A foodborne outbreak of gastroenteritis caused by Norovirus and Bacillus cereus at a university in the Shunyi District of Beijing, China 2018: a retrospective cohort study.

BACKGROUND: On September 4, 2018, a boarding school in the Shunyi District of Beijing, China reported an outbreak of acute gastroenteritis. At least 209 suspected students caused of diarrhea and vomiting. The case was investigated, and control measures were taken to prevent further spread. METHODS: A retrospective cohort study was conducted among the school students and staff in order to test hypothesis that high risk of food served at the school canteen. We collected information on demographics, refectory records, person to person transmission by uniform epidemiological questionnaire. Risk ratios (RR) and 95% confidence intervals (CI) were calculated. Stool specimens of cases and canteen employees, retained food, water, and environmental swabs were investigated by laboratory analysis. RESULTS: We identified 209 cases (including 28 laboratory-confirmed cases) which occurred from August 29 to September 10. All cases were students, and the average age was 20, 52% were male. The outbreak lasted for 13 days, and peaked on September 5. Consumption of Drinks stall and Rice flour stall on September 1 (RR:3.4, 95%CI:1.5-7.8, and RR:7.6, 95%CI:2.8-20.2), Rice flour stall and Fish meal stall on September 2 (RR:4.0, 95%CI:1.2-13.6, and RR:4.6, 95%CI:1.7-12.5), muslim meal stall on September 4 (RR:2.7, 95%CI:1.3-5.4), Barbeque stall on September 5 (RR:3.0, 95%CI:1.2-7.0) were independently associated with increased risk of disease within the following 2 days. Among 35 specimens of rectal swabs or feces from students, 28 specimens were positive. Norovirus GI.6 alone was detected in 23 specimens, Bacillus cereus alone in 3 specimens and both norovirus GI.6 and Bacillus cereus in 2 specimens. Ten specimens of rectal swabs from canteen employees were positive for norovirus GI, and 2 specimens were positive for Bacillus cereus. Four retained food specimens were positive for Bacillus cereus, and environmental samples were negative for any viruses or bacteria. CONCLUSION: Our investigation indicated that canteen employees were infected by two pathogens (norovirus and Bacillus cereus) and transmission may have been possible due to unhygienic practices. Student consumption of food or drink at high-risk stalls was determined as the probable cause of the outbreak.

[Investigation on the dietary iron intake of infants from four month-old to one year-old in Shunyi District of Beijing].

OBJECTIVE: To understand the present status of dietary iron intake of infants from 4 to 12 month-old in urban and rural areas of Shunyi District of Beijing, and to provide scientific basis for their supplementary foods. METHODS: Two hundred and sixty-six infants were selected and investigated with a 3-day (72h) dietary record questionary. RESULTS: The average dietary iron intake of 4 - 5 month-old infants has achieved to the Dietary Reference Intakes, and no significant difference was observed between the intakes in urban and rural areas (P > 0.05). The proportion of infants whose dietary iron intake was higher than the Adequate Intakes (AI) of iron was just 19.8% among the studied infants in rural and 36. 9% in urban areas (P < 0.01). There was no significant difference on breastfeeding rates in rural and urban groups (P > 0.05). The main dietary iron sources were from cereals, fruits, eggs, vegetables and meat. CONCLUSION: The dietary iron intake of 6 - 12 month-old infants in Shunyi was significantly insufficient. Encouraging mothers to go on fully breastfeeding for at least 6 months, as well as giving supplementary foods rich in iron at the right time according to the state of infants.

Gastroenteritis Outbreak Caused by Campylobacter jejuni - Beijing, China, August, 2019.

What is already known about this topic? Campylobacter genus bacteria are recognized as some of the leading causes of the bacterial diarrheal illness in both developing and developed countries. Recent pilot surveillance study revealed Campylobacter is the most common pathogen in the diarrheal cases using the enhanced filtration methods in Beijing. One outbreak caused by multi-drug resistant Campylobacter coli ( C. coli ) was identified in 2018. What is added by this report? This is the first identified gastroenteritis outbreak caused by local Campylobacter jejuni (C . jejuni) infection in Beijing. A total of 14 patients were identified from August 23 to 26, 2019. The epidemiological investigation indicated that all of the patients worked at the same factory and the diarrhea happened after the same meal supplied from one company which service the meal delivery. Fourteen C. jejuni isolates were obtained from 12 patients and 2 food workers. Whole Genome Sequencing (WGS) analysis indicated this outbreak was caused by one highly clonal C. jejuni. What are the implications for public health practice? Campylobacter is the major foodborne pathogen in the world. Surveillance and risk assessment for Campylobacter infection particularly for Guillain-Barré Syndrome (GBS) associated C. jejuni infection in China should closely monitored.