ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2016
Epidemiologic, Virologic, and Host Genetic Factors of Norovirus Outbreaks in Long-term Care Facilities.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 105 citations in OpenAlex.
- Systematic review and meta-analysis of enteric virus shedding in human excretions.EBioMedicine · 2025Pooled it
- Global prevalence of asymptomatic norovirus infection in outbreaks: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- A Wastewater-based Modeling Framework for Inferring Norovirus Transmission Dynamics.Environmental science & technology · 2026Article
- Detectability of Pathogenic RNA Virus Families in Different Body Sites: A Scoping Review.Viruses · 2026Article
- Estimating wastewater concentrations of norovirus and rotavirus from global data on community-level infection prevalence and viral shedding.Journal of water and health · 2026Article
- Impact of Wastewater Use for Irrigation and Contamination of Lettuce by Enteric Viruses: Case of Ouagadougou Market Gardening Sites, Burkina Faso.Food and environmental virology · 2024Article
- The Scope and Impact of Viral Infections in Common Variable Immunodeficiency (CVID) and CVID-like Disorders: A Literature Review.Journal of clinical medicine · 2024Review
- A non-human primate model for human norovirus infection.Nature microbiology · 2024Article
- Norovirus Epidemiology and Genotype Circulation during the COVID-19 Pandemic in Brazil, 2019-2022.Pathogens (Basel, Switzerland) · 2023Article
- Intestinal Norovirus Binding Patterns in Nonsecretor Individuals.Journal of virology · 2022Article
- Norovirus Outbreaks in Long-term Care Facilities in the United States, 2009-2018: A Decade of Surveillance.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Secretor Status Strongly Influences the Incidence of Symptomatic Norovirus Infection in a Genotype-Dependent Manner in a Nicaraguan Birth Cohort.The Journal of infectious diseases · 2022Article
- Norovirus outbreaks in long-term care facilities in Catalonia from 2017 to 2018.Scientific reports · 2021Article
- Review
- Chronic enteropathy-related malabsorption syndrome in an adult with common variable immunodeficiency and symptomatic norovirus infection of the gut.BMJ case reports · 2021Article
- Profound diarrhoea and weight loss in an immunocompromised patient.BMJ case reports · 2021Article
- Article
- Article
- Humoral and Mucosal Immune Responses to Human Norovirus in the Elderly.The Journal of infectious diseases · 2020Article
- Clinical pictures, treatments, and resource use of norovirus gastroenteritis in long-term care facilities: a survey with a chart review in Japan.BMC geriatrics · 2020Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundIn the Unites States, long-term care facilities (LTCFs) are the most common setting for norovirus outbreaks. These outbreaks provide a unique opportunity to better characterize the viral and host characteristics of norovirus disease.
methodsWe enrolled 43 LTCFs prospectively to study the epidemiology, virology, and genetic host factors of naturally occurring norovirus outbreaks. Acute and convalescent stool, serum, and saliva samples from cases, exposed and nonexposed controls were collected. Norovirus infection was confirmed using quantitative polymerase chain reaction testing of stool samples or 4-fold increase in serum antibody titers. The presence of histo-blood group antigens (secretor, ABO, and Lewis type) was determined in saliva.
resultsSixty-two cases, 34 exposed controls, and 18 nonexposed controls from 10 norovirus outbreaks were enrolled. Forty-six percent of acute, 27% of convalescent case, and 11% of control stool samples tested norovirus positive. Outbreak genotypes were GII.4 (Den Haag, n = 3; New Orleans, n = 4; and Sydney, n = 2) and GI.1 (n = 1). Viral load in GII.4 Sydney outbreaks was significantly higher than in outbreaks caused by other genotypes; cases and controls shed similar amounts of virus. Forty-seven percent of cases shed virus for ≥ 21 days. Symptomatic infections with GII.4 Den Haag and GII.4 New Orleans were detected among nonsecretor individuals.
conclusionsAlmost half of all symptomatic individuals shed virus for at least 21 days. Viral load was highest in GII.4 viruses that most recently emerged; these viruses also infect the nonsecretor population. These findings will help to guide development of targeted prevention and control measures in the elderly.
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