Volume 19, Number 8—August 2013
CME ACTIVITY - Research
Effects and Clinical Significance of GII.4 Sydney Norovirus, United States, 2012–2013
Eyal Leshem
, 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
, 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
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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