Cargando…

Active Surveillance to Quantify the Burden of Norovirus in a U.S. Veterans Affairs (VA) Patient Population, Houston, 2015–2016

BACKGROUND: Norovirus is the leading cause of acute gastroenteritis (AGE) outbreaks in the United States; however, little data exist on the burden of endemic norovirus disease among adults. Robust estimates of the norovirus disease burden among US adults are needed to inform assessment of potential...

Descripción completa

Detalles Bibliográficos
Autores principales: Kambhampati, Anita, Vargas, Blanca, Mushtaq, Mahwish, Browne, Hannah, Perregaux, Sara, Grytdal, Scott, Atmar, Robert L, Vinje, Jan, Parashar, Umesh D, Hall, Aron J, Cardemil, Cristina V, Lopman, Benjamin, Rodriguez-Barradas, Maria C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632071/
http://dx.doi.org/10.1093/ofid/ofx163.741
_version_ 1783269627201060864
author Kambhampati, Anita
Vargas, Blanca
Mushtaq, Mahwish
Browne, Hannah
Perregaux, Sara
Grytdal, Scott
Atmar, Robert L
Vinje, Jan
Parashar, Umesh D
Hall, Aron J
Cardemil, Cristina V
Lopman, Benjamin
Rodriguez-Barradas, Maria C
author_facet Kambhampati, Anita
Vargas, Blanca
Mushtaq, Mahwish
Browne, Hannah
Perregaux, Sara
Grytdal, Scott
Atmar, Robert L
Vinje, Jan
Parashar, Umesh D
Hall, Aron J
Cardemil, Cristina V
Lopman, Benjamin
Rodriguez-Barradas, Maria C
author_sort Kambhampati, Anita
collection PubMed
description BACKGROUND: Norovirus is the leading cause of acute gastroenteritis (AGE) outbreaks in the United States; however, little data exist on the burden of endemic norovirus disease among adults. Robust estimates of the norovirus disease burden among US adults are needed to inform assessment of potential norovirus vaccines, which are currently in development. METHODS: We conducted active surveillance for AGE at the Michael E. DeBakey Veteran’s Affairs (VA) Medical Center, where approximately 104,000 unique patients were served in 2016. Cases were defined as veterans with symptoms of AGE (≥3 loose stools, ≥2 vomiting episodes, or ≥1 episodes of both loose stool and vomiting, within 24 hours) occurring in the previous 10 days, who presented to the emergency department or outpatient clinics (outpatients), or were admitted to the hospital (inpatients). Patients without AGE symptoms in the prior 14 days were enrolled as controls. Demographic data and illness characteristics were collected from enrolled subjects, and stool samples were collected and tested using the FilmArray gastrointestinal panel. Norovirus positives were confirmed by real-time RT-PCR and genotyped after sequencing of conventional PCR products. RESULTS: From November 1, 2015–November 30, 2016, 130 inpatient and 85 outpatient AGE cases, along with 20 inpatient and 37 outpatient controls, were enrolled and provided a stool specimen. Among cases, 201 (93%) were male, and 94 (44%) were ≥65 years; median duration of illness was 3 days (range, 1–10 days). Norovirus was detected in 12 (9%) inpatient and 15 (18%) outpatient cases; norovirus was not detected in any controls. Incidence of norovirus-associated hospitalization was 15/100,000 population, and was similar in hospitalized cases aged <65 years (14/100,000) and ≥65 years (15/100,000). Of 22 norovirus positive specimens genotyped, 13 (59%) were GII.4 Sydney. CONCLUSION: This robust, active surveillance platform employed screening and enrollment of patients in a VA population meeting a standardized AGE case definition, as well as asymptomatic controls. Data from this study highlight the burden of norovirus in adults and importance of a norovirus vaccine. DISCLOSURES: R. L. Atmar, Takeda Vaccines, Inc.: Research Support, Research support. B. Lopman, HHS/NIH/NIAID: Grant Investigator, Grant recipient. Bill & Melinda Gates Foundation: Grant Investigator, Grant recipient.
format Online
Article
Text
id pubmed-5632071
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-56320712017-11-07 Active Surveillance to Quantify the Burden of Norovirus in a U.S. Veterans Affairs (VA) Patient Population, Houston, 2015–2016 Kambhampati, Anita Vargas, Blanca Mushtaq, Mahwish Browne, Hannah Perregaux, Sara Grytdal, Scott Atmar, Robert L Vinje, Jan Parashar, Umesh D Hall, Aron J Cardemil, Cristina V Lopman, Benjamin Rodriguez-Barradas, Maria C Open Forum Infect Dis Abstracts BACKGROUND: Norovirus is the leading cause of acute gastroenteritis (AGE) outbreaks in the United States; however, little data exist on the burden of endemic norovirus disease among adults. Robust estimates of the norovirus disease burden among US adults are needed to inform assessment of potential norovirus vaccines, which are currently in development. METHODS: We conducted active surveillance for AGE at the Michael E. DeBakey Veteran’s Affairs (VA) Medical Center, where approximately 104,000 unique patients were served in 2016. Cases were defined as veterans with symptoms of AGE (≥3 loose stools, ≥2 vomiting episodes, or ≥1 episodes of both loose stool and vomiting, within 24 hours) occurring in the previous 10 days, who presented to the emergency department or outpatient clinics (outpatients), or were admitted to the hospital (inpatients). Patients without AGE symptoms in the prior 14 days were enrolled as controls. Demographic data and illness characteristics were collected from enrolled subjects, and stool samples were collected and tested using the FilmArray gastrointestinal panel. Norovirus positives were confirmed by real-time RT-PCR and genotyped after sequencing of conventional PCR products. RESULTS: From November 1, 2015–November 30, 2016, 130 inpatient and 85 outpatient AGE cases, along with 20 inpatient and 37 outpatient controls, were enrolled and provided a stool specimen. Among cases, 201 (93%) were male, and 94 (44%) were ≥65 years; median duration of illness was 3 days (range, 1–10 days). Norovirus was detected in 12 (9%) inpatient and 15 (18%) outpatient cases; norovirus was not detected in any controls. Incidence of norovirus-associated hospitalization was 15/100,000 population, and was similar in hospitalized cases aged <65 years (14/100,000) and ≥65 years (15/100,000). Of 22 norovirus positive specimens genotyped, 13 (59%) were GII.4 Sydney. CONCLUSION: This robust, active surveillance platform employed screening and enrollment of patients in a VA population meeting a standardized AGE case definition, as well as asymptomatic controls. Data from this study highlight the burden of norovirus in adults and importance of a norovirus vaccine. DISCLOSURES: R. L. Atmar, Takeda Vaccines, Inc.: Research Support, Research support. B. Lopman, HHS/NIH/NIAID: Grant Investigator, Grant recipient. Bill & Melinda Gates Foundation: Grant Investigator, Grant recipient. Oxford University Press 2017-10-04 /pmc/articles/PMC5632071/ http://dx.doi.org/10.1093/ofid/ofx163.741 Text en © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Kambhampati, Anita
Vargas, Blanca
Mushtaq, Mahwish
Browne, Hannah
Perregaux, Sara
Grytdal, Scott
Atmar, Robert L
Vinje, Jan
Parashar, Umesh D
Hall, Aron J
Cardemil, Cristina V
Lopman, Benjamin
Rodriguez-Barradas, Maria C
Active Surveillance to Quantify the Burden of Norovirus in a U.S. Veterans Affairs (VA) Patient Population, Houston, 2015–2016
title Active Surveillance to Quantify the Burden of Norovirus in a U.S. Veterans Affairs (VA) Patient Population, Houston, 2015–2016
title_full Active Surveillance to Quantify the Burden of Norovirus in a U.S. Veterans Affairs (VA) Patient Population, Houston, 2015–2016
title_fullStr Active Surveillance to Quantify the Burden of Norovirus in a U.S. Veterans Affairs (VA) Patient Population, Houston, 2015–2016
title_full_unstemmed Active Surveillance to Quantify the Burden of Norovirus in a U.S. Veterans Affairs (VA) Patient Population, Houston, 2015–2016
title_short Active Surveillance to Quantify the Burden of Norovirus in a U.S. Veterans Affairs (VA) Patient Population, Houston, 2015–2016
title_sort active surveillance to quantify the burden of norovirus in a u.s. veterans affairs (va) patient population, houston, 2015–2016
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632071/
http://dx.doi.org/10.1093/ofid/ofx163.741
work_keys_str_mv AT kambhampatianita activesurveillancetoquantifytheburdenofnorovirusinausveteransaffairsvapatientpopulationhouston20152016
AT vargasblanca activesurveillancetoquantifytheburdenofnorovirusinausveteransaffairsvapatientpopulationhouston20152016
AT mushtaqmahwish activesurveillancetoquantifytheburdenofnorovirusinausveteransaffairsvapatientpopulationhouston20152016
AT brownehannah activesurveillancetoquantifytheburdenofnorovirusinausveteransaffairsvapatientpopulationhouston20152016
AT perregauxsara activesurveillancetoquantifytheburdenofnorovirusinausveteransaffairsvapatientpopulationhouston20152016
AT grytdalscott activesurveillancetoquantifytheburdenofnorovirusinausveteransaffairsvapatientpopulationhouston20152016
AT atmarrobertl activesurveillancetoquantifytheburdenofnorovirusinausveteransaffairsvapatientpopulationhouston20152016
AT vinjejan activesurveillancetoquantifytheburdenofnorovirusinausveteransaffairsvapatientpopulationhouston20152016
AT parasharumeshd activesurveillancetoquantifytheburdenofnorovirusinausveteransaffairsvapatientpopulationhouston20152016
AT hallaronj activesurveillancetoquantifytheburdenofnorovirusinausveteransaffairsvapatientpopulationhouston20152016
AT cardemilcristinav activesurveillancetoquantifytheburdenofnorovirusinausveteransaffairsvapatientpopulationhouston20152016
AT lopmanbenjamin activesurveillancetoquantifytheburdenofnorovirusinausveteransaffairsvapatientpopulationhouston20152016
AT rodriguezbarradasmariac activesurveillancetoquantifytheburdenofnorovirusinausveteransaffairsvapatientpopulationhouston20152016