title: A summertime peak of "winter vomiting disease": surveillance of noroviruses in England and Wales, 1995 to 2002.
abstract: BACKGROUND
  Noroviruses are the most common cause of gastroenteritis outbreaks in industrialised countries. Gastroenteritis caused by Norovirus infection has been described as a highly seasonal syndrome, often referred to as "winter vomiting disease".
  
  
  METHODS
  The Public Health Laboratory Service Communicable Disease Surveillance Centre has systematically collected reports of laboratory confirmed cases of Norovirus-gastroenteritis since 1995. We analysed these data for annual and seasonal trends and age distribution.
  
  
  RESULTS
  A mid-summer peak in reported cases of Norovirus was observed in 2002, unlike all six previous years when there was a marked summer decline. Total reports from 2002 have also been higher than all previous years. From the first 10 months of 2002, a total of 3029 Norovirus diagnoses were reported compared the previous peak in 1996 of 2437 diagnoses for the whole 12-month period. The increase in 2002 was most marked in the 65 and older age group.
  
  
  CONCLUSIONS
  This surveillance data challenges the view that Noroviruses infections exclusively have wintertime seasonality.
authors.affiliation: Public Health Laboratory Service Communicable Disease Surveillance Centre, Gastrointestinal Diseases Division, 61 Colindale Avenue, London NW9 5EQ, UK. blopman@phls.org.uk
authors.forename: Ben A
authors.initials: BA
authors.lastname: Lopman
authors.forename: Mark
authors.initials: M
authors.lastname: Reacher
authors.forename: Chris
authors.initials: C
authors.lastname: Gallimore
authors.forename: Goutam K
authors.initials: GK
authors.lastname: Adak
authors.forename: Jim J
authors.initials: JJ
authors.lastname: Gray
authors.forename: David W G
authors.initials: DW
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D017250:Caliciviridae Infections / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004739:England / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005759:Gastroenteritis / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control; D008854:Microscopy, Electron; D008875:Middle Aged; D029322:Norovirus / Q000302:isolation & purification* / Q000472:pathogenicity; D011159:Population Surveillance; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012621:Seasons; D014852:Wales / Q000453:epidemiology