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Review
. 2012 Jul;140(7):1161-72.
doi: 10.1017/S0950268812000234. Epub 2012 Mar 26.

The epidemiology of published norovirus outbreaks: a review of risk factors associated with attack rate and genogroup

J E Matthews  1 , B W Dickey, R D Miller, J R Felzer, B P Dawson, A S Lee, J J Rocks, J Kiel, J S Montes, C L Moe, J N S Eisenberg, J S Leon
Affiliations
Review

The epidemiology of published norovirus outbreaks: a review of risk factors associated with attack rate and genogroup

J E Matthews et al. Epidemiol Infect. 2012 Jul.

Abstract

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. We analysed data from 902 reverse transcriptase-polymerase chain reaction-confirmed, human NoV outbreaks abstracted from a systematic review of articles published from 1993 to 2011 and indexed under the terms 'norovirus' and 'outbreak'. Multivariate regression analyses demonstrated that foodservice and winter outbreaks were significantly associated with higher attack rates. Foodborne and waterborne outbreaks were associated with multiple strains (GI+GII). Waterborne outbreaks were significantly associated with GI strains, while healthcare-related and winter outbreaks were associated with GII strains. These results identify important trends for epidemic NoV detection, prevention, and control.

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Figures

Figure 1
Figure 1
Flow diagram of searches, screening, and selection of eligible articles for creation of NoV outbreak database. The 250 articles meeting inclusion criteria contained 900 outbreaks published between December 1993 and May 2011. Outbreaks spanned from December 1983 to March 2010. Arrows indicate the temporal order of the steps represented in the gray rectangles.
See this image and copyright information in PMC

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