Objective: To investigate the environmental contamination of norovirus in nurseries and primary/secondary schools, so as to provide a scientific basis for effective prevention and control measures. Methods: A total of 483 external environmental samples were collected from 34 cluster outbreaks of norovirus gastroenteritis in kindergartens and primary/secondary schools in Linhai City from 2021 to 2024. Pathogen detection was conducted using a rapid nucleic acid extraction kit and realtime fluorescence RT-PCR, and the results were analyzed using the χ2 test or Fishers exact test. Results: Among the collected external environmental samples, the total positive rate of surface contamination was 13.66%. The positive rates in kindergartens and primary/secondary schools were 12.20% and 15.82%, respectively. In kindergartens, the five surfaces with the highest detection rates were desks/chairs (23.33%), toilet stool troughs (20.69%), urinal troughs (12.00%), washbasins/sinks (11.11%), and toilet mops (9.38%). In primary/secondary schools, the top five were toilet stool troughs (38.30%), urinal troughs (23.53%), toilet door handles (13.04%), toilet mops (12.50%), and drinking cups (11.11%). The difference in positive detection rates among different external environments in primary/secondary schools was statistically significant (Fishers exact probability test, P<0.01). The positive detection rate in sanitary toilets was higher than that in classroom environments (χ2=17.38), while the positive detection rate in classroom environments of kindergartens was higher than that in primary/secondary schools (χ2=5.42)(P<0.05). Conclusions Norovirus exhibits a high contamination rate in nurseries and schools, particularly in restroom areas. Strengthening sanitation and disinfection in highrisk environments, and improving hygiene awareness among children and staff, are essential for the effective prevent and control of norovirus.

Wastewater-based epidemiology has emerged as a transformative surveillance tool for estimating substance consumption and monitoring disease prevalence, particularly during the COVID-19 pandemic. It enables the population-level monitoring of illicit drug use, pathogen prevalence, and environmental pollutant exposure. In this perspective, we summarize the key challenges specific to the Chinese context: (1) Sampling inconsistencies, necessitating standardized 24-hour composite protocols with high-frequency autosamplers (≤ 15 min/event) to improve the representativeness of samples; (2) Biomarker validation, requiring rigorous assessment of excretion profiles and in-sewer stability; (3) Analytical method disparities, demanding inter-laboratory proficiency testing and the development of automated pretreatment instruments; (4) Catchment population dynamics, reducing estimation uncertainties through mobile phone data, flow-based models, or hydrochemical parameters; and (5) Ethical and data management concerns, including privacy risks for small communities, mitigated through data de-identification and tiered reporting platforms. To address these challenges, we propose an integrated framework that features adaptive sampling networks, multi-scale wastewater sample banks, biomarker databases with multidimensional metadata, and intelligent data dashboards. In summary, wastewater-based epidemiology offers unparalleled scalability for equitable health surveillance and can improve the health of the entire population by providing timely and objective information to guide the development of targeted policies.
China/epidemiology* ; Humans ; Wastewater/analysis* ; COVID-19/epidemiology* ; Public Health ; Wastewater-Based Epidemiological Monitoring ; SARS-CoV-2

Consultation fees are included in the service homogenization,standardization,patient awareness,relatively high frequency of clinical use,and the general project catalog commonly carried out by public hospitals.On the basis of sorting out the elements of consultation fee price items in some provinces,this paper summarizes the setting of trigger conditions and rules for dynamic adjustment of consultation fee prices in typical regions,and the progress of substantive start-up of dynamic adjustment for consultation fee prices.It compares the level of consultation fees in some provinces,and analyzes the problems faced by consultation fee fees.Some provinces have not dynamically adjusted the examination fee for a long time,and the price comparison relationship with neighboring regions is not coordinated.The policy direction and operational suggestions for improving the dynamic adjustment mechanism of consultation fee price include:Integrating the elements of consultation price items and improving the price standardization level;Popularize the experience of typical areas,after evaluation,start the dynamic price adjustment of consultation items.

Consultation fees are included in the service homogenization,standardization,patient awareness,relatively high frequency of clinical use,and the general project catalog commonly carried out by public hospitals.On the basis of sorting out the elements of consultation fee price items in some provinces,this paper summarizes the setting of trigger conditions and rules for dynamic adjustment of consultation fee prices in typical regions,and the progress of substantive start-up of dynamic adjustment for consultation fee prices.It compares the level of consultation fees in some provinces,and analyzes the problems faced by consultation fee fees.Some provinces have not dynamically adjusted the examination fee for a long time,and the price comparison relationship with neighboring regions is not coordinated.The policy direction and operational suggestions for improving the dynamic adjustment mechanism of consultation fee price include:Integrating the elements of consultation price items and improving the price standardization level;Popularize the experience of typical areas,after evaluation,start the dynamic price adjustment of consultation items.

Consultation fees are included in the service homogenization,standardization,patient awareness,relatively high frequency of clinical use,and the general project catalog commonly carried out by public hospitals.On the basis of sorting out the elements of consultation fee price items in some provinces,this paper summarizes the setting of trigger conditions and rules for dynamic adjustment of consultation fee prices in typical regions,and the progress of substantive start-up of dynamic adjustment for consultation fee prices.It compares the level of consultation fees in some provinces,and analyzes the problems faced by consultation fee fees.Some provinces have not dynamically adjusted the examination fee for a long time,and the price comparison relationship with neighboring regions is not coordinated.The policy direction and operational suggestions for improving the dynamic adjustment mechanism of consultation fee price include:Integrating the elements of consultation price items and improving the price standardization level;Popularize the experience of typical areas,after evaluation,start the dynamic price adjustment of consultation items.

Consultation fees are included in the service homogenization,standardization,patient awareness,relatively high frequency of clinical use,and the general project catalog commonly carried out by public hospitals.On the basis of sorting out the elements of consultation fee price items in some provinces,this paper summarizes the setting of trigger conditions and rules for dynamic adjustment of consultation fee prices in typical regions,and the progress of substantive start-up of dynamic adjustment for consultation fee prices.It compares the level of consultation fees in some provinces,and analyzes the problems faced by consultation fee fees.Some provinces have not dynamically adjusted the examination fee for a long time,and the price comparison relationship with neighboring regions is not coordinated.The policy direction and operational suggestions for improving the dynamic adjustment mechanism of consultation fee price include:Integrating the elements of consultation price items and improving the price standardization level;Popularize the experience of typical areas,after evaluation,start the dynamic price adjustment of consultation items.

Consultation fees are included in the service homogenization,standardization,patient awareness,relatively high frequency of clinical use,and the general project catalog commonly carried out by public hospitals.On the basis of sorting out the elements of consultation fee price items in some provinces,this paper summarizes the setting of trigger conditions and rules for dynamic adjustment of consultation fee prices in typical regions,and the progress of substantive start-up of dynamic adjustment for consultation fee prices.It compares the level of consultation fees in some provinces,and analyzes the problems faced by consultation fee fees.Some provinces have not dynamically adjusted the examination fee for a long time,and the price comparison relationship with neighboring regions is not coordinated.The policy direction and operational suggestions for improving the dynamic adjustment mechanism of consultation fee price include:Integrating the elements of consultation price items and improving the price standardization level;Popularize the experience of typical areas,after evaluation,start the dynamic price adjustment of consultation items.

Consultation fees are included in the service homogenization,standardization,patient awareness,relatively high frequency of clinical use,and the general project catalog commonly carried out by public hospitals.On the basis of sorting out the elements of consultation fee price items in some provinces,this paper summarizes the setting of trigger conditions and rules for dynamic adjustment of consultation fee prices in typical regions,and the progress of substantive start-up of dynamic adjustment for consultation fee prices.It compares the level of consultation fees in some provinces,and analyzes the problems faced by consultation fee fees.Some provinces have not dynamically adjusted the examination fee for a long time,and the price comparison relationship with neighboring regions is not coordinated.The policy direction and operational suggestions for improving the dynamic adjustment mechanism of consultation fee price include:Integrating the elements of consultation price items and improving the price standardization level;Popularize the experience of typical areas,after evaluation,start the dynamic price adjustment of consultation items.

Consultation fees are included in the service homogenization,standardization,patient awareness,relatively high frequency of clinical use,and the general project catalog commonly carried out by public hospitals.On the basis of sorting out the elements of consultation fee price items in some provinces,this paper summarizes the setting of trigger conditions and rules for dynamic adjustment of consultation fee prices in typical regions,and the progress of substantive start-up of dynamic adjustment for consultation fee prices.It compares the level of consultation fees in some provinces,and analyzes the problems faced by consultation fee fees.Some provinces have not dynamically adjusted the examination fee for a long time,and the price comparison relationship with neighboring regions is not coordinated.The policy direction and operational suggestions for improving the dynamic adjustment mechanism of consultation fee price include:Integrating the elements of consultation price items and improving the price standardization level;Popularize the experience of typical areas,after evaluation,start the dynamic price adjustment of consultation items.

Consultation fees are included in the service homogenization,standardization,patient awareness,relatively high frequency of clinical use,and the general project catalog commonly carried out by public hospitals.On the basis of sorting out the elements of consultation fee price items in some provinces,this paper summarizes the setting of trigger conditions and rules for dynamic adjustment of consultation fee prices in typical regions,and the progress of substantive start-up of dynamic adjustment for consultation fee prices.It compares the level of consultation fees in some provinces,and analyzes the problems faced by consultation fee fees.Some provinces have not dynamically adjusted the examination fee for a long time,and the price comparison relationship with neighboring regions is not coordinated.The policy direction and operational suggestions for improving the dynamic adjustment mechanism of consultation fee price include:Integrating the elements of consultation price items and improving the price standardization level;Popularize the experience of typical areas,after evaluation,start the dynamic price adjustment of consultation items.