Airborne or Fomite Transmission for Norovirus? A Case Study Revisited

Shenglan Xiao, Julian W. Tang and Yuguo Li
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Shenglan Xiao: Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
Julian W. Tang: Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester LE1 7RH, UK
Yuguo Li: Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China

IJERPH, 2017, vol. 14, issue 12, 1-10

Abstract: Norovirus infection, a highly prevalent condition associated with a high rate of morbidity, comprises a significant health issue. Although norovirus transmission mainly occurs via the fecal-oral and vomit-oral routes, airborne transmission has been proposed in recent decades. This paper re-examines a previously described norovirus outbreak in a hotel restaurant wherein airborne transmission was originally inferred. Specifically, the original evidence that suggested airborne transmission was re-analyzed by exploring an alternative hypothesis: could this outbreak instead have occurred via fomite transmission? This re-analysis was based on whether fomite transmission could have yielded similar attack rate distribution patterns. Seven representative serving pathways used by waiters were considered, and the infection risk distributions of the alternative fomite transmission routes were predicted using a multi-agent model. These distributions were compared to the reported attack rate distribution in the original study using a least square methods approach. The results show that with some reasonable assumptions of human behavior patterns and parameter values, the attack rate distribution corresponded well with that of the infection risk via the fomite route. This finding offers an alternative interpretation of the transmission routes that underlay this particular norovirus outbreak and an important consideration in the development of infection control guidelines and the investigation of similar norovirus outbreaks in future.

Keywords: norovirus; multi-agent simulation; fomite; airborne; outbreak analyses (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2017
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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