Norovirus infection epidemiology and demographics: Difference between revisions

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==Overview==
==Overview==
Anyone can become infected with these viruses. There are many different strains of norovirus, which makes it difficult for a person’s body to develop long-lasting [[immunity]]. Therefore, norovirus illness can recur throughout a person’s lifetime. In addition, because of differences in genetic factors, some people are more likely to become infected and develop more severe illness than others.
Norovirus is the leading cause of [[acute gastroenteritis]] and foodborne illness in all age groups in the United States. It causes approximately 21 million cases of [[gastroenteritis]] yearly. The genogroup II, genotype 4 strain is most commonly involved in large [[outbreaks]] of norovirus.


[[CDC]] currently does not conduct active surveillance to monitor outbreaks of [[gastroenteritis]] caused by noroviruses. [[outbreak|Outbreaks]] are reported to CDC's Viral Gastroenteritis Section, Respiratory and Gastroenteric Viruses Branch, Division of Viral Diseases, National Center for Immunization and Respiratoiry Diseases (NCIRD) when states send specimens for testing or sequencing, or outbreaks are reported directly by states to the electronic database (eFORS) maintained by the Foodborne Diarrheal Diseases Branch.
==Epidemiology and Demographics==


== Epidemiology and Demographics ==
 
Each year, norovirus causes about 21 million cases of [[acute gastroenteritis]] (inflammation of the stomach or intestines or both) and contributes to about 70,000 hospitalizations and 800 deaths, mostly among young children and the elderly. You can get norovirus illness at any time during the year. But, it is most common in the winter. Also, there can be 50% more norovirus illness in years when there is a new strain of the virus going around.
===Incidence===
Noroviruses causes about 900 deaths, mostly among adults aged 65 and older; 109,000 [[hospitalizations]]; 465,000 [[emergency]] department visits, mostly in young children; 2,270,000 [[outpatient]] clinic visits annually, mostly in young children and  19 to 21 million cases of vomiting and diarrhea illnesses
norovirus causes about 21 million cases of [[acute gastroenteritis]] yearly. Norovirus accounts for 58% of foodborne illnesses in the United States. Norovirus outbreaks may be observed any time during the year, but it is most common in the winter months. The cost of norovirus illnesses is approximately $60 billion worldwide considering the lost productivity and healthcare costs.<ref name="cdc">Centers for Disease Control and Prevention (2021). Norovirus: Diagnostic Methods. Accessed on January 28, 2021 http://www.cdc.gov/norovirus/php/illness-outbreaks.html </ref><ref>https://www.cdc.gov/norovirus/trends-outbreaks/worldwide.html</ref>
 
===Age===
 
*Norovirus is the leading cause of acute gastroenteritis and foodborne illness in all age groups in the United States.
 
===Gender===
 
*Norovirus shows no gender predilection.
 
===Race===
 
*Norovirus is common across all races.


===Outbreaks===
===Outbreaks===
Most outbreaks of norovirus illness happen when infected people spread the virus to others. But, norovirus can also spread by consuming contaminated food or water and touching things that have the virus on them. Healthcare facilities, including nursing homes and hospitals, are the most commonly reported places for norovirus outbreaks in the United States and other industrialized countries. Nearly two-thirds of all norovirus outbreaks reported in the United States occur in long-term care facilities. Outbreaks of norovirus illness have also occurred in restaurants, cruise ships, schools, banquet halls, summer camps, and even at family dinners. These are all places where people often eat food handled or prepared by others. In fact, norovirus is the leading cause of illness from contaminated food in the United States. About 50% of all outbreaks of food-related illness are caused by norovirus. Foods that are commonly involved in outbreaks of norovirus illness are:
*Leafy greens (such as lettuce),
*Fresh fruits, and
*Shellfish (such as oysters).


However, any food that is served raw or handled after being cooked can get contaminated. Norovirus outbreaks have also been caused by contaminated water from sewage in wells and recreational water, such as pools.
*Most noroviruses that infect humans belong to genogroups GI and GII.<ref name="pmid10752550">{{cite journal
----
|author=Vinjé J, Green J, Lewis DC, Gallimore CI, Brown DW, Koopmans MP
Shown below is a graph that illustrates outbreaks of acute gastroenteritis in 30 states from January 2007 through April 2010. On average, there were nearly 3 times as many norovirus outbreaks (143 per month) as non-norovirus outbreaks (50 per month) and the number of norovirus outbreaks increased dramatically during the winter months. A new virus strain (GII.4 New Orleans) that first appeared in October 2009 did not lead to more outbreaks.
|title=Genetic polymorphism across regions of the three open reading frames of "Norwalk-like viruses"
|journal=Arch. Virol.
|volume=145
|issue=2
|pages=223–41
|year=2000
|pmid=10752550
|doi=10.1007/s007050050020
|url=http://link.springer.de/link/service/journals/00705/bibs/0145002/01450223.htm
}}</ref>
*Noroviruses from Genogroup II, genotype 4 (abbreviated as GII.4) account for the majority of adult outbreaks of [[gastroenteritis]] and often sweep across the globe.<ref>{{cite journal
|author=Noel J, Fankhauser RL, Ando T, Monroe SS, Glass RI
|title=Identification of a distinct common strain of "Norwalk-like viruses" having a global distribution
|journal=J. Infect. Dis.
|volume=179
|issue=6
|pages=1334–44
|year=2000
|pmid=10228052
|doi=10.1086/314783}}</ref>
*Recent examples include US95/96-US strain, associated with global [[outbreaks]] in the mid- to late-1990s, Farmington Hills virus associated with outbreaks in Europe and the United States in 2002 and in 2004, and Hunter virus was associated with outbreaks in Europe, Japan and Australasia. In 2006, there was another large increase in NoV infection around the globe.<ref name="pmid18177226">{{cite journal
|author=Tu ET, Bull RA, Greening GE, Hewitt J, Lyon MJ, Marshall JA, McIver CJ, Rawlinson WD, White PA
|title=Epidemics of gastroenteritis during 2006 were associated with the spread of norovirus GII.4 variants 2006a and 2006b
|journal=Clin. Infect. Dis.
|volume=46
|issue=3
|pages=413–20
|year=2008
|pmid=18177226
|doi=10.1086/525259
|url=http://cid.oxfordjournals.org/content/46/3/413
}}</ref>
*Nearly two-thirds of all norovirus outbreaks reported in the United States occur in long-term care facilities. Outbreaks of norovirus illness have also occurred in restaurants, cruise ships, schools, banquet halls, summer camps, and even at family dinners. These are all places where people often eat food handled or prepared by others. In fact, norovirus is the leading cause of illness from contaminated food in the United States. About 50% of all outbreaks of food-related illness are caused by norovirus. Foods that are commonly involved in outbreaks of norovirus illness are:
*Leafy greens (such as lettuce)
*Fresh fruits
*Shellfish (such as oysters)


[[image:Dsnorovirus_626px.jpg|500px]]
[[image:Dsnorovirus_626px.jpg|left|380px|thumb|This graph illustrates outbreaks of acute gastroenteritis in 30 states from January 2007 through April 2010. On average, there were nearly 3 times as many norovirus outbreaks (143 per month) as non-norovirus outbreaks (50 per month) and the number of norovirus outbreaks increased dramatically during the winter months. A new virus strain (GII.4 New Orleans) that first appeared in October 2009 did not lead to more outbreaks.]]
----
Shown below is a graph that illustrates the setting of 1,518 confirmed norovirus outbreaks in the U.S. from 2010 to 2011: Long-term Care Facility 59% (889 Outbreaks); Restaurants 8% (123 Outbreaks); Party & Event 7% (99 Outbreaks); Hospital 4% (65 Outbreaks); School 4% (64 Outbreaks); Cruise Ship 4% (55 Outbreaks); Other & Unknown 14% (223 Outbreaks).


[[image:Dsnorovirus_379px.jpg|500px]]
[[image:Dsnorovirus_379px.jpg|none|500px|thumb|This graph illustrates the setting of 1,518 confirmed norovirus outbreaks in the U.S. from 2010 to 2011: Long-term Care Facility 59% (889 Outbreaks); Restaurants 8% (123 Outbreaks); Party & Event 7% (99 Outbreaks); Hospital 4% (65 Outbreaks); School 4% (64 Outbreaks); Cruise Ship 4% (55 Outbreaks); Other & Unknown 14% (223 Outbreaks).]]<br><br><br>
----
===Epidemiologic criteria===
Epidemiologic criteria have been proposed for use in determining whether an outbreak of gastroenteritis is of viral origin. Although quite specific, these criteria are not very sensitive, and therefore the possibility of a viral etiology should not be discarded if the criteria are not met. Kaplan's criteria for this purpose are as follows:
*A mean (or median) illness duration of 12 to 60 hours
*A mean (or median) incubation period of 24 to 48 hours
*More than 50% of people with vomiting
*No bacterial agent previously found


==Sources==
===Developing Countries===
*http://www.cdc.gov/norovirus/index.html


== References ==
*Epidemiological data from developing countries about the importance of norovirus in [[pediatric]] [[diarrhea]] are limited. Recently, in Nicaragua, it has been observed that norovirus is responsible for 11% of the diarrhea cases occurring in children less than five years of age at community level and 15% of the moderate to severe cases requiring [[intravenous]] [[rehydration]].<ref>Bucardo F, Nordgren J, Carlsson B, Paniagua M, Lindgren PE, Espinoza F, Svensson L., "Pediatric norovirus diarrhea in Nicaragua", ''J. Clin. Microbiology'', '''46''': 8 (August 2008), pp. 2573–80.</ref>
 
*In the Guangdong province of the People's Republic of China, the Provincial Health Department said on December 17, 2010, that it had confirmed 429 cases of norovirus infection in the November 2010 outbreak in Conghua, Guangzhou, but no one died from it.<ref>[http://english.cntv.cn/20101217/106924.shtml Norovirus infects 429 people in Guangzhou (CNTV reports)]</ref>
 
==References==
{{Reflist|2}}
{{Reflist|2}}


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[[Category:Disease]]
[[Category:Disease]]
[[Category:Infectious disease]]
 
[[Category:Needs overview]]
[[Category:Viral diseases]]

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Norovirus is the leading cause of acute gastroenteritis and foodborne illness in all age groups in the United States. It causes approximately 21 million cases of gastroenteritis yearly. The genogroup II, genotype 4 strain is most commonly involved in large outbreaks of norovirus.

Epidemiology and Demographics

Incidence

Noroviruses causes about 900 deaths, mostly among adults aged 65 and older; 109,000 hospitalizations; 465,000 emergency department visits, mostly in young children; 2,270,000 outpatient clinic visits annually, mostly in young children and 19 to 21 million cases of vomiting and diarrhea illnesses norovirus causes about 21 million cases of acute gastroenteritis yearly. Norovirus accounts for 58% of foodborne illnesses in the United States. Norovirus outbreaks may be observed any time during the year, but it is most common in the winter months. The cost of norovirus illnesses is approximately $60 billion worldwide considering the lost productivity and healthcare costs.[1][2]

Age

  • Norovirus is the leading cause of acute gastroenteritis and foodborne illness in all age groups in the United States.

Gender

  • Norovirus shows no gender predilection.

Race

  • Norovirus is common across all races.

Outbreaks

  • Most noroviruses that infect humans belong to genogroups GI and GII.[3]
  • Noroviruses from Genogroup II, genotype 4 (abbreviated as GII.4) account for the majority of adult outbreaks of gastroenteritis and often sweep across the globe.[4]
  • Recent examples include US95/96-US strain, associated with global outbreaks in the mid- to late-1990s, Farmington Hills virus associated with outbreaks in Europe and the United States in 2002 and in 2004, and Hunter virus was associated with outbreaks in Europe, Japan and Australasia. In 2006, there was another large increase in NoV infection around the globe.[5]
  • Nearly two-thirds of all norovirus outbreaks reported in the United States occur in long-term care facilities. Outbreaks of norovirus illness have also occurred in restaurants, cruise ships, schools, banquet halls, summer camps, and even at family dinners. These are all places where people often eat food handled or prepared by others. In fact, norovirus is the leading cause of illness from contaminated food in the United States. About 50% of all outbreaks of food-related illness are caused by norovirus. Foods that are commonly involved in outbreaks of norovirus illness are:
  • Leafy greens (such as lettuce)
  • Fresh fruits
  • Shellfish (such as oysters)
This graph illustrates outbreaks of acute gastroenteritis in 30 states from January 2007 through April 2010. On average, there were nearly 3 times as many norovirus outbreaks (143 per month) as non-norovirus outbreaks (50 per month) and the number of norovirus outbreaks increased dramatically during the winter months. A new virus strain (GII.4 New Orleans) that first appeared in October 2009 did not lead to more outbreaks.
This graph illustrates the setting of 1,518 confirmed norovirus outbreaks in the U.S. from 2010 to 2011: Long-term Care Facility 59% (889 Outbreaks); Restaurants 8% (123 Outbreaks); Party & Event 7% (99 Outbreaks); Hospital 4% (65 Outbreaks); School 4% (64 Outbreaks); Cruise Ship 4% (55 Outbreaks); Other & Unknown 14% (223 Outbreaks).




Developing Countries

  • Epidemiological data from developing countries about the importance of norovirus in pediatric diarrhea are limited. Recently, in Nicaragua, it has been observed that norovirus is responsible for 11% of the diarrhea cases occurring in children less than five years of age at community level and 15% of the moderate to severe cases requiring intravenous rehydration.[6]
  • In the Guangdong province of the People's Republic of China, the Provincial Health Department said on December 17, 2010, that it had confirmed 429 cases of norovirus infection in the November 2010 outbreak in Conghua, Guangzhou, but no one died from it.[7]

References

  1. ↑ Centers for Disease Control and Prevention (2021). Norovirus: Diagnostic Methods. Accessed on January 28, 2021 http://www.cdc.gov/norovirus/php/illness-outbreaks.html
  2. ↑ https://www.cdc.gov/norovirus/trends-outbreaks/worldwide.html
  3. ↑ Vinjé J, Green J, Lewis DC, Gallimore CI, Brown DW, Koopmans MP (2000). "Genetic polymorphism across regions of the three open reading frames of "Norwalk-like viruses"". Arch. Virol. 145 (2): 223–41. doi:10.1007/s007050050020. PMID 10752550.
  4. ↑ Noel J, Fankhauser RL, Ando T, Monroe SS, Glass RI (2000). "Identification of a distinct common strain of "Norwalk-like viruses" having a global distribution". J. Infect. Dis. 179 (6): 1334–44. doi:10.1086/314783. PMID 10228052.
  5. ↑ Tu ET, Bull RA, Greening GE, Hewitt J, Lyon MJ, Marshall JA, McIver CJ, Rawlinson WD, White PA (2008). "Epidemics of gastroenteritis during 2006 were associated with the spread of norovirus GII.4 variants 2006a and 2006b". Clin. Infect. Dis. 46 (3): 413–20. doi:10.1086/525259. PMID 18177226.
  6. ↑ Bucardo F, Nordgren J, Carlsson B, Paniagua M, Lindgren PE, Espinoza F, Svensson L., "Pediatric norovirus diarrhea in Nicaragua", J. Clin. Microbiology, 46: 8 (August 2008), pp. 2573–80.
  7. ↑ Norovirus infects 429 people in Guangzhou (CNTV reports)


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