Prevalence and characteristics of asymptomatic norovirus infection in the community in England

SUMMARY Norovirus is a major cause of infectious intestinal disease, and a substantial prevalence of asymptomatic infection has been reported. We describe the prevalence, seasonality and characteristics of asymptomatic norovirus infection in England. Healthy individuals were recruited at random from the general population during the Study of Infectious Intestinal Disease (1993–1996). Norovirus was identified using real-time RT–PCR. The age-adjusted prevalence of asymptomatic norovirus infection was 12%; prevalence was highest in children aged <5 years and showed wintertime seasonality. More work is needed to understand whether asymptomatic infections are important for norovirus transmission leading to sporadic illness and outbreaks.

[1]  Benjamin A Lopman,et al.  Two Epidemiologic Patterns of Norovirus Outbreaks: Surveillance in England and Wales, 1992–2000 , 2003, Emerging infectious diseases.

[2]  J. Brassard,et al.  Comparative evaluation of RT-PCR, nucleic acid sequence-based amplification (NASBA) and real-time RT-PCR for detection of noroviruses in faecal material. , 2006, Journal of virological methods.

[3]  P. Dennehy,et al.  Transmission of rotavirus and other enteric pathogens in the home , 2000, The Pediatric infectious disease journal.

[4]  M. Iturriza-Gómara,et al.  Detection by PCR of eight groups of enteric pathogens in 4,627 faecal samples: re-examination of the English case-control Infectious Intestinal Disease Study (1993–1996) , 2007, European Journal of Clinical Microbiology & Infectious Diseases.

[5]  D. Goldmann Transmission of viral respiratory infections in the home , 2000, The Pediatric infectious disease journal.

[6]  P. Teunis,et al.  Norwalk virus: How infectious is it? , 2008, Journal of medical virology.

[7]  J. Vinjé,et al.  Molecular epidemiology of human enteric caliciviruses in The Netherlands. , 2000, Novartis Foundation symposium.

[8]  R. Glass,et al.  Detection and differentiation of antigenically distinct small round-structured viruses (Norwalk-like viruses) by reverse transcription-PCR and southern hybridization , 1995, Journal of clinical microbiology.

[9]  S. Fukushi,et al.  Broadly Reactive and Highly Sensitive Assay for Norwalk-Like Viruses Based on Real-Time Quantitative Reverse Transcription-PCR , 2003, Journal of Clinical Microbiology.

[10]  Y. V. van Duynhoven,et al.  Sensor, a population-based cohort study on gastroenteritis in the Netherlands: incidence and etiology. , 2001, American journal of epidemiology.

[11]  F. Ruggeri,et al.  Broadly Reactive Nested Reverse Transcription-PCR Using an Internal RNA Standard Control for Detection of Noroviruses in Stool Samples , 2005, Journal of Clinical Microbiology.

[12]  D. Graham,et al.  Norwalk Virus Shedding after Experimental Human Infection , 2008, Emerging infectious diseases.

[13]  J. Giesecke,et al.  Clinical spectrum and transmission characteristics of infection with Norwalk-like virus: findings from a large community outbreak in Sweden. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[14]  S. Palmer,et al.  The role of the pre-symptomatic food handler in a common source outbreak of food-borne SRSV gastroenteritis in a group of hospitals , 1994, Epidemiology and Infection.

[15]  R. Glass,et al.  Identification of a distinct common strain of "Norwalk-like viruses" having a global distribution. , 1999, The Journal of infectious diseases.

[16]  M. Iturriza-Gómara,et al.  Diagnosing norovirus-associated infectious intestinal disease using viral load , 2009, BMC infectious diseases.

[17]  D. Sethi,et al.  A study of infectious intestinal disease in England: plan and methods of data collection. , 1999, Communicable disease and public health.

[18]  David Bruce Lewis,et al.  Broadly reactive reverse transcriptase polymerase chain reaction for the diagnosis of SRSV‐associated gastroenteritis , 1995, Journal of medical virology.

[19]  H R Smith,et al.  A study of infectious intestinal disease in England: microbiological findings in cases and controls. , 1999, Communicable disease and public health.

[20]  A. Friedrich,et al.  Incidence and risk factors for community-acquired acute gastroenteritis in north-west Germany in 2004 , 2009, European Journal of Clinical Microbiology & Infectious Diseases.