The burden of norovirus disease in children in the European Union.
BACKGROUND
Noroviruses (NoVs) are the leading cause of acute gastroenteritis across all age groups. Because a vaccine is in clinical development, burden of disease data are required to guide the eventual introduction of this vaccine. In this study, we estimate the burden of NoV disease in children less than 5 years of age in the European Union (EU).


METHODS
We carried out a literature search using PubMed to identify studies providing incidence or prevalence data for NoV disease in the EU. We applied the pooled average NoV incidence and prevalence rates to the EU population less than 5 years of age to obtain the annual number of NoV illnesses, medical visits, hospitalizations and deaths occurring in the EU among children younger than 5 years.


RESULTS
Data from 12 studies were included. We estimate that NoV infection may cause up to 5.7 million illnesses in the community, 800,000 medical visits, 53,000 hospitalizations and 102 deaths every year in children younger than 5 years in the EU.


CONCLUSIONS
The burden of NoV disease in children in the EU is substantial, and will grow in relative importance as rotavirus (RV) vaccines are rolled out in the EU. This burden of disease is comparable with the burden of RV disease in the EU before RV vaccine introduction. More country-specific studies are needed to better assess this burden and guide the potential introduction of a vaccine against NoV at the national level.
From the *Department of Pediatrics and Adolescent Medicine, University Medical Centre, Johannes Gutenberg University, Mainz, Germany; and †P95 Pharmacovigilance and Epidemiology Services, Leuven, Belgium.
Frank
F
Kowalzik
Margarita
M
Riera-Montes
Thomas
T
Verstraeten
Fred
F
Zepp
D000553:Ambulatory Care / Q000706:statistics & numerical data; D017250:Caliciviridae Infections / Q000453:epidemiology*; D002675:Child, Preschool; D005062:European Union / Q000706:statistics & numerical data*; D005759:Gastroenteritis / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D009026:Mortality; D029322:Norovirus; D017063:Outcome Assessment, Health Care; D015995:Prevalence