title: Norovirus epidemiology in community and health care settings and association with patient age, Denmark.
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.
authors: Kristina T
authors: KT
authors: Franck
authors: Jannik
authors: J
authors: Fonager
authors: Annette K
authors: AK
authors: Ersbøll
authors: Blenda
authors: B
authors: Böttiger
mesh_terms: D000293:Adolescent; D000328:Adult; D017250:Caliciviridae Infections / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care; D003718:Denmark / Q000453:epidemiology; D004196:Disease Outbreaks; D005243:Feces / Q000821:virology; D005260:Female; D005516:Food Microbiology; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D029322:Norovirus / Q000235:genetics*; D012367:RNA, Viral / Q000235:genetics; D012111:Residence Characteristics; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D012367:RNA, Viral
keywords: age distribution; community-acquired infections; gastroenteritis; general practice; genotype; health care settings; hospitals; molecular epidemiology; norovirus; viruses