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Volume 19, Number 8—August 2013

Research

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

Brian RhaComments to Author , Sherry Burrer, Soyoun Park, Tarak Trivedi, Umesh D. Parashar, and Benjamin A. Lopman
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (B. Rha, S. Burrer, S. Park, T. Trivedi, U.D. Parashar, B.A. Lopman); McKing Consulting Corporation, Atlanta (S. Park)

Main Article

Table 1

Linear regression model estimates of the association between norovirus outbreaks and BioSense emergency department visit data, by age group, United States, January 2007–April 2010*

Subsyndrome and age group, y Norovirus,† β1, × 10−4 (95% CI) p value‡ R
Diarrhea
0–4§ 1.72 (1.15–2.29) <0.0001 0.926
5–17¶ 1.59 (1.23–1.95) <0.0001 0.828
18–64¶ 0.70 (0.56–0.83) <0.0001 0.864
>65§¶ 0.71 (0.55–0.86) <0.0001 0.917
All ages§ 0.94 (0.74–1.14) <0.0001 0.910
Nausea/vomiting
0–4§ 7.01 (4.93–9.09) <0.0001 0.866
5–17 5.73 (4.24–7.23) <0.0001 0.796
18–64¶ 1.60 (1.14–2.06) <0.0001 0.758
>65 0.61 (0.31–0.91) 0.0002 0.729
All ages 2.78 (2.15–3.40) <0.0001 0.832

*Emergency department chief complaint–based subsyndrome visits as a monthly proportion of all visits in 6 states (GA, MO, OH, PA, TN, WY) regressed on norovirus and rotavirus surveillance data and time variable. Intercept for each model p<0.0001.
†Suspected and confirmed norovirus outbreaks.
‡By t test.
§Included term for proportion of rotavirus tests positive in the model, as it is significant and positive (p<0.05). β2 for 0–4-y age group diarrhea model = 0.0539 (95% CI 0.0403–0.0674); β2 for 0–4-y age group nausea/vomiting model = 0.0745 (95% CI 0.0252–0.1237); β2 for ≥65-y age group diarrhea model = 0.0048 (95% CI 0.0011–0.0084); β2 for all-ages age group diarrhea model = 0.0065 (95% CI 0.0018–0.0112).
¶Time variable not significant in model (p>0.05).

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