Community incidence of norovirus-associated infectious intestinal disease in England: improved estimates using viral load for norovirus diagnosis.


Phillips, G; Tam, CC; Conti, S; Rodrigues, LC; Brown, D; Iturriza-Gomara, M; Gray, J; Lopman, B; (2010) Community incidence of norovirus-associated infectious intestinal disease in England: improved estimates using viral load for norovirus diagnosis. American journal of epidemiology, 171 (9). pp. 1014-22. ISSN 0002-9262 DOI: 10.1093/aje/kwq021

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Abstract

Existing estimates of the incidence of infectious intestinal disease (IID) caused by norovirus are based on electron microscopy or reverse transcription-polymerase chain reaction (RT-PCR). Neither method accurately represents norovirus disease burden: Electron microscopy has poor diagnostic sensitivity, and RT-PCR has poor diagnostic specificity. In this study, viral load measurements were used to identify cases of norovirus-associated IID and to produce new incidence estimates for England. IID cases were ascertained in the Study of Infectious Intestinal Disease in England (1993-1996), and stool specimens were tested by semiquantitative real-time RT-PCR for norovirus. The age-adjusted community incidence of norovirus-associated IID was 4.5/100 person-years (95% credibility interval: 3.8, 5.2), equating to 2 million episodes/year. Among children aged less than 5 years, the community incidence was 21.4/100 person-years (95% credibility interval: 15.9, 27.7), and the incidence of consultations to general practitioners for norovirus-associated IID was 3.2/100 person-years (95% credibility interval: 2.6, 3.8), with 100,000 children visiting their general practitioner for norovirus-associated IID each year. Norovirus is the most common cause of IID in the community in England and is responsible for a similar number of pediatric primary care consultations as rotavirus.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Public Health and Policy > Dept of Health Services Research and Policy
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
Vaccine Centre
PubMed ID: 20360244
Web of Science ID: 276999100008
URI: http://researchonline.lshtm.ac.uk/id/eprint/3814

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