title: Molecular epidemiology of norovirus in children and the elderly in Atlanta, Georgia, United States.
abstract: Noroviruses are an important cause of gastroenteritis, which can be severe at the extremes of ages. Data documenting the endemic burden of norovirus among children and elderly adults are lacking. Stool specimens submitted for clinical testing were collected from elderly (≥ 65 years) adults and children (<18 years) with acute vomiting and/or diarrhea seeking care at several metropolitan Atlanta adult and pediatric hospitals from January 2013-June 2013. Specimens were tested for norovirus with real-time RT-PCR and sequenced if norovirus was detected. Corresponding clinical and demographic data were abstracted from retrospective chart review. Norovirus was detected in 11% (11/104) of elderly specimens and 11% (67/628) of pediatric, with GII.4 Sydney_2012 detected in 64% (7/11) of elderly norovirus-positive and 11% (8/67) of pediatric specimens, P < 0.001. In comparison to hospitalized children, hospitalized elderly with norovirus were more commonly admitted to the intensive care unit (ICU) (36% vs. 7%, P = 0.02). Norovirus in the elderly can be associated with severe illness requiring ICU admissions. The pediatric group demonstrated greater variability in genotype distribution. Ongoing surveillance of norovirus genotypes is crucial for norovirus vaccine development in understanding circulating and emerging genotypes.
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Jumi
authors.initials: J
authors.lastname: Yi
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Kelly
authors.initials: K
authors.lastname: Wahl
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Bethany K
authors.initials: BK
authors.lastname: Sederdahl
authors.affiliation: Children's Healthcare of Atlanta, Atlanta, Georgia.|Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Robert R
authors.initials: RR
authors.lastname: Jerris
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia.|Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Colleen S
authors.initials: CS
authors.lastname: Kraft
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Courtney
authors.initials: C
authors.lastname: McCracken
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Scott
authors.initials: S
authors.lastname: Gillespie
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.|Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Evan J
authors.initials: EJ
authors.lastname: Anderson
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Kirby
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.|Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.|Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Andi L
authors.initials: AL
authors.lastname: Shane
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Moe
mesh_terms: D000293:Adolescent; D000368:Aged; D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000209:etiology / Q000821:virology; D005243:Feces / Q000821:virology*; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000821:virology*; D005838:Genotype; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D029322:Norovirus / Q000145:classification / Q000235:genetics*; D010802:Phylogeny; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D017422:Sequence Analysis, DNA
chemical_list: D012367:RNA, Viral
keywords: genotype; molecular epidemiology; norovirus; vaccine