Household transmission of acute gastroenteritis during the winter season in Japan

OBJECTIVES: Acute gastroenteritis, including illness caused by norovirus, is sometimes transmissible among susceptible persons who experience close contact, including those within a household, and it disturbs social activities of patients and their family. However, epidemiological assessment of the transmissibility and its heterogeneity has not been conducted. The present study aimed to quantify the frequency of household transmission that was likely caused by norovirus, and characterize its determinants. METHODS: A household survey was conducted, analyzing the history of suspected norovirus infection from January to March, 2017. Noro-like illness was clinically defined as a patient with either: (i) diarrhea or vomiting multiple times a day; or (ii) diarrhea or vomiting persisting for 2 or more days. RESULTS: Among 380 households, 132 households (34.7%) were eligible for epidemiological analysis, with an estimated secondary attack risk of 13.8% (38/276). Age-specific secondary attack risk was highest among index case patients aged 0 to 14 years (25.8%). The prevalence of vomiting in this age group was higher than in other age groups, with an odds ratio of household transmission estimated at 4.3. CONCLUSIONS: Age-dependent heterogeneity was successfully identified, offering critical insights into future considerations for norovirus control at various social settings.