Norovirus constitutes the most frequently identified infectious cause of disease outbreaks associated with untreated recreational water. When investigating outbreaks related to surface water, a One Health approach is insightful. Historically, there has been a focus on potential contamination of recreational water by bird droppings and a recent publication demonstrating human noroviruses in bird faeces suggested this should be investigated in future water-related norovirus outbreaks. Here, we describe a One Health approach investigating a norovirus outbreak in a natural playground. On social media, a large amount of waterfowl were reported to defecate near these playground premises leading to speculations about their potential involvement. Surface water, as well as human and bird faecal specimens, was tested for human noroviruses. Norovirus was found to be the most likely cause of the outbreak but there was no evidence for transmission via waterfowl. Cases had become known on social media prior to notification to the public health service underscoring the potential of online media as an early warning system. In view of known risk factors, advice was given for future outbreak investigations and natural playground design.

中文翻译：

---

在自然游乐场爆发诺如病毒：一种健康方法。

诺如病毒是与未经处理的娱乐用水相关的疾病爆发的最常见的传染性原因。在调查与地表水相关的疫情时，One Health 方法很有见地。从历史上看，人们一直关注鸟粪对休闲用水的潜在污染，最近的一份出版物表明鸟类粪便中含有人类诺如病毒，这表明应该在未来与水有关的诺如病毒爆发中对此进行调查。在这里，我们描述了一种调查自然游乐场中诺如病毒爆发的 One Health 方法。在社交媒体上，据报道有大量水禽在这些操场附近排便，这导致人们猜测它们可能参与其中。对地表水以及人类和鸟类的粪便样本进行了人类诺如病毒检测。发现诺如病毒是爆发的最可能原因，但没有证据表明通过水禽传播。在通知公共卫生服务部门之前，社交媒体上就已经知道病例，这凸显了在线媒体作为预警系统的潜力。鉴于已知的风险因素，对未来的疫情调查和自然游乐场设计提出了建议。