Abstract
BackgroundNorovirus 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. We undertook a systematic review to determine the nature, scope and scale of community-based surveillance systems which capture information on norovirus disease.MethodsWe searched MEDLINE, EMBASE and Scopus for studies published between 01 January 1995 and 31 December 2015, using terms relating to norovirus and surveillance. Publications were screened independently by two reviewers using exclusion criteria. Data extraction from included papers was performed using a standardized data extraction form. Outcomes were descriptions of the methods reported in included papers, and any estimates of incidence rate of norovirus disease in each community, stratified by age.ResultsAfter exclusions, we reviewed 45 papers of which 23 described surveillance studies and 19 included estimates of incidence. The estimates of incidence varied by outcome measure, type of laboratory test and study population. There were two estimates of norovirus hospitalisation; 0.72 and 1.04 per 1000 person-years. Estimates of norovirus disease ranged between 0.024 cases per 1000 person-years and 60 cases per 1000 person-years and estimates of all gastroenteritis varied between 49 and 1100 cases per 1000 person-years.ConclusionsOur systematic review found few papers describing community-based surveillance for norovirus disease. Standardised age-specific estimates of norovirus incidence would be valuable for calculating the true global burden of norovirus disease; robust community surveillance systems would be able to produce this information.Trial RegistrationPROSPERO 2016:CRD42016048659.
Highlights
Norovirus is a common cause of infectious gastrointestinal disease
In order to determine the nature, scope and scale of community-based surveillance of norovirus disease, we described the methods reported in papers included in the review, as a primary objective
Characteristics of included studies The number of publications regarding the communitybased surveillance of norovirus disease increased over the 20 year period included in this review; two thirds of papers (n = 30) were published since 2010
Summary
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. Norovirus infection is the most common cause of infectious gastrointestinal disease in the United Kingdom (UK) and many other countries [1, 2]. Norovirus is a common cause of gastroenteritis outbreaks in healthcare settings [4]. 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 [10]. 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 [5, 11, 12], but there is
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