Materiały źródłowe

• #1 Norovirus – StatPearls – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube

  https://www.ncbi.nlm.nih.gov/books/NBK513265/

  Noroviruses are nonenveloped, positive-sense, single-stranded RNA viruses from the Caliciviridae family and are the leading cause of acute gastrointestinal illness worldwide. […] Worldwide, norovirus is responsible for an estimated 685 million cases of gastroenteritis, 150,000 adult deaths, and 50,000 child deaths annually. […] In the United States, approximately 21 million cases of norovirus gastrointestinal illness are diagnosed each year. […] Norovirus is believed to cause approximately 60% of cases of acute gastroenteritis in the United States, and the CDC attributes 400,000 emergency department visits and 71,000 hospitalizations each year to norovirus infection. […] Although people of all age groups are at risk of contracting norovirus, those at the extremes of age and the immunocompromised are at the highest risk of poor outcomes.

• #1 Norovirus infection

  https://www.ecdc.europa.eu/en/norovirus-infection

  Norovirus infections can spread rapidly among people, especially in community settings such as hospitals, schools, daycare centres, and nursing homes. These places often see outbreaks due to close contact among individuals. […] Noroviruses are part of the Caliciviridae family and are known for causing what is often called „winter-vomiting disease” or „stomach flu” which often spreads during the winter months. The viruses can withstand freezing and high temperatures (up to 60C), and can also persist on surfaces for extended periods. […] Noroviruses are highly contagious, and it takes only a small number, typically between 10 to 100 viral particles, to infect someone. […] These viruses are primarily spread through what is known as the „faecal-oral route,” which means they can be transmitted when areas contaminated with the virus come into contact with the mouth. This can happen through consuming contaminated food or water, or through direct person-to-person contact.

• #1 A narrative review of norovirus epidemiology, biology, and challenges to vaccine development

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11137017/

  Estimates of norovirus AGE occurrence differ substantially in publications reflecting variability in methods of surveillance, laboratory test(s) used, study populations examined, and year-to-year variation in circulating genotypes. In one global systematic review of community-based surveillance studies conducted in all ages, norovirus AGE incidence rates ranged widely from 12.5 to 60 per 1000 person-years (PYs). Surveillance for norovirus in most countries is largely based on outbreak detection with individual cases not reported; therefore, estimates of population-based norovirus AGE incidence come primarily from cohort studies. […] Norovirus AGE outbreaks are associated with high attack rates and substantial economic and clinical burden. The most commonly reported setting for norovirus outbreaks in the US and other industrialized countries is healthcare settings. The costs to hospitals associated with outbreaks can be substantial, depending on the number of units affected.

• #1 Norovirus – StatPearls – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube

  https://www.ncbi.nlm.nih.gov/books/NBK513265/

  Norovirus infections are also more prevalent in developing nations. […] As of December 2024, United States surveillance data has identified a significant increase in norovirus-associated gastroenteritis compared with a similar period from previous years. […] The primary mode of transmission of norovirus is fecal-oral. […] Norovirus outbreaks are common in several different settings. […] Good hand hygiene and effective surface cleaning should be stressed during norovirus outbreaks. […] Studies suggest that washing hands with soap and running water for at least 20 seconds is the most effective form of hand hygiene for eliminating norovirus. […] Infection control is a priority in preventing norovirus outbreaks. […] Norovirus vaccine development remains a priority for both the perceived public health and economic benefits.

• #1 Norovirus | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/information-other-diseases-and-conditions-fact-sheets/norovirus

  There have also been outbreaks associated with people vomiting and aerosolizing virus in public settings. Waterborne outbreaks of norovirus have been caused by sewage contamination of wells and recreational water. Diapered children playing in kiddie pools filled with tap water (pools that have not been chlorinated) have also been associated with norovirus outbreaks. […] Iowa Administrative Code 641-1.3(139) stipulates that the laboratory and the healthcare provider must immediately report suspected or confirmed outbreaks. […] Disease reporting regulations require that suspected or confirmed outbreaks, including norovirus, be reported to local public health agencies by the most rapid means available within 24 hours. […] The University of Iowa State Hygienic Laboratory performs PCR testing for Norovirus.

• #1 Norovirus Infection – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/norovirus-infection/

  Norovirus infection is caused by a very contagious virus called norovirus. […] Outbreaks caused by norovirus occur in a variety of places, including healthcare settings (e.g., long-term care facilities, hospitals), restaurants, schools, daycare centers, and cruise ships. […] During outbreaks, public health laboratories can test stool specimens to identify the virus and confirm the cause of the outbreak. […] People should stay home when sick and for at least two days after symptoms stop to prevent spreading norovirus to other people.

• #1 Epidemiology of norovirus gastroenteritis in Germany 2001–2009: eight seasons of routine surveillance | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/epidemiology-of-norovirus-gastroenteritis-in-germany-20012009-eight-seasons-of-routine-surveillance/F3BB7117767FC59E962DA1C9B4C8705D

  Notification data show a strong, single-peak seasonality with the majority (76%) of cases occurring between November and March. […] Seventy-six percent of cases were reported in outbreaks ranging from 56% in 2003/2004 to 87% in 2001/2002. […] We found that norovirus incidence and mortality were higher in females than in males, and female cases were older than male cases. […] The incidence in the Eastern German federal states was higher than in the Western states. […] We considered 31 644 reported norovirus outbreaks for our analyses giving a total of 552 823 cases. […] Of the outbreaks with a reported setting (75%), half occurred in nursing homes or hospitals followed by outbreaks in private households and childcare facilities. […] The median case number per outbreak was nine (IQR 323).

• #1 A narrative review of norovirus epidemiology, biology, and challenges to vaccine development | npj Vaccines

  https://www.nature.com/articles/s41541-024-00884-2

  Norovirus AGE outbreaks are associated with high attack rates and substantial economic and clinical burden. […] The most commonly reported setting for norovirus outbreaks in the US and other industrialized countries is healthcare settings. […] Outbreaks in long-term care facilities (LTCFs) are of particular concern, as individuals receiving care in these settings are more likely to be elderly or have underlying medical conditions. […] Norovirus AGE causes substantial economic and clinical burden, with direct healthcare costs and lost productivity from personal illness or time spent caring for an ill child estimated to cost $60 billion globally each year. […] A reduction in norovirus AGE incidence was observed during periods of shutdown for COVID-19; however, recent data have shown that, with the lifting of COVID-19 pandemic restrictions, norovirus AGE incidence has returned to pre-pandemic levels.

• #1 Norovirus infection epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Norovirus_infection_epidemiology_and_demographics

  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. […] 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. […] 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.

• #1 A narrative review of norovirus epidemiology, biology, and challenges to vaccine development | npj Vaccines

  https://www.nature.com/articles/s41541-024-00884-2

  Observational studies have attempted to quantify incidence rates in smaller, defined populations, but wider, routine population-based surveillance is needed to fully appreciate the societal impact of norovirus AGE. […] The lack of standard testing for norovirus outside of outbreak settings makes estimation of the true burden of disease challenging from routine sources and is an area for improvement. […] There is currently no licensed vaccine for norovirus AGE, and many features of the virus and the human immune response to it have made vaccine development a challenge. […] Given the substantial morbidity and mortality associated with norovirus AGE, a vaccine to prevent the disease would have a significant impact on global public health.

• #1 Epidemiology of Norovirus Outbreaks Reported to the Public Health Emergency Event Surveillance System, China, 2014–2017

  https://www.mdpi.com/1999-4915/11/4/342

  We conducted a retrospective analysis of norovirus outbreaks reported to the National Public Health Emergency Event Surveillance System (PHEESS) in China from January 1, 2014 to December 31, 2017. We reviewed all acute gastroenteritis outbreaks (n = 692) submitted to PHEESS to identify the frequency, seasonality, geographic distribution, setting, and transmission mode of outbreaks due to norovirus. A total of 616 norovirus outbreaks resulting in 30,848 cases were reported. Among these outbreaks, 571 (93%) occurred in school settings including 239 (39%) in primary schools, 136 (22%) in childcare facilities, and 121 (20%) in secondary schools. The majority of outbreaks (63%) were due to person-to-person transmission, followed by multiple modes of transmission (11%), foodborne (5%) and waterborne (3%) transmission. These findings highlight the importance of improving hand hygiene and environmental disinfection in high-risk settings. Developing a standard and quantitative outbreak reporting structure could improve the usefulness of PHEESS for monitoring norovirus outbreaks.

• #1 Epidemiology of Norovirus Outbreaks Reported to the Public Health Emergency Event Surveillance System, China, 2014–2017

  https://www.mdpi.com/1999-4915/11/4/342

  According to the National Guidelines for Information Reporting Management of Public Health Emergency Events, AGE outbreaks involving 20 or more cases, or involving one or more outbreak-related deaths, should be reported to PHEESS. […] Monitoring norovirus outbreaks can help to improve our understanding of norovirus epidemiology, identify changes in occurrence, and provide evidence for targeted intervention strategies. […] Among the 692 AGE outbreaks, 616 (89.0%) were caused by norovirus, resulting in 30,848 illnesses. […] The reported transmission mode varied by outbreak setting. Person-to-person transmission was the primary cause of outbreaks in childcare facilities (75.7%), primary schools (76.1%), and secondary schools (50.4%). […] The high incidence of norovirus outbreaks at schools resulting from person-to-person transmission underscores the importance of excluding ill persons, improving hand hygiene, and proper environmental disinfection.

• #1 What You Need to Know

  https://dphhs.mt.gov/publichealth/cdepi/diseases/Norovirus

  Most outbreaks of norovirus that are reported in the United States occur in healthcare facilities, including nursing homes and hospitals. In the previous five years, 64% of all norovirus outbreaks in Montana were reported in health care settings such as long-term care facilities, assisted living facilities and hospitals. […] Norovirus is a leading cause of disease from contaminated foods in the United States. Foods that are most commonly involved in foodborne norovirus outbreaks include leafy greens (such as lettuce), fresh fruits, and shellfish (such as oysters). […] About 50% of all outbreaks of food-related illness are caused by norovirus.

• #1 Norovirus | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/information-other-diseases-and-conditions-fact-sheets/norovirus

  Norovirus is common worldwide, and is mostly associated with sporadic outbreaks. […] Norovirus is the most common cause of acute gastroenteritis in the United States. Each year, it causes 19-21 million illnesses and contributes to 56,000-71,000 hospitalizations and 570-800 deaths. Norovirus is also the most common cause of foodborne-disease outbreaks in the United States. […] In Iowa, noroviruses cause the majority of foodborne illness outbreaks. Rough, wet, uncooked foods are at highest risk of transmission. Most foodborne outbreaks of norovirus illness arise from direct contamination of food by those who handle the food before it is eaten. Outbreaks have frequently been associated with consumption of cold foods, including salads, sandwiches, and bakery products. […] Most outbreaks are due to person-to-person spread, but many are foodborne. Implicating a specific food in foodborne norovirus outbreaks is often difficult. Rough, wet, uncooked foods such as salads, sandwiches, and bakery products pose the highest risk of transmission. Most foodborne outbreaks of norovirus arise from direct contamination by those who handle the food before it is eaten.

• #1 Community-based surveillance of norovirus disease: a systematic review | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2758-1

  Norovirus is a common cause of infectious gastrointestinal disease. Despite the increased ability to detect norovirus in affected people, the number of reported cases and outbreaks in the community is still substantially underestimated. […] Surveillance of norovirus disease is essential for providing information for norovirus prevention and control. Different types of surveillance system are used and have been described elsewhere. Norovirus surveillance is largely based on laboratory diagnosis and the ability to detect norovirus in affected people has increased with the adoption of more sensitive molecular methods. There is evidence that the number of reported cases and outbreaks in the community is substantially underestimated; and that this underestimation is greater in the community than hospital settings, but there is little evidence of the type and variety of community-based norovirus surveillance systems.

• #1 Norovirus Reporting and Surveillance | Norovirus | CDC

  https://www.cdc.gov/norovirus/php/reporting/index.html

  CDC reporting systems for norovirus include NORS, CaliciNet, NoroSTAT, NREVSS, and NREVSS Enhanced. […] CDC uses surveillance systems (NVSN and NoroSurv) to generate estimates of norovirus illness and monitor trends. […] Health departments are encouraged to report all suspected and confirmed norovirus outbreaks through the National Outbreak Reporting System (NORS) and CaliciNet. […] In addition to collecting norovirus outbreak data from state and local health departments, CDC uses the following platforms to generate estimates of norovirus illness and monitor trends over time. […] NVSN: New Vaccine Surveillance Network (NVSN) includes study sites that conduct active, population-based surveillance for hospitalizations and outpatient visits associated with acute gastroenteritis in children, as well as surveillance for acute respiratory illness. […] NoroSurv is a global pediatric norovirus strain surveillance network. The aim of the network is to collect data on the circulating norovirus genotypes in hospitalized children under 5 years of age across different countries and continents.

• #1 NoroSTAT Surveillance Network | Norovirus | CDC

  https://www.cdc.gov/norovirus/php/reporting/norostat.html

  NoroSTAT is a network of state health departments that work with CDC to provide near real-time reporting and monitoring of norovirus outbreak activity. […] The data are used to track current norovirus activity, better understand outbreaks, and make recommendations to prevent future outbreaks. […] Outbreaks of norovirus, the leading cause of acute gastroenteritis and foodborne illness in the United States. […] CDC established the Norovirus Sentinel Testing and Tracking (NoroSTAT) network in August 2012. […] Together, they improve timeliness, completeness, and consistency of norovirus outbreak reporting to CDC’s National Outbreak Reporting System (NORS) and CaliciNet. […] This allows CDC and state health departments to quickly evaluate current outbreak activity. […] NoroSTAT also enhances communication among epidemiologists and laboratorians in state health departments and CDC. This enables timely exchange of information regarding norovirus outbreak surveillance.

• #1

  https://www.gov.uk/government/statistics/national-norovirus-and-rotavirus-surveillance-reports-2024-to-2025-season

  Reports of norovirus and rotavirus laboratory surveillance and enteric virus outbreaks in hospital and community settings in England during the 2024 to 2025 season. […] This report provides an overview of norovirus and rotavirus activity in England during the 2024 to 2025 season. It is published weekly during the winter period and monthly during the summer period. […] The data presented is derived from 4 national UK Health Security Agency (UKHSA) systems, including laboratory reporting of norovirus and rotavirus, enteric virus (norovirus, rotavirus, sapovirus and astrovirus) outbreaks in hospital and community settings, and molecular surveillance data on circulating strains of norovirus. […] All surveillance data included in this report is extracted from live reporting systems, are subject to a reporting delay and the number reported in the most recent weeks may rise further as more reports are received. Therefore, data pertaining to the most recent 2 weeks is not included.

• #1 Epidemiology of norovirus gastroenteritis in Germany 2001–2009: eight seasons of routine surveillance | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/epidemiology-of-norovirus-gastroenteritis-in-germany-20012009-eight-seasons-of-routine-surveillance/F3BB7117767FC59E962DA1C9B4C8705D

  For every reported person meeting the surveillance case definition (see below), the LPHD completes an electronic case report which is transmitted (without the name and address of the patient) to the RKI via one of the 16 state health departments. […] The incidence of reported norovirus gastroenteritis by season was calculated using the information on the German population size provided by the statistical offices of the federal states. […] We considered cases with disease onset 1 day after hospital admission as potentially nosocomial cases. […] From season 2001/2002 to season 2008/2009, a total of 856 539 norovirus cases were reported in Germany. […] The case number by season varied between 15 414 in 2001/2002 and 246 800 in 2007/2008, corresponding to a mean incidence per season of 130 (range 19300) cases/100 000 population.

• #1 Norovirus: For health professionals – Canada.ca

  https://www.canada.ca/en/public-health/services/food-poisoning/norovirus/health-professionals.html

  Noroviruses cause approximately 90% of all outbreaks of epidemic gastroenteritis. They are an important source of foodborne outbreaks globally. […] Outbreaks of norovirus are nationally notifiable. Report any outbreaks that meet the national outbreak case definition to the federal government. […] Canada uses different surveillance systems to monitor outbreaks of norovirus. These include: Canadian Notifiable Disease Surveillance System, National Enteric Surveillance Program (NESP).

• #1 Norovirus GII wastewater monitoring for epidemiological surveillance | PLOS Water

  https://journals.plos.org/water/article?id=10.1371/journal.pwat.0000198

  Norovirus GII wastewater monitoring for epidemiological surveillance […] While the Centers for Disease Control and Prevention coordinates several outbreak and clinical surveillance systems for norovirus, norovirus is strongly under-reported due to individuals not seeking care or not being tested. […] Wastewater monitoring can potentially provide a comprehensive and consistent data stream that can help to triangulate across these different data sets. […] The best correlations between data sources were observed when the wastewater sewershed population had high overlap with the population included by other monitoring methods. […] The increased specificity and earlier detection of HuNoV GII using wastewater compared to other data, and the ability to make this data available to healthcare, public health, and the public in a timely manner, suggests that wastewater measurements of HuNoV GII will enhance existing public health surveillance efforts of norovirus.

• #1 Journal of Medical Internet Research – Identifying Potential Norovirus Epidemics in China via Internet Surveillance

  https://www.jmir.org/2017/8/e282/

  Internet-based surveillance offers a potential means for monitoring emergent infectious diseases, whose effectiveness and dependability have been explored and examined in some studies. […] In this study, we used Internet-based surveillance to identify the association between possible norovirus case number and the fluctuant retrieval index of norovirus-related keywords from the Baidu search engine, and explored an optimal model with specific time lag for the prediction of norovirus epidemics. […] Given the short disease course, the serious symptom of acute gastroenteritis, and the characteristics of self-healing, the clustered epidemics of norovirus infection in young groups were more likely to be monitored, particularly in schools. […] The early warning of norovirus epidemics by Internet surveillance might be limited for epidemics with short incubation periods and rapid disease progression.

• #1 Journal of Medical Internet Research – Predicting Norovirus in England Using Existing and Emerging Syndromic Data: Infodemiology Study

  https://www.jmir.org/2023/1/e37540/

  Detection of increasing disease levels in the community by syndromic surveillance is generally faster than traditional surveillance approaches, though may not be pathogen-specific, as it relies on symptoms rather than confirmed diagnosis. […] In addition to existing syndromic surveillance systems, multiple emerging syndromic data sources have been identified with the potential to be used for public health benefits. […] The focus of this study is to assess the value of existing and emerging syndromic data sources in the prediction of confirmed laboratory reports of norovirus infection captured by national surveillance. […] Our findings suggest that both existing and emerging syndromic surveillance data can predict the number of laboratory reports of norovirus, but the success and specific variables vary across age groups and regions of England.

• #1 A narrative review of norovirus epidemiology, biology, and challenges to vaccine development

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11137017/

  Norovirus is a leading cause of acute gastroenteritis (AGE) globally. AGE resulting from norovirus causes significant morbidity and mortality in countries of all income levels, particularly among young children and older adults. Prevention of norovirus AGE represents a unique challenge as the virus is genetically diverse with multiple genogroups and genotypes cocirculating globally and causing disease in humans. Variants of the GII.4 genotype are typically the most common genotype, and other genotypes cause varying amounts of disease year-to-year, with GII.2, GII.3, and GII.6 most prevalent in recent years. Noroviruses are primarily transmitted via the fecal-oral route and only a very small number of virions are required for infection, which makes outbreaks of norovirus extremely difficult to control when they occur.

• #1 The epidemiology of published norovirus outbreaks: a review of risk factors associated with attack rate and genogroup | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/epidemiology-of-published-norovirus-outbreaks-a-review-of-risk-factors-associated-with-attack-rate-and-genogroup/79933DB1D32790A0D714A23ED6CA1F06

  The purpose of this study was to examine global epidemiological trends in human norovirus (NoV) outbreaks by transmission route and setting, and describe relationships between these characteristics, viral attack rates, and the occurrence of genogroup I (GI) or genogroup II (GII) strains in outbreaks. […] NoV infection has an average incubation period between 24 and 48 h and average illness duration between 12 and 60 h. […] The primary mode of transmission is faecal-oral and occurs through ingestion of contaminated water, consumption of contaminated food, or direct contact with environmental surfaces or infected persons. […] NoV are genetically classified into five genogroups, of which GII, GI, and GIV (rarely), in order of greatest to lowest numbers, are responsible for human outbreaks.

• #1 The epidemiology of published norovirus outbreaks: a review of risk factors associated with attack rate and genogroup | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/epidemiology-of-published-norovirus-outbreaks-a-review-of-risk-factors-associated-with-attack-rate-and-genogroup/79933DB1D32790A0D714A23ED6CA1F06

  Attack rates were significantly higher in outbreaks related to food, water, and in winter. […] By contrast, the attack rate was lower in healthcare-related outbreaks. […] We also found that GII strains, particularly GII.4, were more likely to be present in outbreaks that occurred in healthcare settings.

• #1 SciELO Brazil – Epidemiological and molecular surveillance of norovirus in the Brazilian Amazon: description of recombinant genotypes and improvement of evolutionary analysis Epidemiological and molecular surveillance of norovirus in the Brazilian Amazon

  https://www.scielo.br/j/rimtsp/a/rsMKP4b9vZctBYxBL5NsMTn/

  All age groups showed NoV infections, but a considerable frequency was observed in children under two years of age, as it was inferred that children at this age were twice as likely to be affected by NoV gastroenteritis (33.3% – 98/294). […] Considering the available information on norovirus epidemiological surveillance, 102 samples were selected for RT-PCR and sequencing. […] The majority of NoV cases found in this study were caused by the GII.P16/GII.4 genotype, which was present in all years analyzed. […] This study revealed that NoV is one of the major causes of gastroenteritis in the Amazon. This underscores the importance of conducting epidemiological surveillance to prevent the spread of such infections.

• #1 Norovirus – Page 1 | Food Safety

  https://www.food-safety.com/keywords/1161-norovirus

  A limited number of state jurisdictions have completely adopted the most recent norovirus food safety provisions outlined in the FDA Food Code, according to an analysis conducted in 2020 by CDC researchers. […] The UK Health Security Agency (UKHSA) recently published its first annual report summarizing infectious disease trends, which noted increases in the incidence of infections by important foodborne pathogens like Escherichia coli, Salmonella, Listeria monocytogenes, Campylobacter, and norovirus. […] Norovirus was the leading cause of illnesses and hospitalizations, but Salmonella topped fatalities. […] Following a winter with higher-than-average reports of norovirus cases linked to an emergent genotype, the UK Health Security Agency (UKHSA) is warning the public about a potential second wave of infections associated with a second, more common genotype. […] A new study has shown that wastewater surveillance can be a useful tool for local health departments pursuing norovirus outbreak investigations.

• #1 Norovirus infection

  https://www.ecdc.europa.eu/en/norovirus-infection

  During a norovirus outbreak, multiple modes of transmission often occur. […] Immunity to noroviruses is relatively short-lived, lasting only a few months, and it is specific to the particular strain of the virus that an individual is exposed to. Given the genetic diversity of noroviruses, people can be infected multiple times throughout their lives. Some individuals however appears to be resistant to infection and disease from the most common form of norovirus, due to genetic factors.

• #1 The epidemiology of published norovirus outbreaks: a review of risk factors associated with attack rate and genogroup | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/epidemiology-of-published-norovirus-outbreaks-a-review-of-risk-factors-associated-with-attack-rate-and-genogroup/79933DB1D32790A0D714A23ED6CA1F06

  Despite the ability to detect and classify NoV through antibody-based assays (since 1985) and genomic amplification assays (since 1992), many fundamental questions regarding NoV outbreak characteristics have either been incompletely addressed or remain unanswered from analysis of surveillance data. […] In general, these studies suggest that a majority of reported NoV outbreaks occur in healthcare facilities and foodservice settings. […] In addition, foodborne and waterborne outbreaks have often been associated with high attack rates. […] Furthermore, a higher proportion of GII strains, compared to GI strains, was reported in a majority of outbreaks across several studies and was commonly associated with healthcare settings. […] The goal of this analysis was to examine relationships between primary attack rate, genogroup, mode of transmission, outbreak setting, and other NoV outbreak characteristics.

• #1 Department of Health | Communicable Disease Service | Norovirus

  https://www.nj.gov/health/cd/topics/norovirus.shtml

  Individual cases of this disease are not reportable. All outbreaks are Immediately reportable to the Local Health Department. […] Noroviruses are a group of related viruses that affect the stomach and intestines and cause an illness called gastroenteritis (an inflammation of the stomach and intestines). This illness is highly contagious and outbreaks are common due to the ease of transmission. Outbreaks may occur in places where people consume water and/or food prepared or handled by others, such as nursing homes, hospitals, restaurants, cruise ships, banquet halls, summer camps and family dinners.

• #1 A narrative review of norovirus epidemiology, biology, and challenges to vaccine development | npj Vaccines

  https://www.nature.com/articles/s41541-024-00884-2

  Norovirus is a leading cause of acute gastroenteritis (AGE) globally. […] Each year, an estimated 1.5 million deaths occur globally due to all-cause AGE, with 136,000 to 278,000 related to norovirus infection. […] Young children, older adults, and immunocompromised individuals are particularly vulnerable to severe norovirus disease and its associated complications. […] Estimates of norovirus AGE occurrence differ substantially in publications reflecting variability in methods of surveillance, laboratory test(s) used, study populations examined, and year-to-year variation in circulating genotypes. […] Surveillance for norovirus in most countries is largely based on outbreak detection with individual cases not reported; therefore, estimates of population-based norovirus AGE incidence come primarily from cohort studies.

• #1 Norovirus GII wastewater monitoring for epidemiological surveillance | PLOS Water

  https://journals.plos.org/water/article?id=10.1371/journal.pwat.0000198

  Human norovirus (HuNoV) surveillance practices vary greatly across the US, and there is no requirement for local, territorial, or state agencies to report individual norovirus cases to the national system. […] Public health officials often rely on syndromic data, such as school and emergency department gastrointestinal illness reports, as early indicators of norovirus outbreaks. […] Health departments are encouraged to report all waterborne, foodborne, and enteric disease outbreaks, which would include norovirus outbreaks, to the National Reporting System (NORS) and norovirus outbreaks to Calicinet. […] The Centers for Disease Control and Prevention (CDC) and health departments from fourteen states, including Michigan, participate in the Norovirus Sentinel Testing and Tracking (NoroSTAT) network. […] This suggests a need to examine corresponding wastewater and epidemiological surveillance data for multiple populations at high resolution and concurrently against multiple sources of conventional norovirus surveillance data.

• #1 Electronic Outbreak Surveillance in Germany: A First Evaluation for Nosocomial Norovirus Outbreaks | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0017341

  Many NNOs are not notified by hospitals and differences in LPHA procedures have an impact on the number of outbreaks captured in the surveillance system. […] Public health surveillance systems should be evaluated periodically to ensure that problems of public health importance are being monitored efficiently and effectively. […] Our evaluation confirms previous, anecdotal reports of NNO being underreported in Germany and the contribution of LPHAs for ascertainment of NNO by actively searching for outbreaks. […] The use of a second dataset the NNO control study dataset suggests that all NNOs known at Hessian LPHAs could be retrieved from the national surveillance database. […] More than one quarter of all ascertained cases in NNOs needed to be forwarded to the LPHA responsible for the cases counties of residence.

• #1 CDC researcher highlights the importance of increasing surveillance against norovirus and identifying factors of severity and origin of outbreaks | Oswaldo Cruz Institute

  https://www.ioc.fiocruz.br/en/noticias/pesquisador-do-cdc-destaca-importancia-de-aumentar-vigilancia-contra-norovirus-e

  If surveillance strategies are established to identify the risk of contamination in these foods, most cases of foodborne contamination could be avoided, he believes. […] For the North American, the results found allow us to think about establishing a norovirus surveillance network. […] We can think about creating a global norovirus surveillance network, which would be very important for identifying emerging strains and monitoring the genetic variability of new variants, especially GII.4.

• #1 Norovirus GII wastewater monitoring for epidemiological surveillance | PLOS Water

  https://journals.plos.org/water/article?id=10.1371/journal.pwat.0000198

  Wastewater monitoring for HuNoV has the potential to provide more local, early-warning information to inform public health decision-making potentially prior to clinically detected outbreaks. […] A recent study in the US showed population weighted average HuNoV GII RNA levels across 145 WWTPs positively correlated to national NoroSTAT clinical data. […] Our results suggest that wastewater monitoring of HuNoV GII leads or concurs with other epidemiological monitoring methods, but correlations between wastewater and other data sources varied by the degree of overlap between the sewershed and the population catchment of the other data source.

• #2 A narrative review of norovirus epidemiology, biology, and challenges to vaccine development | npj Vaccines

  https://www.nature.com/articles/s41541-024-00884-2

  Norovirus is a leading cause of acute gastroenteritis (AGE) globally. […] Each year, an estimated 1.5 million deaths occur globally due to all-cause AGE, with 136,000 to 278,000 related to norovirus infection. […] Young children, older adults, and immunocompromised individuals are particularly vulnerable to severe norovirus disease and its associated complications. […] Estimates of norovirus AGE occurrence differ substantially in publications reflecting variability in methods of surveillance, laboratory test(s) used, study populations examined, and year-to-year variation in circulating genotypes. […] Surveillance for norovirus in most countries is largely based on outbreak detection with individual cases not reported; therefore, estimates of population-based norovirus AGE incidence come primarily from cohort studies.

• #2 Epidemiology of norovirus infections among diarrhea outpatients in a diarrhea surveillance system in Shanghai, China: a cross-sectional study | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-015-0922-z

  Previous studies have reported that norovirus mainly peaked in winter or cold seasons. In this study, the result verified this conclusion, as more strains were detected from October to April (when the weather was comparatively cold in Shanghai). […] […] This study was the first in Shanghai to be concerned with sporadic norovirus infections of the whole population. It was based on a diarrhea disease surveillance system in Shanghai, which began in 2012. […] […] Norovirus GII is predominantly responsible for acute diarrhea worldwide, as described in most studies, and our findings (10.41% GI, 85.16% GII, 4.43% mix of both genotypes) were consistent with them. […] […] These results might serve to promote diagnosis in a clinical setting, especially for medical staff to detect outbreaks and trace sources early. For public health workers, the results could help determine focus timing and populations of norovirus infections.

• #2 Noroviruses

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/diseases/noroviruses.html

  Noroviruses are an important cause of gastrointestinal illness throughout the United States, including Illinois. […] The U.S. Centers for Disease Control and Prevention estimates that at least half of all foodborne outbreaks of gastroenteritis can be attributed to noroviruses. […] Noroviruses are highly contagious and can spread easily from person to person. […] Outbreaks of norovirus in long-term care facilities are not uncommon and are frequently transmitted from person to person (including residents, staff, visitors and volunteers). Strict compliance with good hygiene practices is important to prevent the spread of norovirus in this population.

• #2 Norovirus – Information and Epidemiology Services

  https://www.ehagroup.com/resources/pathogens/norovirus/

  Norovirus induced diarrhea is transmitted by the fecal-oral route and is transmitted via contaminated food and water and also hand to mouth behavior in infants of contaminated objects. […] It is the most common cause of diarrhea in all ages under 18, and constitutes 2/3 of all diarrhea cases in children between 6-24 months. […] Shellfish, salads, raw clams and oysters are the foods most commonly implicated in the spread of Norovirus during outbreaks. […] Recently, highly publicized outbreaks on cruise ships have been identified. […] However, this is due in part to surveillance. […] Outbreaks at schools, prisons and health care facilities also occur and when investigated, Norovirus has been identified as the causative organism.

• #2 A narrative review of norovirus epidemiology, biology, and challenges to vaccine development

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11137017/

  Outbreaks in long-term care facilities (LTCFs) are of particular concern, as individuals receiving care in these settings are more likely to be elderly or have underlying medical conditions. […] Other commonly reported settings for norovirus AGE outbreaks include restaurants and catered events, schools and childcare centers, and settings where individuals reside in close contact, such as cruise ships or dormitories. […] Norovirus AGE causes substantial economic and clinical burden, with direct healthcare costs and lost productivity from personal illness or time spent caring for an ill child estimated to cost $60 billion globally each year. […] Due to limitations in surveillance (based on outbreaks only), it is challenging to determine the full burden of norovirus. Observational studies have attempted to quantify incidence rates in smaller, defined populations, but wider, routine population-based surveillance is needed to fully appreciate the societal impact of norovirus AGE.

• #2 NoroSTAT Surveillance Network | Norovirus | CDC

  https://www.cdc.gov/norovirus/php/reporting/norostat.html

  State health departments report the following preliminary information: Epidemiologic data. This includes outbreak onset date, primary transmission mode, total number of people sick, outbreak setting, and whether norovirus is the suspected or confirmed cause. […] After their initial report, state health departments often submit additional epidemiologic data through NORS as these data become available.

• #2 Epidemiology of norovirus gastroenteritis in Germany 2001–2009: eight seasons of routine surveillance | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/epidemiology-of-norovirus-gastroenteritis-in-germany-20012009-eight-seasons-of-routine-surveillance/F3BB7117767FC59E962DA1C9B4C8705D

  Notification data show a strong, single-peak seasonality with the majority (76%) of cases occurring between November and March. […] Seventy-six percent of cases were reported in outbreaks ranging from 56% in 2003/2004 to 87% in 2001/2002. […] We found that norovirus incidence and mortality were higher in females than in males, and female cases were older than male cases. […] The incidence in the Eastern German federal states was higher than in the Western states. […] We considered 31 644 reported norovirus outbreaks for our analyses giving a total of 552 823 cases. […] Of the outbreaks with a reported setting (75%), half occurred in nursing homes or hospitals followed by outbreaks in private households and childcare facilities. […] The median case number per outbreak was nine (IQR 323).

• #2 Norovirus GII wastewater monitoring for epidemiological surveillance | PLOS Water

  https://journals.plos.org/water/article?id=10.1371/journal.pwat.0000198

  Wastewater monitoring for HuNoV has the potential to provide more local, early-warning information to inform public health decision-making potentially prior to clinically detected outbreaks. […] A recent study in the US showed population weighted average HuNoV GII RNA levels across 145 WWTPs positively correlated to national NoroSTAT clinical data. […] Our results suggest that wastewater monitoring of HuNoV GII leads or concurs with other epidemiological monitoring methods, but correlations between wastewater and other data sources varied by the degree of overlap between the sewershed and the population catchment of the other data source.

• #2 A narrative review of norovirus epidemiology, biology, and challenges to vaccine development

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11137017/

  There is currently no licensed vaccine for norovirus AGE, and many features of the virus and the human immune response to it have made vaccine development a challenge. Genotype GII.4 is the primary cause of global norovirus AGE; however, non-GII.4 genotypes may be underestimated in existing outbreak-focused surveillance systems. Multivalent vaccines are needed to provide broad coverage of the at-risk population, and regular composition updates based on norovirus epidemiology may be required. Given the substantial morbidity and mortality associated with norovirus AGE, a vaccine to prevent the disease would have a significant impact on global public health.

• #2 Norovirus

  https://prod.nmhealth.org/about/erd/ideb/noro/

  Individual cases of norovirus infection are not required to be reported to the New Mexico Department of Health. However, norovirus outbreaks do require reporting under the “suspected foodborne illness in two or more unrelated persons.” […] The New Mexico Department of Health investigates many norovirus outbreaks every year. […] CaliciNet is an electronic norovirus outbreak surveillance network allowing certified laboratories to upload their genotyping information to a national database. […] The CaliciNet database allows tracking of transmission sources and temporal spread of specific norovirus genotypes.

• #2 A narrative review of norovirus epidemiology, biology, and challenges to vaccine development

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11137017/

  Estimates of norovirus AGE occurrence differ substantially in publications reflecting variability in methods of surveillance, laboratory test(s) used, study populations examined, and year-to-year variation in circulating genotypes. In one global systematic review of community-based surveillance studies conducted in all ages, norovirus AGE incidence rates ranged widely from 12.5 to 60 per 1000 person-years (PYs). Surveillance for norovirus in most countries is largely based on outbreak detection with individual cases not reported; therefore, estimates of population-based norovirus AGE incidence come primarily from cohort studies. […] Norovirus AGE outbreaks are associated with high attack rates and substantial economic and clinical burden. The most commonly reported setting for norovirus outbreaks in the US and other industrialized countries is healthcare settings. The costs to hospitals associated with outbreaks can be substantial, depending on the number of units affected.

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