Epidemiology of Acute Gastroenteritis Outbreaks Caused by Human Calicivirus (Norovirus and Sapovirus) in Catalonia: A Two Year Prospective Study, 2010-2011.
The epidemiology of cases of acute gastroenteritis (AGE) of viral etiology is a relevant public health issue. Due to underreporting, the study of outbreaks is an accepted approach to investigate their epidemiology. The objective of this study was to investigate the epidemiological characteristics of AGE outbreaks due to norovirus (NoV) and sapovirus (SV) in Catalonia.



Prospective study of AGE outbreaks of possible viral etiology notified during two years in Catalonia. NoV and SV were detected by real time reverse transcription polymerase (RT-PCR).



A total of 101 outbreaks were registered affecting a total of 2756 persons and 12 hospitalizations (hospitalization rate: 0.8x1,000,000 persons-year); 49.5% of outbreaks were foodborne, 45.5% person to person and 5% waterborne. The distribution of outbreaks according to the setting showed a predominance of catering services (39.6%), nursing homes and long term care facilities (26.8%) and schools (11.9%). The median number of cases per outbreak was 17 (range 2-191). The total Incidence rate (IR) was 18.3 per 100,000 persons-years (95%CI: 17.6-19.0). The highest IR was in persons aged ≥65 years (43.6x100,000 (95% CI: 41.0-46.2)) (p<0.001). A total of 1065 samples were analyzed with a positivity rate of 60.8%. 98% of positive samples were NoV (GII 56.3%; GI 4.2%; GII+GI 4.2%; non- typable 33.0%). SV was identified in two person-to-person transmission outbreaks in children.



These results confirm the relevance of viral AGE outbreaks, both foodborne and person-to-person, especially in institutionalized persons. SV should be taken into account when investigating viral AGE outbreaks.
Public Health Agency of Catalonia, Barcelona, Spain.|CIBER Epidemiología y Salud Pública CIBERESP, Carlos III Health Institute, Madrid, Spain.|Public Health Department, University of Barcelona, Barcelona, Spain.
Nuria
0000-0003-0143-5295
N
Torner
Public Health Agency of Catalonia, Barcelona, Spain.|CIBER Epidemiología y Salud Pública CIBERESP, Carlos III Health Institute, Madrid, Spain.
Ana
A
Martinez
CIBER Epidemiología y Salud Pública CIBERESP, Carlos III Health Institute, Madrid, Spain.
Sonia
S
Broner
Public Health Agency of Barcelona, Barcelona, Spain.
Antonio
A
Moreno
Public Health Agency of Catalonia, Barcelona, Spain.
Neus
N
Camps
CIBER Epidemiología y Salud Pública CIBERESP, Carlos III Health Institute, Madrid, Spain.|Public Health Department, University of Barcelona, Barcelona, Spain.
Angela
A
Domínguez
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000821:virology; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D029322:Norovirus / Q000235:genetics / Q000472:pathogenicity*; D009735:Nursing Homes; D011446:Prospective Studies; D029341:Sapovirus / Q000235:genetics / Q000472:pathogenicity*; D055815:Young Adult