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Meta-Analysis
. 2017 Sep 29;17(1):657.
doi: 10.1186/s12879-017-2758-1.

Community-based surveillance of norovirus disease: a systematic review

Thomas Inns  1   2   3 , John Harris  4   5 , Roberto Vivancos  2   3   6 , Miren Iturriza-Gomara  2   7 , Sarah O'Brien  1   2
Affiliations
Meta-Analysis

Community-based surveillance of norovirus disease: a systematic review

Thomas Inns et al. BMC Infect Dis. .

Abstract

Background: Norovirus is a common cause of infectious gastrointestinal disease. Despite the increased ability to detect norovirus in affected people, the number of reported cases and outbreaks in the community is still substantially underestimated. We undertook a systematic review to determine the nature, scope and scale of community-based surveillance systems which capture information on norovirus disease.

Methods: We searched MEDLINE, EMBASE and Scopus for studies published between 01 January 1995 and 31 December 2015, using terms relating to norovirus and surveillance. Publications were screened independently by two reviewers using exclusion criteria. Data extraction from included papers was performed using a standardized data extraction form. Outcomes were descriptions of the methods reported in included papers, and any estimates of incidence rate of norovirus disease in each community, stratified by age.

Results: After exclusions, we reviewed 45 papers of which 23 described surveillance studies and 19 included estimates of incidence. The estimates of incidence varied by outcome measure, type of laboratory test and study population. There were two estimates of norovirus hospitalisation; 0.72 and 1.04 per 1000 person-years. Estimates of norovirus disease ranged between 0.024 cases per 1000 person-years and 60 cases per 1000 person-years and estimates of all gastroenteritis varied between 49 and 1100 cases per 1000 person-years.

Conclusions: Our systematic review found few papers describing community-based surveillance for norovirus disease. Standardised age-specific estimates of norovirus incidence would be valuable for calculating the true global burden of norovirus disease; robust community surveillance systems would be able to produce this information.

Trial registration: PROSPERO 2016: CRD42016048659 .

Keywords: Community; Gastroenteritis; Norovirus; Surveillance; Systematic review.

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Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Study selection, systematic review of community-based surveillance of norovirus disease (n = 1058)
Fig. 2
Fig. 2
Reviewed studies; shown by year of publication and geography of study location (n = 44*). *One study published in 2015 was based in several sites across the world
Fig. 3
Fig. 3
Studies with estimates of community incidence, shown by measured outcome and population age group (n = 19). *No published Confidence Interval estimate; (a) population under 1; (b) 6 months to 3 years old; (c) males aged 18 to 34
See this image and copyright information in PMC

References

    1. Atmar RL, Estes MK. The Epidemiologic and Clinical Importance of Norovirus Infection. Gastroenterol Clin N Am. 2006;35(2):275–290. doi: 10.1016/j.gtc.2006.03.001. - DOI - PubMed
    1. Patel MM, Hall AJ, Vinjé J, Parashar UD. Noroviruses: A comprehensive review. J Clin Virol. 2009;44(1):1–8. doi: 10.1016/j.jcv.2008.10.009. - DOI - PubMed
    1. Ahmed SM, Hall AJ, Robinson AE, Verhoef L, Premkumar P, Parashar UD, Koopmans M, Lopman BA. Global prevalence of norovirus in cases of gastroenteritis: a systematic review and meta-analysis. Lancet Infect Dis. 2014;14(8):725–730. doi: 10.1016/S1473-3099(14)70767-4. - DOI - PMC - PubMed
    1. Meakins SM, Adak GK, Lopman BA, O'Brien SJ. General outbreaks of infectious intestinal disease (IID) in hospitals, England and Wales, 1992–2000. J Hosp Infect. 2003;53(1):1–5. doi: 10.1053/jhin.2002.1326. - DOI - PubMed
    1. Harris JP. Norovirus Surveillance: An Epidemiological Perspective. J Infect Dis. 2016;213(suppl 1):S8–S11. doi: 10.1093/infdis/jiv452. - DOI - PubMed