Emergency Department Visit Data for Rapid Detection and Monitoring of Norovirus Activity, United States

Overview

Journal Emerg Infect Dis

Specialty Infectious Diseases

Date 2013 Jul 24

PMID 23876432

Citations 16

Authors

Brian Rha

Sherry Burrer

Soyoun Park

Tarak Trivedi

Umesh D Parashar

Benjamin A Lopman

Affiliations

Soon will be listed here.

Abstract

Noroviruses are the leading cause of gastroenteritis in the United States, but timely measures of disease are lacking. BioSense, a national-level electronic surveillance system, assigns data on chief complaints (patient symptoms) collected during emergency department (ED) visits to 78 subsyndromes in near real-time. In a series of linear regression models, BioSense visits mapped by chief complaints of diarrhea and nausea/vomiting subsyndromes as a monthly proportion of all visits correlated strongly with reported norovirus outbreaks from 6 states during 2007-2010. Higher correlations were seen for diarrhea (R = 0.828-0.926) than for nausea/vomiting (R = 0.729-0.866) across multiple age groups. Diarrhea ED visit proportions exhibited winter seasonality attributable to norovirus; rotavirus contributed substantially for children <5 years of age. Diarrhea ED visit data estimated the onset, peak, and end of norovirus season within 4 weeks of observed dates and could be reliable, timely indicators of norovirus activity.

Citing Articles

Surveillance System for Infectious Disease Prevention and Management: Direction of Korea's Infectious Disease Surveillance System.

Jang Y, Lee H, Park H J Korean Med Sci. 2025; 40(8):e108.

PMID: 40034093 PMC: 11876785. DOI: 10.3346/jkms.2025.40.e108.

Spatiotemporal Trends in Norovirus Outbreaks in the United States, 2009-2019.

Kambhampati A, Calderwood L, Wikswo M, Barclay L, Mattison C, Balachandran N Clin Infect Dis. 2022; 76(4):667-673.

PMID: 35913377 PMC: 11389822. DOI: 10.1093/cid/ciac627.

Determination of Antiviral Mechanism of Centenarian Gut-Derived Against Norovirus.

Li Y, Gao J, Xue L, Shang Y, Cai W, Xie X Front Nutr. 2022; 9:812623.

PMID: 35419394 PMC: 8997286. DOI: 10.3389/fnut.2022.812623.

Heavy precipitation, drinking water source, and acute gastrointestinal illness in Philadelphia, 2015-2017.

De Roos A, Kondo M, Robinson L, Rai A, Ryan M, Haas C PLoS One. 2020; 15(2):e0229258.

PMID: 32092111 PMC: 7039462. DOI: 10.1371/journal.pone.0229258.

Consensus Development of a Modern Ontology of Emergency Department Presenting Problems-The Hierarchical Presenting Problem Ontology (HaPPy).

Horng S, Greenbaum N, Nathanson L, McClay J, Goss F, Nielson J Appl Clin Inform. 2019; 10(3):409-420.

PMID: 31189204 PMC: 6561773. DOI: 10.1055/s-0039-1691842.

References

Payne D, Vinje J, Szilagyi P, Edwards K, Staat M, Weinberg G . Norovirus and medically attended gastroenteritis in U.S. children. N Engl J Med. 2013; 368(12):1121-30. PMC: 4618551. DOI: 10.1056/NEJMsa1206589. View

Hall A, Rosenthal M, Gregoricus N, Greene S, Ferguson J, Henao O . Incidence of acute gastroenteritis and role of norovirus, Georgia, USA, 2004-2005. Emerg Infect Dis. 2011; 17(8):1381-8. PMC: 3381564. DOI: 10.3201/eid1708.101533. View

. Norovirus activity--United States, 2006-2007. MMWR Morb Mortal Wkly Rep. 2007; 56(33):842-6. View

Hulth A, Andersson Y, Hedlund K, Andersson M . Eye-opening approach to norovirus surveillance. Emerg Infect Dis. 2010; 16(8):1319-21. PMC: 3298324. DOI: 10.3201/eid1608.100093. View

Karsten C, Baumgarte S, Friedrich A, von Eiff C, Becker K, Wosniok W . Incidence and risk factors for community-acquired acute gastroenteritis in north-west Germany in 2004. Eur J Clin Microbiol Infect Dis. 2009; 28(8):935-43. PMC: 2723666. DOI: 10.1007/s10096-009-0729-1. View

Mounts A, Ando T, Koopmans M, Bresee J, Noel J, Glass R . Cold weather seasonality of gastroenteritis associated with Norwalk-like viruses. J Infect Dis. 2000; 181 Suppl 2:S284-7. DOI: 10.1086/315586. View

Bresee J, Marcus R, Venezia R, Keene W, Morse D, Thanassi M . The etiology of severe acute gastroenteritis among adults visiting emergency departments in the United States. J Infect Dis. 2012; 205(9):1374-81. DOI: 10.1093/infdis/jis206. View

. Emergence of new norovirus strain GII.4 Sydney--United States, 2012. MMWR Morb Mortal Wkly Rep. 2013; 62(3):55. PMC: 4604874. View

Wikswo M, Hall A . Outbreaks of acute gastroenteritis transmitted by person-to-person contact--United States, 2009-2010. MMWR Surveill Summ. 2012; 61(9):1-12. View

10.

Haustein T, Harris J, Pebody R, Lopman B . Hospital admissions due to norovirus in adult and elderly patients in England. Clin Infect Dis. 2009; 49(12):1890-2. DOI: 10.1086/648440. View

11.

Loveridge P, Cooper D, Elliot A, Harris J, Gray J, Large S . Vomiting calls to NHS Direct provide an early warning of norovirus outbreaks in hospitals. J Hosp Infect. 2010; 74(4):385-93. DOI: 10.1016/j.jhin.2009.10.007. View

12.

Patel M, Widdowson M, Glass R, Akazawa K, Vinje J, Parashar U . Systematic literature review of role of noroviruses in sporadic gastroenteritis. Emerg Infect Dis. 2008; 14(8):1224-31. PMC: 2600393. DOI: 10.3201/eid1408.071114. View

13.

Patel M, Hall A, Vinje J, Parashar U . Noroviruses: a comprehensive review. J Clin Virol. 2008; 44(1):1-8. DOI: 10.1016/j.jcv.2008.10.009. View

14.

Desai R, Hall A, Lopman B, Shimshoni Y, Rennick M, Efron N . Norovirus disease surveillance using Google Internet query share data. Clin Infect Dis. 2012; 55(8):e75-8. DOI: 10.1093/cid/cis579. View

15.

Gastanaduy P, Hall A, Curns A, Parashar U, Lopman B . Burden of norovirus gastroenteritis in the ambulatory setting--United States, 2001-2009. J Infect Dis. 2013; 207(7):1058-65. DOI: 10.1093/infdis/jis942. View

16.

Zheng D, Widdowson M, Glass R, Vinje J . Molecular epidemiology of genogroup II-genotype 4 noroviruses in the United States between 1994 and 2006. J Clin Microbiol. 2009; 48(1):168-77. PMC: 2812295. DOI: 10.1128/JCM.01622-09. View

17.

Lopman B, Hall A, Curns A, Parashar U . Increasing rates of gastroenteritis hospital discharges in US adults and the contribution of norovirus, 1996-2007. Clin Infect Dis. 2011; 52(4):466-74. DOI: 10.1093/cid/ciq163. View

18.

Tam C, OBrien S, Tompkins D, Bolton F, Berry L, Dodds J . Changes in causes of acute gastroenteritis in the United Kingdom over 15 years: microbiologic findings from 2 prospective, population-based studies of infectious intestinal disease. Clin Infect Dis. 2012; 54(9):1275-86. DOI: 10.1093/cid/cis028. View

19.

Scallan E, Hoekstra R, Angulo F, Tauxe R, Widdowson M, Roy S . Foodborne illness acquired in the United States--major pathogens. Emerg Infect Dis. 2011; 17(1):7-15. PMC: 3375761. DOI: 10.3201/eid1701.p11101. View

20.

. Reduction in rotavirus after vaccine introduction--United States, 2000-2009. MMWR Morb Mortal Wkly Rep. 2009; 58(41):1146-9. View