Two Epidemiologic Patterns ofNorovirusOutbreaks: Surveillance in England and Wales, 1992–2000

Abstract

In the period 1992–2000, the Public Health Laboratory Service Communicable Disease Surveillance Centre collected standardized epidemiologic data on 1,877 general outbreaks of Norovirus (formerly “Norwalk-like virus”) infection in England and Wales. Seventy-nine percent of general outbreaks occurred in health-care institutions, i.e., hospitals (40%) and residential-care facilities (39%). When compared with outbreaks in other settings, those in health-care institutions were unique in exhibiting a winter peak (p<0.0001); these outbreaks were also associated with significantly higher death rates and prolonged duration but were smaller in size and less likely to be foodborne. These data suggest that Norovirus infection has considerable impact on the health service and the vulnerable populations residing in institutions such as hospitals and residential homes. A distinct outbreak pattern in health-care institutions suggests a combination of host, virologic, and environmental factors that mediate these divergent epidemiologic patterns.

Prevalence and characteristics of asymptomatic norovirus infection in the community in England

“…Outbreaks of norovirus-associated IID in community settings in the United Kingdom show very little seasonality, in strong contrast to outbreaks in health-care settings, which show marked winter-time seasonality (29). A number of factors may contribute to these differing patterns of seasonality between community disease and outbreaks in different settings.…”

Actualités sur les norovirus

“…Ces virus sont aussi responsables des gastroentérites chez les personnes âgées chez lesquelles elles sont plus graves et plus fréquentes, et peuvent s'accompagner d'une déshydratation déstabilisant un état précaire et néces-sitant une hospitalisation ; elles peuvent parfois entraîner le décès. La mortalité liée à ces gastroentérites se situerait entre 0,8 et 2,8‰ [24]. Enfin, des diarrhées chroniques à norovirus ont été observées chez des patients transplantés prenant un traitement immunosuppresseur [25].…”

Norovirusinfektionen in Deutschland

“…Mole ku lar bio lo gi sche Un ter su chun gen weisen da rauf hin, dass in den bei den Wintern mit sehr ho her No ro vi ru sin zi denz je weils eine neue Vi rus va ri an te der Ge nogrup pe GGII. [18,45,58]). Als mög li che Er klä run gen für eine grö ße re Vi ru lenz des Er re gers wer den eine ge stei ger te Um welt re sis tenz, eine erhöh te In fek tio si tät so wie eine man geln de er re ger spe zi fi sche Re ak ti on der kör pereige nen Im mu n ab wehr dis ku tiert.…”