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Volume 19, Number 8—August 2013

CME ACTIVITY - Research

Effects and Clinical Significance of GII.4 Sydney Norovirus, United States, 2012–2013

Eyal LeshemComments to Author , Mary Wikswo, Leslie Barclay, Eric Brandt, William Storm, Ellen Salehi, Traci DeSalvo, Tim Davis, Amy Saupe, Ginette Dobbins, Hillary A. Booth, Christianne Biggs, Katie Garman, Amy M. Woron, Umesh D. Parashar, Jan Vinjé, and Aron J. Hall
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (E. Leshem, M. Wikswo, L. Barclay, U.D. Parashar, J. Vinjé, A.J. Hall); Ohio Department of Health, Columbus, Ohio, USA (E. Brandt, W. Storm, E. Salehi); Wisconsin Department of Health Services, Madison, Wisconsin, USA (T. DeSalvo); Wisconsin State Laboratory of Hygiene, Madison (T. Davis); Minnesota Department of Health, St. Paul, Minnesota, USA (A. Saupe, G. Dobbins); Oregon Public Health Division, Portland, Oregon, USA (H.A. Booth, C. Biggs); Tennessee Department of Health, Nashville, Tennessee, USA (K. Garman, A.M. Woron)

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Table 1

Number and percentage of norovirus gastroenteritis outbreaks, by genotype, strain, setting, and mode of transmission in Minnesota, Ohio, Oregon, Tennessee, and Wisconsin, August 2012–April 2013*

Outbreak No. (%) outbreaks with sequence data
No. (%) outbreaks with no sequence data, n = 279 Total no. (%), N = 637
GII.4 Sydney, n = 226 Non–GII.4 Sydney, n = 132 RR (95% CI)
Mode of transmission
Person to person 172 (76.1) 93 (70.5) 1.08 (0.95–1.23) 216 (77.4) 481 (75.5)
Foodborne 35 (15.5) 28 (21.2) 0.73 (0.47–1.14) 28 (10.0) 91 (14.3)
Water 0 1 (0.8) NA 0 1 (0.2)
Environmental 0 2 (1.5) NA 0 2 (0.3)
Other/unknown
19 (8.4)
8 (6.1)
1.39 (0.62–3.08)
35 (12.5)
62 (9.7)
Setting
LTCF/hospital 170 (75.2) 63 (47.7) 1.58 (1.30–1.91) 189 (67.7) 422 (66.2)
School/CCC 4 (1.8) 28 (21.2) 0.08 (0.03–0.23) 49 (17.6) 81 (12.7)
Restaurant/banquet facility 35 (15.5) 25 (18.9) 0.82 (0.51–1.30) 23 (8.2) 83 (13.0)
Other/multiple settings† 14 (6.2) 13 (9.8) 0.63 (0.31–1.30) 15 (5.4) 42 (6.6)
Unknown 3 (1.3) 3 (2.3) 0.58 (0.12–2.85) 3 (1.1) 9 (1.4)

*RR, rate ratio; NA, not available; LTCF, long- term care facility; CCC, childcare center.
†Other settings include the following: private home (n = 15), noncafeteria workplace (n = 7), church (n= 2), other religious location (n = 2), hotel (n = 2), party (n = 3), apple orchard (n = 1), camp (n = 1), football tournament (n = 1), ship (n = 1), indoor playground (n = 1), movie theater (n = 1), trip to relatives (n = 1), other unspecified (n = 1), and multiple settings (n = 3).

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