Epidemiology of norovirus gastroenteritis in Germany 2001–2009: eight seasons of routine surveillance

Abstract

SUMMARYWe analysed data on laboratory or epidemiologically confirmed cases (n = 856 539) and on outbreaks (n = 31 644) notified during week 31 (2001) to week 30 (2009), and performed molecular typing of specimens from 665 outbreaks. We aimed at identifying demographic and molecular characteristics to inform on potential additional approaches to prevent disease spread in the population. The mean incidence by norovirus season (week 31 in one year to week 30 in the following year) was 130 (range 19-300) cases/100 000 population and was highest in persons aged <5 years (430/100 000) and 575 years (593/100 000). The proportion hospitalized in community-acquired cases was 8-19% per season. The mean norovirus-associated mortality was 0·05/100 000 per season and 0·5/100 000 in the 575 years age group. Most outbreaks with known setting (75%) occurred in hospitals (32%), nursing homes (28%), households (24%) and childcare facilities (10%). GII strains dominated in the outbreak specimens. GII.4 strains were found in 82% of nursing home outbreaks, 85% of hospital outbreaks, and 33% of childcare facility and school outbreaks. Cases in younger individuals were notified earlier during the season than adult cases, and outbreaks in childcare facilities and schools preceded those in nursing/residential homes, hospitals and private households. We suggest future studies to investigate more closely potential transmission patterns between children and adults.

Disease burden of selected gastrointestinal pathogens in Australia, 2010

“…6 The viral study pathogens are not nationally notifiable in Australia, and so we applied population mortality rates for rotavirus and norovirus reported in two German studies to the 2010 Australian population. 35,36 For mild AGE cases (pathogen-specific), we subtracted the sum of outpatient, hospitalized, and fatal AGE cases from total AGE cases for each pathogen. This ensured internal consistency in our pathogen-specific estimates.…”

Murine Norovirus Transcytosis across anIn VitroPolarized Murine Intestinal Epithelial Monolayer Is Mediated by M-Like Cells

“…They are the causative agents of most nonbacterial infectious gastroenteritis worldwide (3)(4)(5). HuNoV infections spread rapidly, and outbreaks often take place in closed or semiclosed settings where communities gather (e.g., nursing homes, schools, hospitals, restaurants, and cruise ships) (6)(7)(8). Annually, HuNoVs cause an estimate of 21 million cases of acute gastroenteritis and 800 deaths in the United States alone (9, 10).…”

Analysis of norovirus outbreaks reveals the need for timely and extended microbiological testing

“…4 Indeed, we found that 62 (87%) of the analysed outbreaks Interestingly, a single index case was identifiable in >75% of all outbreaks. This suggests that identification and the following management of this first case might be one of the most effective measures for prevention of norovirus outbreaks.…”

“…[1][2][3][4][5] Moreover, the clinical impact of norovirus infection in the vulnerable population of hospitalized, elderly, or immunosuppressed patients may even be more severe and prolonged than formerly suspected. [6][7][8][9][10] Even in otherwise healthy individuals norovirus infection may lead to post-infectious irritable bowel syndrome.…”