Objective To analyze the epidemiological characteristics of norovirus infection outbreaks in schools and child care settings in Hubei province and provide evidence for the improvement of prevention and control strategies.

Methods The data from norovirus infection outbreak reports and investigation reports in schools and child care settings in Hubei from 2015 to 2025 were collected. The epidemiological characteristics, transmission routes of the outbreaks and response measures were analyzed.

Results A total of 43 norovirus infection outbreaks were reported in schools and child care settings in Hubei from 2015 to 2025, in which 2 162 cases were reported cumulatively with an overall attack rate of 3.40%. The outbreaks showed a seasonal peak in winter and spring and mainly occurred in urban areas (65.12%) and primary schools (41.86%). The main clinical symptoms included vomiting (72.02%), abdominal pain (40.26%), and diarrhea (37.23%). Norovirus GⅡ was the predominant genotype (93.02%). Person-to-person transmission was the main transmission route. The key factor leading to the person to person transmission of the outbreaks was vomiting ofthe index case in campus and improper vomitus disposal measures taken subsequently. Asymptomatic infection or working while ill in school canteen staff was the main cause of foodborne infection. The duration of the outbreaks was positively correlated with the time interval from the first case to reporting (r=0.799, P<0.001) and from investigation to the end of the outbreak (r=0.755, P<0.001). The scale of outbreaks was positively correlated with the first case vomiting in public places (r=0.498, P<0.001) and improper disposal of vomitus (r=0.339, P=0.013).

Conclusion Norovirus infection outbreaks in schools and child care settings in Hubei mainly occurred in winter and spring in primary schools and urban areas, and person to person transmission was the main transmission route. It is suggested to strengthen morning and afternoon health checks, health surveillance in canteen workers, and standardized vomitus disposal in schools and child care settings, strictly implement early isolation and reporting, and improve the standardization of outbreak investigation and response.