title: Norovirus disease in the United States.
abstract: Although recognized as the leading cause of epidemic acute gastroenteritis across all age groups, norovirus has remained poorly characterized with respect to its endemic disease incidence. Use of different methods, including attributable proportion extrapolation, population-based surveillance, and indirect modeling, in several recent studies has considerably improved norovirus disease incidence estimates for the United States. Norovirus causes an average of 570-800 deaths, 56,000-71,000 hospitalizations, 400,000 emergency department visits, 1.7-1.9 million outpatient visits, and 19-21 million total illnesses per year. Persons >65 years of age are at greatest risk for norovirus-associated death, and children <5 years of age have the highest rates of norovirus-associated medical care visits. Endemic norovirus disease occurs year round but exhibits a pronounced winter peak and increases by ≤ 50% during years in which pandemic strains emerge. These findings support continued development and targeting of appropriate interventions, including vaccines, for norovirus disease.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. ajhall@cdc.gov
authors.forename: Aron J
authors.initials: AJ
authors.lastname: Hall
authors.forename: Ben A
authors.initials: BA
authors.lastname: Lopman
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Payne
authors.forename: Manish M
authors.initials: MM
authors.lastname: Patel
authors.forename: Paul A
authors.initials: PA
authors.lastname: Gastañaduy
authors.forename: Jan
authors.initials: J
authors.lastname: Vinjé
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
mesh_terms: D017250:Caliciviridae Infections / Q000401:mortality* / Q000628:therapy*; D004196:Disease Outbreaks; D062665:Epidemiological Monitoring; D006760:Hospitalization; D006801:Humans; D029322:Norovirus / Q000276:immunology*; D012306:Risk; D012621:Seasons; D014481:United States / Q000453:epidemiology
keywords: United States; epidemic acute gastroenteritis; incidence; norovirus; norovirus disease; viruses