Abstract
Norovirus (NoV) infections occur very frequently yet are rarely diagnosed. In Denmark, NoV infections are not under surveillance. We aimed to collect and describe existing laboratory-based NoV data. National NoV laboratory data were collected for 2011-2018, including information on patient identification number, age and sex, requesting physician, analysis date and result. We defined positive patient-episodes by using a 30-day time window and performed descriptive and time series analysis. Diagnostic methods used were assessed through a survey. We identified 15 809 patient-episodes (11%) out of 142 648 tested patients with an increasing trend, 9366 in 2011 vs. 32 260 in 2018. This corresponded with a gradual introduction of polymerase chain reaction analysis in laboratories. The highest positivity rate was in patients aged <5 years (15%) or >85 years (17%). There was a large difference in test performance over five Danish geographical regions and a marked seasonal variation with peaks from December to February. This is the first analysis of national NoV laboratory data in Denmark. A future laboratory-based surveillance system may benefit public health measures by describing trend, burden and severity of seasons and possibly pinpoint hospital outbreaks.
Highlights
Norovirus (NoV) is the most common cause of acute gastroenteritis and outbreaks worldwide [1]
Recent systematic reviews estimate that NoV causes 18% of diarrhoeal disease worldwide [1, 2]
The exemplar clinical case is an acute and self-limiting gastroenteritis that can be managed by rehydration therapy
Summary
Norovirus (NoV) is the most common cause of acute gastroenteritis and outbreaks worldwide [1]. NoV can spread via vomit or faecal contamination, especially in the absence of appropriate hygienic conditions. The majority of the reported outbreaks in developed countries take place in healthcare facilities, including nursing homes. These outbreaks often affect vulnerable people, such as hospitalised patients or the elderly. The outbreaks are disruptive and costly to health services and are best managed through infection control measures such as improved hygiene and patient isolation [3,4,5,6,7,8,9]. In Northern European countries, NoV infections commonly occur in the winter months and have been referred to as ‘winter vomiting disease’ [10]
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