TY - JOUR AU - Verhoef, Linda AU - Depoortere, Evelyn AU - Boxman, Ingeborg AU - Duizer, Erwin AU - van Duynhoven, Yvonne AU - Harris, John AU - Johnsen, Christina AU - Kroneman, Annelies AU - Le Guyader, Soizick AU - Lim, Wilina AU - Maunula, Leena AU - Meldal, Hege AU - Ratcliff, Rod AU - Reuter, Gábor AU - Schreier, Eckart AU - Siebenga, Joukje AU - Vainio, Kirsti AU - Varela, Carmen AU - Vennema, Harry AU - Koopmans, Marion T1 - Emergence of New Norovirus Variants on Spring Cruise Ships and Prediction of Winter Epidemics T2 - Emerging Infectious Disease journal PY - 2008 VL - 14 IS - 2 SP - 238 SN - 1080-6059 AB - In June 2006, reported outbreaks of norovirus on cruise ships suddenly increased; 43 outbreaks occurred on 13 vessels. All outbreaks investigated manifested person-to-person transmission. Detection of a point source was impossible because of limited investigation of initial outbreaks and data sharing. The most probable explanation for these outbreaks is increased norovirus activity in the community, which coincided with the emergence of 2 new GGII.4 variant strains in Europe and the Pacific. As in 2002, a new GGII.4 variant detected in the spring and summer corresponded with high norovirus activity in the subsequent winter. Because outbreaks on cruise ships are likely to occur when new variants circulate, an active reporting system could function as an early warning system. Internationally accepted guidelines are needed for reporting, investigating, and controlling norovirus illness on cruise ships in Europe. KW - Norovirus KW - epidemiology KW - virology KW - outbreaks KW - transmission KW - gastroenteritis KW - communicable diseases KW - surveillance KW - ships KW - research DO - 10.3201/eid1402.061567 UR - https://wwwnc.cdc.gov/eid/article/14/2/06-1567_article ER - End of Reference