Predicting norovirus and rotavirus resurgence in the United States following the COVID-19 pandemic: a mathematical modelling study

Abstract

Background To reduce the burden from the COVID-19 pandemic in the United States, federal and state local governments implemented restrictions such as limitations on gatherings, restaurant dining, and travel, and recommended non-pharmaceutical interventions including physical distancing, mask-wearing, surface disinfection, and increased hand hygiene. Resulting behavioral changes impacted other infectious diseases including enteropathogens such as norovirus and rotavirus, which had fairly regular seasonal patterns prior to the COVID-19 pandemic. The study objective was to project future incidence of norovirus and rotavirus gastroenteritis as contacts resumed and other NPIs are relaxed. Methods We fitted compartmental mathematical models to pre-pandemic U.S. surveillance data (2012–2019) for norovirus and rotavirus using maximum likelihood estimation. Then, we projected incidence for 2022–2030 under scenarios where the number of contacts a person has per day varies from70%, 80%, 90%, and full resumption (100%) of pre-pandemic levels. Results We found that the population susceptibility to both viruses increased between March 2020 and November 2021. The 70–90% contact resumption scenarios led to lower incidence than observed pre-pandemic for both viruses. However, we found a greater than two-fold increase in community incidence relative to the pre-pandemic period under the 100% contact scenarios for both viruses. With rotavirus, for which population immunity is driven partially by vaccination, patterns settled into a new steady state quickly in 2022 under the 70–90% scenarios. For norovirus, for which immunity is relatively short-lasting and only acquired through infection, surged under the 100% contact scenario projection. Conclusions These results, which quantify the consequences of population susceptibility build-up, can help public health agencies prepare for potential resurgence of enteric viruses.

Rotavirus A during the COVID-19 Pandemic in Brazil, 2020–2022: Emergence of G6P[8] Genotype

“…In many countries, the restrictions were relaxed and raised concerns about a potential rapid rise in infectious diseases, including RVA. Mathematical modeling studies suggest that, if contact patterns return to pre-pandemic levels, the population’s susceptibility to RVA and norovirus infections would likely increase [ 46 , 47 ]. During our study, the RVA detection rate decreased dramatically in 2021 (0.5%) to a rate that was significantly lower than the rates observed in previous years in Brazil [ 34 , 35 ].…”

Molecular evolutionary analysis of novel NSP4 mono-reassortant G1P[8]-E2 rotavirus strains that caused a discontinuous epidemic in Japan in 2015 and 2018

“…This shift is considered to have been due to travel, social restrictions, and non-pharmaceutical interventions ( Dapper et al, 2022 ). After resuming social activities, RVA strains are speculated to once again readily spread domestically and internationally, as noted in other articles ( Lappe et al, 2023 ; Wang et al, 2023 ). Continuous molecular epidemiological studies based on full genome analysis will continue to be critical for detecting the emergence of new epidemic RVA strains.…”

Norovirus Epidemiology and Genotype Circulation during the COVID-19 Pandemic in Brazil, 2019–2022

“…In the same line, a study in Shanghai, China, showed that the detection rate of norovirus among children ≤5 years of age with AGE symptoms abruptly decreased in 2020, the first year of the COVID-19 pandemic, compared to 2021 and 2022 [27]. Mathematical modeling studies have suggested that, if contact patterns return to pre-pandemic levels, the population's susceptibility to rotavirus and norovirus infections would likely increase [52,53].…”