Outbreaks of Acute Gastroenteritis Transmitted by Person-to-Person Contact, Environmental Contamination, and Unknown Modes of Transmission — United States, 2009–2013

Wikswo, Mary E.; Kambhampati, Anita; Shioda, Kayoko; Walsh, Kelly A.; Bowen, Anna; Hall, Aron J.

doi:10.15585/mmwr.mm6412a1

Cited by 70 publications

(65 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Noroviruses (NV) are the most common cause of acute nonbacterial gastroenteritis in the United States and worldwide. 1,2 Disease due to NV is usually mild and self-limiting in immunocompetent individuals.…”

Section: Introductionmentioning

confidence: 99%

Predictors of persistent diarrhea in norovirus enteritis after solid organ transplantation

Chong

Duin

Sonderup

et al. 2016

Clinical Transplantation

View full text Add to dashboard Cite

Solid organ transplant (SOT) recipients may develop protracted diarrheal illness from norovirus. We performed a retrospective chart review between January 2010 and April 2014 to identify predictors of persistent diarrhea in transplant recipients with norovirus enteritis. A total of 152 SOT recipients with mean age of 31.5 years (SD 23.1) were included: 43.4% male, 34.2% pediatric patients. Allograft types were abdominal 136 (89.5%) (kidney [39.5%], liver-small bowel [23%], other [27%]) and thoracic 16 (10.5%). The median time to diagnosis of first norovirus enteritis episode from date of transplantation was 1.7 (0.3-5.3) years. At time of presentation, diarrhea was present in 141 (93%). Thirty percent had persistent diarrhea at 2 weeks. Hospitalization was required for treatment in 121 (80%) of episodes with the mean length of stay of 10±15.2 days. Most (91%) infections were due to norovirus genogroup II, and gastrointestinal coinfections were seen in 23 (19%) norovirus enteritis episodes. Nausea at time of diagnosis (P=.002) and cytomegalovirus (CMV) infection in the preceding 90 days (P=.036) were identified as independent risk factors for persistent diarrhea using univariate and multivariable logistic regression. Our study shows that nausea on presentation and prior CMV infection were associated with persistent diarrhea in patients with norovirus enteritis.

show abstract

Section: Introductionmentioning

confidence: 99%

Predictors of persistent diarrhea in norovirus enteritis after solid organ transplantation

Chong

Duin

Sonderup

et al. 2016

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

“…Actually, in many incidences, it is not possible to identify the source of the infection. 47,50 In our study, consuming raw bivalves was associated with norovirus-positive diarrhea among diarrheal cases, indicating that raw bivalves are an important food vector for norovirus-associated diarrhea (Table 3). However, Odds ratios for having norovirus-positive diarrhea (95% confidence interval) England reported that consuming bivalves was attributed to only a relatively small proportion of acute gastroenteritis.…”

Section: Discussionmentioning

confidence: 53%

The association between consuming bivalves, and acute gastroenteritis and norovirus in Tokyo, Japan

Kobayashi

Saito

Heike

et al. 2019

Journal of Medical Virology

View full text Add to dashboard Cite

A prospective matched case‐control study was conducted to evaluate associations between dietary histories, including consumption of bivalves, diarrhea, and norovirus positive diarrhea in adult ambulatory patients at an outpatient clinic of a hospital in Tokyo, Japan. Ambulatory cases with diarrhea were matched with nondiarrheal control patients, who visited the same clinic. A standardized questionnaire was used to obtain patients’ information, including histories of food consumption and clinical information. Norovirus infection was confirmed using real‐time reverse transcription polymerase chain reaction. A total of 207 patients, including 69 diarrheal cases and 138 nondiarrheal cases were included in the analysis. Among them, 60 (29.0%) participants reported consuming bivalves. Norovirus was detected in 35% (24/69) of diarrheal cases. Of those, 10 (41.7%) reported consumption of bivalves and of those, 6 (60.0%) consumed raw bivalves. The proportion of those who consumed raw bivalves was significantly higher in norovirus‐positive diarrheal cases than in norovirus‐negative diarrheal cases (25.0% vs 6.7%; odds ratio [OR], 4.67; 95% confidence interval [CI], 1.1‐20.7) and matched nondiarrheal controls (25.0% vs 6.3%, OR: 5.00; 95% CI, 1.1‐22.2). The attributable fraction of consuming raw bivalves for norovirus‐associated diarrhea to matched nondiarrheal controls was 20.0%. Consuming raw bivalves was substantially attributed to norovirus‐associated diarrhea in adult ambulatory patients and preventive measures for reducing the risk associated with consumption of raw bivalves could decrease the incidence of norovirus‐associated diarrhea.

show abstract

“…With nearly half of this age group spending some part of their lives in nursing homes [2], the number of older adults using paid long-term care services is expected to grow substantially over the coming decade [3]. In the U.S. and other high-income countries, gastroenteritis outbreaks are common in nursing homes, skilled nursing facilities and assisted living facilities, which are collectively known as long-term care facilities (LTCFs) [4][5][6][7]. Despite the perception that norovirus is a foodborne disease or the 'cruise ship virus', the majority of all norovirus outbreaks reported to the CDC occur in LTCFs [6].…”

Section: Introductionmentioning

confidence: 99%

“…In the U.S. and other high-income countries, gastroenteritis outbreaks are common in nursing homes, skilled nursing facilities and assisted living facilities, which are collectively known as long-term care facilities (LTCFs) [4][5][6][7]. Despite the perception that norovirus is a foodborne disease or the 'cruise ship virus', the majority of all norovirus outbreaks reported to the CDC occur in LTCFs [6]. While norovirus gastroenteritis is generally mild and self-limiting, older nursing home residents are vulnerable to infection leading to hospitalization and death [8], with the vast majority of norovirus-associated deaths in the U.S. occurring among persons aged 65 years and older [9].…”

Section: Introductionmentioning

confidence: 99%

Quantifying the roles of vomiting, diarrhea, and residents vs. staff in norovirus transmission in U.S. nursing home outbreaks

et al. 2020

Self Cite

View full text Add to dashboard Cite

OPEN ACCESSCitation: Adams C, Young D, Gastañaduy PA, Paul P, Marsh Z, Hall AJ, et al. (2020) Quantifying the roles of vomiting, diarrhea, and residents vs. staff in norovirus transmission in U.S. nursing home outbreaks. PLoS Comput Biol 16(3): e1007271.The majority of all norovirus outbreaks reported to the CDC occur in long-term care facilities (LTCFs), including nursing homes, where older residents are at risk for more severe or prolonged infection. Because there is currently no publicly available norovirus vaccine, sound control measures are key to controlling norovirus outbreaks, but there is little evidence that standard control measures are effective in reducing the size and/or duration of LTCF norovirus outbreaks. Hence, studies leading to a better understanding of disease spread and prevention of additional cases, and thus more effective control measures, are needed. To this end, we aimed to quantify factors associated with norovirus transmission and to examine how transmission changes over the course of an outbreak. We show that vomiting and, to a lesser extent, diarrhea are critical in initiating and sustaining norovirus transmission in U.S. nursing home norovirus outbreaks. We also show that nursing home residents, rather than staff, are the primary drivers of transmission. Results suggest that control measures focusing on cases who vomit, particularly if those cases are residents, would be most effective at curtailing norovirus transmission in these settings. PLOS COMPUTATIONAL BIOLOGYNorovirus transmission in nursing home outbreaks PLOS Computational Biology | https://doi.org/10.

show abstract

Outbreaks of Acute Gastroenteritis Transmitted by Person-to-Person Contact, Environmental Contamination, and Unknown Modes of Transmission — United States, 2009–2013

Cited by 70 publications

References 39 publications

Predictors of persistent diarrhea in norovirus enteritis after solid organ transplantation

Predictors of persistent diarrhea in norovirus enteritis after solid organ transplantation

The association between consuming bivalves, and acute gastroenteritis and norovirus in Tokyo, Japan

Quantifying the roles of vomiting, diarrhea, and residents vs. staff in norovirus transmission in U.S. nursing home outbreaks

Contact Info

Product

Resources

About