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. 2019 Aug 16:12:2543-2551.
doi: 10.2147/IDR.S204175. eCollection 2019.

Application of the susceptible-infected-recovered deterministic model in a GII.P17 emergent norovirus strain outbreak in Romania in 2015

Emilian Damian Popovici  1   2 , Dana Gabriela Negru  3 , Teodora Olariu  4 , Mariana Nagy  5 , Sorin Dinu  6 , Gabriela Oprisan  6   7 , Lavinia Zota  8 , Luminita Mirela Baditoiu  1
Affiliations

Application of the susceptible-infected-recovered deterministic model in a GII.P17 emergent norovirus strain outbreak in Romania in 2015

Emilian Damian Popovici et al. Infect Drug Resist. .

Abstract

Purpose: This study shows the epidemiological profile of the first gastroenteritis outbreak of GII.P17 in the Romanian territory. An outbreak with such large amplitude in a European territory was previously undocumented.

Patients and methods: Using a cross-sectional design, with the susceptible-infected-recovered (SIR) deterministic compartmental model for a fixed population, and the cluster method for establishing the high-incidence zones, we carried out our investigation by means of questionnaires containing personal data, affected collectivities, disease onset and duration, symptoms displayed, medical assistance provided, previous antibiotic intake where applicable, food consumption and water sources, and sanitation conditions. The confirmation of cases was done based on the typical norovirus gastroenteritis symptomatology and using three laboratory confirmations (by molecular diagnosis) for GII.P17-GII.17 genotype noroviruses from three patients.

Results: A gastroenteritis outbreak occurred in October-November 2015, affecting 328 people in Arad, a county in Western Romania, covering 44 neighbouring localities with a total population of 35,440 people. The study detected an inter-human transmission of the infection, with an intrafamilial risk of disease of 2.26 (95% CI 1.76 to 2.90) compared with the community transmission (in school collectivity). The basic reproduction number Ro dropped from 1.26 to 0.18 during weeks 43:44, after controlling the transmission by decontamination and isolation.

Conclusion: SIR made it possible to highlight the expansion of the emerging norovirus strain infection from community to family collectivities. This study provides practical solutions to limit disease cases, even in the absence of etiology, and shows the importance of sometimes underestimated traditional control methods.

Keywords: SIR; basic reproduction number; norovirus, GII.17_Kawasaki.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Outbreak of norovirus gastroenteritis – daily case distribution, Sebis area, Romania, 2015. Note: 16.10. to 29.11 represent dates from October 16 to November 29.
Figure 2
Figure 2
Outbreak of norovirus gastroenteritis, Sebis area, Romania, 2015 (cluster seer map, k10 cut-off). Note: The red-circled dots highlight the clusters identified after the software application (localities in which there are several cases).
Figure 3
Figure 3
Outbreak of norovirus gastroenteritis – solution curves in the SIR without vital dynamics event, Romania, 2015. (A) in the Sebis area; (B) in the school collectivities. Abbreviations: SIR, susceptible-infected-recovered deterministic compartmental model; poly, polynomial approximations.
See this image and copyright information in PMC

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