{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T15:53:59Z","timestamp":1772466839122,"version":"3.50.1"},"reference-count":44,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"High-level Public Health Technical Talents Construction Project","award":["Academic Leader 02-07"],"award-info":[{"award-number":["Academic Leader 02-07"]}]},{"name":"Joint Research Fund for Beijing Natural Science Foundation and Haidian Original Innovation","award":["L232011"],"award-info":[{"award-number":["L232011"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Norovirus is the leading cause of acute gastroenteritis outbreaks worldwide. A total of 1859 norovirus outbreaks were reported from 2016 to 2022 in Beijing, China. GII.2[P16] was the predominant genotype during 2016\u20132021, and GII.3[P12] during 2021\u20132022. In the early stage of the COVID-19 epidemic (January to June of 2020), strict prevention and control measures were implemented, and only eight norovirus outbreaks were reported. Most norovirus outbreaks occurred in schools (95.6%, 1778). As the level of schooling rises, the scale of norovirus outbreaks also increases (median case numbers: 8 for kindergarten, 10 for primary school, 11 for secondary school, and 14 for college; p trend &lt; 0.001), while the attack rate decreases (median attack rates were correspondingly 25.8%, 17.5%, 10.0%, and 8.8%; p trend &lt; 0.001). Compared to outbreaks caused by person-to-person transmission, foodborne and waterborne outbreaks are larger in scale. Delayed outbreak response is also a risk factor for larger-scale outbreaks. Norovirus outbreaks have emerged as a significant concern for public health in Beijing. Persistent genotyping efforts are essential to facilitate early warning. Outbreaks in different locations or through different transmission routes require specific prevention and control measures.<\/jats:p>","DOI":"10.3390\/v18030295","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T14:55:01Z","timestamp":1772463301000},"page":"295","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiologic Trends, Genetic Diversity, and Risk Factors of Norovirus Outbreaks in Beijing, China, 2016\u22122022"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5523-5868","authenticated-orcid":false,"given":"Yu","family":"Wang","sequence":"first","affiliation":[{"name":"Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing 100013, China"},{"name":"Beijing Key Laboratory of Surveillance, Early Warning and Pathogen Research on Emerging Infectious Diseases, Beijing Center for Disease Prevention and Control, Beijing 100013, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weihong","family":"Li","sequence":"additional","affiliation":[{"name":"Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing 100013, China"},{"name":"Beijing Key Laboratory of Surveillance, Early Warning and Pathogen Research on Emerging Infectious Diseases, Beijing Center for Disease Prevention and Control, Beijing 100013, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baiwei","family":"Liu","sequence":"additional","affiliation":[{"name":"Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing 100013, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingyu","family":"Shen","sequence":"additional","affiliation":[{"name":"Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing 100013, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Tian","sequence":"additional","affiliation":[{"name":"Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing 100013, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Jia","sequence":"additional","affiliation":[{"name":"Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing 100013, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanqiu","family":"Yan","sequence":"additional","affiliation":[{"name":"Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing 100013, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Laboratory Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2804-0827","authenticated-orcid":false,"given":"Qingbin","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daitao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing 100013, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Yang","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Surveillance, Early Warning and Pathogen Research on Emerging Infectious Diseases, Beijing Center for Disease Prevention and Control, Beijing 100013, China"},{"name":"Beijing Research Center for Respiratory Infectious Diseases,  Beijing 100013, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quanyi","family":"Wang","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Surveillance, Early Warning and Pathogen Research on Emerging Infectious Diseases, Beijing Center for Disease Prevention and Control, Beijing 100013, China"},{"name":"Beijing Research Center for Respiratory Infectious Diseases,  Beijing 100013, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiyong","family":"Gao","sequence":"additional","affiliation":[{"name":"Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing 100013, China"},{"name":"Beijing Key Laboratory of Surveillance, Early Warning and Pathogen Research on Emerging Infectious Diseases, Beijing Center for Disease Prevention and Control, Beijing 100013, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuqiang","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Laboratory Science and Technology and Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China"},{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China"},{"name":"Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing 100191, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"105259","DOI":"10.1016\/j.micpath.2021.105259","article-title":"Global prevalence of norovirus in cases of acute gastroenteritis from 1997 to 2021: An updated systematic review and meta-analysis","volume":"161","author":"Liao","year":"2021","journal-title":"Microb. Pathog."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"437","DOI":"10.3201\/eid2603.191183","article-title":"Norovirus Outbreak Surveillance, China, 2016\u20132018","volume":"26","author":"Jin","year":"2020","journal-title":"Emerg. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1093\/cid\/ciac627","article-title":"Spatiotemporal Trends in Norovirus Outbreaks in the United States, 2009\u20132019","volume":"76","author":"Kambhampati","year":"2023","journal-title":"Clin. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1093\/infdis\/jiy569","article-title":"The Norovirus Epidemiologic Triad: Predictors of Severe Outcomes in US Norovirus Outbreaks, 2009\u20132016","volume":"219","author":"Burke","year":"2019","journal-title":"J. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Lanata, C.F., Fischer-Walker, C.L., Olascoaga, A.C., Torres, C.X., Aryee, M.J., Black, R.E., and Child Health Epidemiology Reference Group of the World Health Organization and UNICEF (2013). Global causes of diarrheal disease mortality in children < 5 years of age: A systematic review. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0072788"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e202","DOI":"10.1016\/S2542-5196(22)00003-1","article-title":"Associations between ambient temperature and enteric infections by pathogen: A systematic review and meta-analysis","volume":"6","author":"Chua","year":"2022","journal-title":"Lancet Planet. Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e2382","DOI":"10.1002\/rmv.2382","article-title":"Norovirus outbreaks in China, 2000\u20132018: A systematic review","volume":"32","author":"Yu","year":"2022","journal-title":"Rev. Med. Virol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3201\/eid3014.240307","article-title":"Molecular Characterization of Noroviruses Causing Acute Gastroenteritis Outbreaks among US Military Recruits, 2013\u20132023","volume":"30","author":"Anderson","year":"2024","journal-title":"Emerg. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.jinf.2019.05.019","article-title":"Norovirus outbreaks in Beijing, China, from 2014 to 2017","volume":"79","author":"Gao","year":"2019","journal-title":"J. Infect."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Anfruns-Estrada, E., Sabat\u00e9, S., Razquin, E., Cornejo S\u00e1nchez, T., Bartolom\u00e9, R., Torner, N., Izquierdo, C., Soldevila, N., Coronas, L., and Dom\u00ednguez, \u00c0. (2022). Epidemiological and Genetic Characterization of Norovirus Outbreaks That Occurred in Catalonia, Spain, 2017\u20132019. Viruses, 14.","DOI":"10.3390\/v14030488"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1093\/cid\/ciab808","article-title":"Norovirus Outbreaks in Long-term Care Facilities in the United States, 2009\u20132018: A Decade of Surveillance","volume":"74","author":"Calderwood","year":"2022","journal-title":"Clin. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1002\/jmv.25684","article-title":"Molecular epidemiology of norovirus outbreaks in Argentina, 2013\u20132018","volume":"92","author":"Degiuseppe","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"151600","DOI":"10.1016\/j.ijmm.2024.151600","article-title":"Impact of the COVID-19 pandemic on norovirus circulation in Germany","volume":"314","author":"Jacobsen","year":"2024","journal-title":"Int. J. Med. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Qin, S., Chan, T., Cai, J., Zhao, N., Miao, Z.P., Chen, Y.J., and Liu, S.L. (2017). Genotypic and Epidemiological Trends of Acute Gastroenteritis Associated with Noroviruses in China from 2006 to 2016. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14111341"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e70803","DOI":"10.1002\/jmv.70803","article-title":"GII.17[P17] Norovirus Resurge in Beijing, China, 2024\u20132025","volume":"98","author":"Li","year":"2026","journal-title":"J. Med. Virol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e70729","DOI":"10.1002\/jmv.70729","article-title":"Resurgence and Predominance of GII.17[P17] Norovirus in Children with Sporadic Acute Gastroenteritis in Shanghai, China","volume":"97","author":"Lu","year":"2025","journal-title":"J. Med. Virol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2400625","DOI":"10.2807\/1560-7917.ES.2024.29.39.2400625","article-title":"Increased circulation of GII.17 noroviruses, six European countries and the United States, 2023 to 2024","volume":"29","author":"Chhabra","year":"2024","journal-title":"Eurosurveillance"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.3201\/eid3107.250524","article-title":"Increasing Predominance of Norovirus GII.17 over GII.4, United States, 2022\u20132025","volume":"31","author":"Barclay","year":"2025","journal-title":"Emerg. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ai, J., Zhu, Y., Fu, J., Cheng, X., Zhang, X., Ji, H., Liu, W., Rui, J., Xu, J., and Yang, T. (2022). Study of Risk Factors for Total Attack Rate and Transmission Dynamics of Norovirus Outbreaks, Jiangsu Province, China, From 2012 to 2018. Front. Med., 8.","DOI":"10.3389\/fmed.2021.786096"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.jhin.2018.01.011","article-title":"Risk factors for hospital norovirus outbreaks: Impact of vomiting, genotype, and multi-occupancy rooms","volume":"98","author":"Fraenkel","year":"2018","journal-title":"J. Hosp. Infect."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"841","DOI":"10.46234\/ccdcw2024.181","article-title":"Risk Factors for Norovirus Outbreaks in Schools and Kindergartens\u2014Beijing Municipality, China, July 2017\u2013June 2022","volume":"6","author":"Liu","year":"2024","journal-title":"China CDC Wkly."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1017\/S0950268812000234","article-title":"The epidemiology of published norovirus outbreaks: A review of risk factors associated with attack rate and genogroup","volume":"140","author":"Matthews","year":"2012","journal-title":"Epidemiol. Infect."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s13099-025-00756-7","article-title":"Increased GII.3[P12] norovirus outbreaks and viral whole genome analysis in Beijing, China during 2021 and 2023","volume":"17","author":"Fu","year":"2025","journal-title":"Gut Pathog."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s13099-021-00430-8","article-title":"Evolution of the GII.3[P12] Norovirus from 2010 to 2019 in Jiangsu, China","volume":"13","author":"Fu","year":"2021","journal-title":"Gut Pathog."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e28627","DOI":"10.1002\/jmv.28627","article-title":"Excess acute diarrhoea cases attributed to norovirus variants in Beijing, China between 2011 and 2018","volume":"95","author":"Liu","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e52","DOI":"10.1017\/S0950268820000461","article-title":"Detection of norovirus infections in Denmark, 2011\u20132018","volume":"148","author":"Korcinska","year":"2020","journal-title":"Epidemiol. Infect."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/S1473-3099(13)70342-6","article-title":"Hand, foot, and mouth disease in China, 2008\u201312: An epidemiological study","volume":"14","author":"Xing","year":"2014","journal-title":"Lancet Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Ennuschat, N., H\u00e4rtel, S., Pietsch, C., and Liebert, U.G. (2021). Norovirus Epidemiology and Genetic Diversity in Leipzig, Germany during 2013\u20132017. Viruses, 13.","DOI":"10.3390\/v13101961"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.3201\/eid2705.204756","article-title":"Global trends in Norovirus genotype distribution among children with acute gastroenteritis","volume":"27","author":"Cannon","year":"2021","journal-title":"Emerg. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Nagasawa, K., Matsushima, Y., Motoya, T., Mizukoshi, F., Ueki, Y., Sakon, N., Murakami, K., Shimizu, T., Okabe, N., and Nagata, N. (2018). Genetic Analysis of Human Norovirus Strains in Japan in 2016\u20132017. Front Microbiol., 9.","DOI":"10.3389\/fmicb.2018.00001"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"30447","DOI":"10.2807\/1560-7917.ES.2017.22.4.30447","article-title":"Steep rise in norovirus cases and emergence of a new recombinant strain GII.P16-GII.2, Germany, winter 2016","volume":"22","author":"Niendorf","year":"2017","journal-title":"Eurosurveillance"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s13099-019-0303-z","article-title":"Variation of human norovirus GII genotypes detected in Ibaraki, Japan, during 2012\u20132018","volume":"11","author":"Motoya","year":"2019","journal-title":"Gut Pathog."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Niendorf, S., Faber, M., Tr\u00f6ger, A., Hackler, J., and Jacobsen, S. (2020). Diversity of Noroviruses throughout Outbreaks in Germany 2018. Viruses, 12.","DOI":"10.3390\/v12101157"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s13099-021-00473-x","article-title":"Epidemiological characteristics and genetic diversity of norovirus infections among outpatient children with diarrhea under 5 years of age in Beijing, China, 2011\u20132018","volume":"13","author":"Li","year":"2021","journal-title":"Gut Pathog."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.46234\/ccdcw2021.276","article-title":"Molecular Epidemiological Characteristics of Gastroenteritis Outbreaks Caused by Norovirus GII.4 Sydney [P31] Strains\u2014China, October 2016\u2013December 2020","volume":"3","author":"Zhu","year":"2021","journal-title":"China CDC Wkly."},{"key":"ref_36","first-page":"1210","article-title":"Epidemiological characteristics of outbreaks of norovirus-G II.2, G II.17 and G II.4\/Sydney in Guangdong province, 2013-2017","volume":"39","author":"Zhang","year":"2018","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"ref_37","first-page":"751","article-title":"Epidemiological characteristics of norovirus acute gastroenteritis outbreaks and influencing factors in China, 2007\u20132021","volume":"44","author":"Tang","year":"2023","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1093\/infdis\/jiv452","article-title":"Norovirus Surveillance: An Epidemiological Perspective","volume":"213","author":"Harris","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e29153","DOI":"10.1002\/jmv.29153","article-title":"Transmissibility quantification of norovirus outbreaks in 2016\u20132021 in Beijing, China","volume":"95","author":"Wang","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.3201\/eid1908.130482","article-title":"Acute gastroenteritis surveillance through the National Outbreak Reporting System, United States","volume":"19","author":"Hall","year":"2013","journal-title":"Emerg. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"472","DOI":"10.4315\/JFP-20-093","article-title":"Characteristics of Norovirus Food Poisoning Outbreaks in Korea in the 2000s","volume":"84","author":"Kim","year":"2021","journal-title":"J. Food. Prot."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2100071","DOI":"10.2807\/1560-7917.ES.2022.27.3.2100071","article-title":"Surveillance and characteristics of food-borne outbreaks in the Netherlands, 2006 to 2019","volume":"27","author":"Friesema","year":"2022","journal-title":"Eurosurveillance"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Kirk, M.D., Pires, S.M., Black, R.E., Caipo, M., Crump, J.A., Devleesschauwer, B., D\u00f6pfer, D., Fazil, A., Fischer-Walker, C.L., and Hald, T. (2015). World Health Organization Estimates of the Global and Regional Disease Burden of 22 Foodborne Bacterial, Protozoal, and Viral Diseases, 2010: A Data Synthesis. PLoS Med., 12.","DOI":"10.1371\/journal.pmed.1001940"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Mao, A., Yang, Y., and Qiu, W. (2021). The Running Track of Government Responsibility During the Pandemic, Characteristic Analysis of Policy Documents Relevant to the COVID-19 Pandemic Released by Beijing Municipal Government in 2020. Front. Public Health, 9.","DOI":"10.3389\/fpubh.2021.713879"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/18\/3\/295\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T14:58:12Z","timestamp":1772463492000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/18\/3\/295"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,28]]},"references-count":44,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["v18030295"],"URL":"https:\/\/doi.org\/10.3390\/v18030295","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,28]]}}}