PMID- 34523674
OWN - NLM
STAT- MEDLINE
DCOM- 20220314
LR  - 20230108
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Print)
IS  - 1058-4838 (Linking)
VI  - 74
IP  - 1
DP  - 2022 Jan 7
TI  - Norovirus Outbreaks in Long-term Care Facilities in the United States, 2009-2018: 
      A Decade of Surveillance.
PG  - 113-119
LID - 10.1093/cid/ciab808 [doi]
AB  - BACKGROUND: In the United States, norovirus is the leading cause of 
      healthcare-associated gastroenteritis outbreaks. To inform prevention efforts, we 
      describe the epidemiology of norovirus outbreaks in long-term care facilities 
      (LTCFs). METHODS: The Centers for Disease Control and Prevention (CDC) collect 
      epidemiologic and laboratory data on norovirus outbreaks from US health 
      departments through the National Outbreak Reporting System (NORS) and CaliciNet. 
      Reports from both systems were merged, and norovirus outbreaks in nursing homes, 
      assisted living, and other LTCFs occurring in 2009-2018 were analyzed. Data from 
      the Centers for Medicare and Medicaid Services and the National Center for Health 
      Statistics were used to estimate state LTCF counts. RESULTS: During 2009-2018, 50 
      states, Washington D.C., and Puerto Rico reported 13 092 norovirus outbreaks and 
      416 284 outbreak-associated cases in LTCFs. Participation in NORS and CaliciNet 
      increased from 2009 to 2014 and median reporting of LTCF norovirus outbreaks 
      stabilized at 4.1 outbreaks per 100 LTCFs (interquartile range [IQR]: 1.0-7.1) 
      annually since 2014. Most outbreaks were spread via person-to-person transmission 
      (90.4%), and 75% occurred during December-March. Genogroup was reported for 7292 
      outbreaks with 862 (11.8%) positive for GI and 6370 (87.3%) for GII. Among 4425 
      GII outbreaks with typing data, 3618 (81.8%) were GII.4. LTCF residents had 
      higher attack rates than staff (median 29.0% vs 10.9%; P < .001). For every 1000 
      cases, there were 21.6 hospitalizations and 2.3 deaths. CONCLUSIONS: LTCFs have a 
      high burden of norovirus outbreaks. Most LTCF norovirus outbreaks occurred during 
      winter months and were spread person-to-person. Outbreak surveillance can inform 
      development of interventions for this vulnerable population, such as vaccines 
      targeting GII.4 norovirus strains.
CI  - Published by Oxford University Press for the Infectious Diseases Society of 
      America 2021.
FAU - Calderwood, Laura E
AU  - Calderwood LE
AD  - Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, 
      Georgia,USA.
AD  - Cherokee Nation Assurance, Arlington, Virginia, USA.
FAU - Wikswo, Mary E
AU  - Wikswo ME
AD  - Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, 
      Georgia,USA.
FAU - Mattison, Claire P
AU  - Mattison CP
AD  - Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, 
      Georgia,USA.
AD  - Cherokee Nation Assurance, Arlington, Virginia, USA.
FAU - Kambhampati, Anita K
AU  - Kambhampati AK
AD  - Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, 
      Georgia,USA.
FAU - Balachandran, Neha
AU  - Balachandran N
AD  - Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, 
      Georgia,USA.
AD  - Cherokee Nation Assurance, Arlington, Virginia, USA.
FAU - Vinje, Jan
AU  - Vinje J
AD  - Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, 
      Georgia,USA.
FAU - Barclay, Leslie
AU  - Barclay L
AD  - Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, 
      Georgia,USA.
FAU - Hall, Aron J
AU  - Hall AJ
AD  - Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, 
      Georgia,USA.
FAU - Parashar, Umesh
AU  - Parashar U
AD  - Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, 
      Georgia,USA.
FAU - Mirza, Sara A
AU  - Mirza SA
AD  - Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, 
      Georgia,USA.
LA  - eng
GR  - CC999999/ImCDC/Intramural CDC HHS/United States
GR  - CDC/
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases 
      Society of America
JID - 9203213
SB  - IM
MH  - Aged
MH  - *Caliciviridae Infections
MH  - Disease Outbreaks
MH  - Genotype
MH  - Humans
MH  - Long-Term Care
MH  - Medicare
MH  - *Norovirus/genetics
MH  - Nursing Homes
MH  - United States/epidemiology
PMC - PMC8978331
MID - NIHMS1791631
OTO - NOTNLM
OT  - long-term care
OT  - norovirus
OT  - outbreaks
OT  - surveillance
COIS- Potential conflicts of interest. The authors: No reported conflicts of interest. 
      All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts 
      of Interest. Conflicts that the editors consider relevant to the content of the 
      manuscript have been disclosed.
EDAT- 2021/09/16 06:00
MHDA- 2022/03/15 06:00
PMCR- 2023/01/07
CRDT- 2021/09/15 08:55
PHST- 2021/05/26 00:00 [received]
PHST- 2021/09/16 06:00 [pubmed]
PHST- 2022/03/15 06:00 [medline]
PHST- 2021/09/15 08:55 [entrez]
PHST- 2023/01/07 00:00 [pmc-release]
AID - 6370508 [pii]
AID - 10.1093/cid/ciab808 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2022 Jan 7;74(1):113-119. doi: 10.1093/cid/ciab808.