Norovirus epidemiology in community and health care settings and association with patient age, Denmark.

Kristina T Franck,Blenda Böttiger,Annette K Ersbøll,Jannik Fonager

doi:10.3201/eid2007.130781

Kristina T Franck, Blenda Böttiger + Show 2 more

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https://doi.org/10.3201/eid2007.130781

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Abstract

Norovirus (NoV) is a major cause of gastroenteritis. NoV genotype II.4 (GII.4) is the predominant genotype in health care settings but the reason for this finding is unknown. Stool samples containing isolates with a known NoV genotype from 2,109 patients in Denmark (patients consulting a general practitioner or outpatient clinic, inpatients, and patients from foodborne outbreaks) were used to determine genotype distribution in relation to age and setting. NoV GII.4 was more prevalent among inpatients than among patients in community settings or those who became infected during foodborne outbreaks. In community and health care settings, we found an association between infection with GII.4 and increasing age. Norovirus GII.4 predominated in patients ≥ 60 years of age and in health care settings. A larger proportion of children than adults were infected with NoV GII.3 or GII.P21. Susceptibility to NoV infection might depend on patient age and infecting NoV genotype. Cohort studies are warranted to test this hypothesis.

Highlights

Norovirus (NoV) is a major cause of viral gastroenteritis [1] and a common cause of outbreaks of acute gastroenteritis in institutional settings, such as hospitals, nursing homes, and schools
The purpose of this study was to describe the distribution of NoV genotypes among infections in patients consulting a general practitioner (GP) or outpatient clinic, patients in health care settings, and patients in foodborne outbreaks
NoV by routine diagnostic procedures for gastroenteritis in Denmark during 2006–2010, we detected an association between an age ≥60 years and infection with NoV GII.4 in patients from community and health care settings

Summary

Introduction

Norovirus (NoV) is a major cause of viral gastroenteritis [1] and a common cause of outbreaks of acute gastroenteritis in institutional settings, such as hospitals, nursing homes, and schools. Foodborne outbreaks of NoV infection are common [2,3]. On the basis of amino acid or nucleotide sequencing of the polymerase and capsid regions, NoV can be divided into 6 genogroups (GI–GVI) and several genotypes. Genotyping of NoV should ideally be based on sequencing of the capsid and polymerase regions of the viral genome [9]. Outbreaks in health care settings are most often caused by NoV genogroup II genotype 4 (GII.4) [10,11,12,13]. The purpose of this study was to describe the distribution of NoV genotypes among infections in patients consulting a general practitioner (GP) or outpatient clinic, patients in health care settings, and patients in foodborne outbreaks. The association between NoV GII. and age of the patients in community and health care settings was determined

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