logistic regression were used to estimate the score difference on demographic characteristics, each item and KAP. The odds ratios (OR) with 95% confidence and intervals (CI) for the association between statistical indicators were mainly used to explain the effects before and after intervention. RESULTS: Overall, 98.72% and 74.9% of the kindergarten and school participants were female, and all respondents had the highest scores difference of practice. Following intervention, univariate analysis indicated that primary school and female respondents achieved higher knowledge scores. Staff age beyond 35 (OR = 0.56, CI:0.34-0.92; OR = 0.67, CI:0.50-0.90) and with more than ten years of service (OR = 0.58, CI:0.36-0.91; OR = 0.38, CI:0.17-0.84) demonstrated a significantly lower post-intervention score for attitude and practice in both kindergartens and schools. The staff members exhibited a general lack of familiarity with the transmission of aerosols and the seasonal patterns of NoVs diarrhea pandemics. Item analysis revealed that kindergarten staff aged 26 and above demonstrated superior performance in terms of the efficacy of medical alcohol for inactivation (OR = 1.93, CI:1.13-3.31) and management strategies for unexplained vomiting among students (OR = 1.97, CI:1.21-3.18). Private school personnel displayed more significant improvement in their practices following educational interventions. School administrators' negative attitudes were primarily evident in their perspectives on morning inspections (OR = 0.11, CI:0.05-0.84). CONCLUSIONS: The potential negative impact of faculty age on NoVs-related knowledge can be mitigated by the positive attitudes fostered through seniority. Furthermore, it is imperative to urgently address the lack of knowledge among administrators, and the identification and treatment of vomiting symptoms should be emphasized as crucial aspects of school prevention strategies. Therefore, education authorities should implement comprehensive public health interventions in the future.

High-rise buildings: A risk factor in the COVID-19 Omicron epidemic period.

Objectives: This study aimed to investigate possible viral transmission scenarios inside a high-rise building during the Omicron phase of the COVID-19 pandemic. Study design: Cross-sectional study design. Methods: In order to determine the pathogenicity of the Omicron variant of SARS-CoV-2, demographic, vaccination and clinical data were collected from COVID-19 positive cases during an outbreak in a high-rise residential building in Shenzhen, China, in early 2022. The pattern of viral transmission inside the building was determined through field investigation and engineering analysis. The results highlight the risk of Omicron infection in high-rise residential buildings. Results: Symptoms of infection with the Omicron variant are predominantly mild. Younger age has a greater impact on the severity of disease than vaccination status. Each floor of the high-rise building investigated contained 7 apartments, numbered 01 to 07, positioned in the same layout on each floor. The drainage system included vertical pipes from the ground to the roof of the building. There were statistically significant differences in infection rates at different time points and incidence ratios between apartment numbers ending in 07 (type 07) and other apartments (P < 0.001). Households with early disease onset were concentrated in apartment type 07 and the severity of their disease was more severe. The incubation period of the outbreak was 5.21-5.31 days and the time-dependent reproduction number (Rt) was 12.08 (95% confidence interval [CI] 7.66, 18.29). Results suggest both non-contact and contact viral transmission may have contributed to the outbreak. The drainage system in the building allows aerosol regurgitation, thus indicating that the structure of the building may have led to spread of the virus from the sewage pipes. Infections in other apartments may have been as result of viral transmission in the elevators and intimate family contact. Conclusions: Results from this study suggest that Omicron transmission was likely to be via the sewage system, supplemented by contact transmission in the stairs and elevators. The environmental spread of Omicron needs to be highlighted and prevented.