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Volume 19, Number 8—August 2013

CME ACTIVITY

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 2

Number and percentage of patients in outbreaks of acute gastroenteritis attributed to norovirus, by symptoms, clinical outcomes, and reported strain in Minnesota, Ohio, Oregon, Tennessee, and Wisconsin, August 2012–April 2013*

Characteristic No. (%) patients linked to outbreaks with sequence data
No. (%) patients linked to outbreaks with no sequence data No. (%) total
GII.4 Sydney Non–GII.4 Sydney RR (95% CI)
Demographics
Sex
M 576 (31.8) 448 (33.4) 0.95 (0.86–1.06) 355 (31.8) 1,379 (32.3)
F 1,235 (68.2) 895 (66.6) 1.02 (0.97–1.08) 761 (68.2) 2,891 (67.7)
Age, y
0–4 14 (0.9) 26 (2.3) 0.42 (0.22–0.79) 39 (3.9) 79 (2.2)
5–9 5 (0.3) 156 (13.7) 0.02 (0.01–0.06) 120 (12.0) 281 (7.8)
10–19 109 (7.4) 86 (7.5) 0.98 (0.74–1.28) 107 (10.7) 302 (8.3)
20–49 376 (25.4) 372 (32.6) 0.78 (0.69–0.88) 190 (19.0) 938 (25.9)
50–74 310 (20.9) 174 (15.2) 1.37 (1.16–1.63) 157 (15.7) 641 (17.7)
>75
666 (45.0)
327 (28.7)
1.57 (1.41–1.75)
387 (38.7)
1,380 (38.1)
Symptoms
Diarrhea 2,385 (84.8) 1,549 (75.7) 1.12 (1.09–1.15) 1,882 (81.6) 5,816 (81.2)
Vomiting 1,337 (53.0) 1,214 (60.4) 0.88 (0.83–0.92) 1,356 (60.9) 3,907 (57.8)
Fever 1,191 (50.9) 1,126 (58.7) 0.87 (0.82–0.92) 1,030 (56.8) 3,347 (55.1)
Abdominal cramps
995 (48.1)
850 (54.5)
0.88 (0.83–0.94)
544 (44.9)
2,389 (49.3)
Outcome
Outpatient visit 122 (7.9) 55 (4.3) 1.81 (1.33–2.47) 54 (5.9) 231 (6.2)
Emergency department visit 43 (2.4) 24 (1.8) 1.23 (0.79–2.13) 34 (3.7) 101 (2.5)
Hospitalized 49 (2.2) 22 (1.4) 1.54 (0.93–2.53) 65 (4.4) 136 (2.6)
Death 9 (0.4) 3 (0.2) 2.2 (0.60–8.12) 9 (0.4) 21 (0.3)

*Because of the preliminary nature of the data, information on demographic characteristics, symptoms, or outcomes were available for 310 (49%) of 637 total norovirus outbreaks reported during the study period. The number of patients and the relative proportions of illnesses by symptoms and outcomes from the outbreaks that included such data are reported. RR, rate ratio.

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