Epidemiological characteristics of infectious disease outbreaks in schools in Zhejiang province, China, from 2013 to 2021

Abstract Background Schools are special and important places where susceptible groups of infectious diseases congregate, providing conditions for infectious disease outbreaks. A retrospective analysis of school outbreaks was conducted to explore the epidemiological characteristics of school outbreak...

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Main Authors: Yan Feng, Feng Ling, Jimin Sun, Shelan Liu, Jinren Pan, Zhao Yu, Zenghao Xu, Jialie Jin, Xiaopeng Shang, Jian Cai
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-10867-w
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author Yan Feng
Feng Ling
Jimin Sun
Shelan Liu
Jinren Pan
Zhao Yu
Zenghao Xu
Jialie Jin
Xiaopeng Shang
Jian Cai
author_facet Yan Feng
Feng Ling
Jimin Sun
Shelan Liu
Jinren Pan
Zhao Yu
Zenghao Xu
Jialie Jin
Xiaopeng Shang
Jian Cai
author_sort Yan Feng
collection DOAJ
description Abstract Background Schools are special and important places where susceptible groups of infectious diseases congregate, providing conditions for infectious disease outbreaks. A retrospective analysis of school outbreaks was conducted to explore the epidemiological characteristics of school outbreaks in Zhejiang Province, China. Methods Data on school infectious disease outbreaks reported in Zhejiang Province from 2013 to 2021 were collected. The characteristics of the temporal and spatial distributions, attack rates, identification durations, outbreak durations and influencing factors were studied using descriptive epidemiological methods. Results A total of 1248 school outbreaks of 20 infectious causes were reported, for an overall attack rate of 2.97%. Among intestinal and respiratory infections, norovirus acute gastroenteritis and varicella, respectively, were the most common causes. May and December presented the greatest number of causes of school outbreaks, whereas November to January presented the peak number of school outbreaks. The three causes of outbreaks with the highest attack rates were herpeticangina (7.76%), influenza-like illness (7.48%), and influenza (6.37%) outbreaks. The three most common causes with the longest median identification duration and median outbreak duration were tuberculosis, Mycoplasma pneumoniae, and mumps. Kindergartens (5.54%), by school closures (3.44%), and rural schools (4.02%) presented higher attack rates, whereas reporting outbreaks within two days yielded a lower attack rate (2.09%). The median duration of outbreaks in kindergartens (4.00 days), by school closures (7.00 days), and reporting outbreaks within two days (3.00 days) was shorter, whereas that in rural schools was longer (10.50 days). Conclusion Kindergartens and rural schools are the key units for preventing and controlling school outbreaks. May and November–January should receive more attention. Timely reporting and school closures could be implemented to reduce the attack rate, outbreak duration, and impact of infectious diseases on students’ health.
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spelling doaj-art-c117b1a815e648969d65269bcb7fe60f2025-08-20T03:10:09ZengBMCBMC Infectious Diseases1471-23342025-04-0125111110.1186/s12879-025-10867-wEpidemiological characteristics of infectious disease outbreaks in schools in Zhejiang province, China, from 2013 to 2021Yan Feng0Feng Ling1Jimin Sun2Shelan Liu3Jinren Pan4Zhao Yu5Zenghao Xu6Jialie Jin7Xiaopeng Shang8Jian Cai9Department of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and PreventionGeneral Office, Zhejiang Provincial Center for Disease Control and PreventionDepartment of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and PreventionDepartment of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and PreventionDepartment of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and PreventionDepartment of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and PreventionDepartment of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and PreventionDepartment of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and PreventionDepartment of Public Health Emergency Response, Zhejiang Provincial Center for Disease Control and PreventionDepartment of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and PreventionAbstract Background Schools are special and important places where susceptible groups of infectious diseases congregate, providing conditions for infectious disease outbreaks. A retrospective analysis of school outbreaks was conducted to explore the epidemiological characteristics of school outbreaks in Zhejiang Province, China. Methods Data on school infectious disease outbreaks reported in Zhejiang Province from 2013 to 2021 were collected. The characteristics of the temporal and spatial distributions, attack rates, identification durations, outbreak durations and influencing factors were studied using descriptive epidemiological methods. Results A total of 1248 school outbreaks of 20 infectious causes were reported, for an overall attack rate of 2.97%. Among intestinal and respiratory infections, norovirus acute gastroenteritis and varicella, respectively, were the most common causes. May and December presented the greatest number of causes of school outbreaks, whereas November to January presented the peak number of school outbreaks. The three causes of outbreaks with the highest attack rates were herpeticangina (7.76%), influenza-like illness (7.48%), and influenza (6.37%) outbreaks. The three most common causes with the longest median identification duration and median outbreak duration were tuberculosis, Mycoplasma pneumoniae, and mumps. Kindergartens (5.54%), by school closures (3.44%), and rural schools (4.02%) presented higher attack rates, whereas reporting outbreaks within two days yielded a lower attack rate (2.09%). The median duration of outbreaks in kindergartens (4.00 days), by school closures (7.00 days), and reporting outbreaks within two days (3.00 days) was shorter, whereas that in rural schools was longer (10.50 days). Conclusion Kindergartens and rural schools are the key units for preventing and controlling school outbreaks. May and November–January should receive more attention. Timely reporting and school closures could be implemented to reduce the attack rate, outbreak duration, and impact of infectious diseases on students’ health.https://doi.org/10.1186/s12879-025-10867-wSchoolInfectious diseaseOutbreakEpidemiological characteristicsInfluencing factors
spellingShingle Yan Feng
Feng Ling
Jimin Sun
Shelan Liu
Jinren Pan
Zhao Yu
Zenghao Xu
Jialie Jin
Xiaopeng Shang
Jian Cai
Epidemiological characteristics of infectious disease outbreaks in schools in Zhejiang province, China, from 2013 to 2021
BMC Infectious Diseases
School
Infectious disease
Outbreak
Epidemiological characteristics
Influencing factors
title Epidemiological characteristics of infectious disease outbreaks in schools in Zhejiang province, China, from 2013 to 2021
title_full Epidemiological characteristics of infectious disease outbreaks in schools in Zhejiang province, China, from 2013 to 2021
title_fullStr Epidemiological characteristics of infectious disease outbreaks in schools in Zhejiang province, China, from 2013 to 2021
title_full_unstemmed Epidemiological characteristics of infectious disease outbreaks in schools in Zhejiang province, China, from 2013 to 2021
title_short Epidemiological characteristics of infectious disease outbreaks in schools in Zhejiang province, China, from 2013 to 2021
title_sort epidemiological characteristics of infectious disease outbreaks in schools in zhejiang province china from 2013 to 2021
topic School
Infectious disease
Outbreak
Epidemiological characteristics
Influencing factors
url https://doi.org/10.1186/s12879-025-10867-w
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