Evidence map›Paper›PMID 34398953›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021

Norovirus and Other Viral Causes of Medically Attended Acute Gastroenteritis Across the Age Spectrum: Results from the Medically Attended Acute Gastroenteritis Study in the United States.

Rachel M Burke, Claire P Mattison, Zachary Marsh, Kayoko Shioda, Judy Donald, S Bianca Salas, Allison L Naleway, Christianne Biggs, Mark A Schmidt, Aron J Hall

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed.

  1. Pathogen-Specific Effects of Probiotics in Children With Acute Gastroenteritis Seeking Emergency Care: A Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
    Trial
  2. Article
  3. Article
  4. Symptomatic and Asymptomatic Norovirus Infections in Early Life; the PREVAIL Cohort, 2017-2020.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
    Article
  5. Review
  6. Global trends in norovirus genotype distribution among medically attended children with acute gastroenteritis, 2020-2025.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2026
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Rachel M BurkeViral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, Georgia,USA.ORCID 0000-0002-5678-5826
Claire P MattisonViral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, Georgia,USA.
Zachary MarshViral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, Georgia,USA.
Kayoko ShiodaViral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, Georgia,USA.
Judy DonaldCenter for Health Research, Kaiser Permanente Northwest, Portland, Oregon,USA.
S Bianca SalasCenter for Health Research, Kaiser Permanente Northwest, Portland, Oregon,USA.
Allison L NalewayCenter for Health Research, Kaiser Permanente Northwest, Portland, Oregon,USA.
Christianne BiggsPublic Health Division of the Oregon Health Authority, Portland, Oregon,USA.
Mark A SchmidtCenter for Health Research, Kaiser Permanente Northwest, Portland, Oregon,USA.
Aron J HallViral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, Georgia,USA.

Funding

CDC FoundationIntramural CDC HHS CC999999
6 · The paper itself

Abstract

backgroundAcute gastroenteritis (AGE) causes a substantial burden in the United States, but its etiology frequently remains undetermined. Active surveillance within an integrated healthcare delivery system was used to estimate the prevalence and incidence of medically attended norovirus, rotavirus, sapovirus, and astrovirus.

methodsActive surveillance was conducted among all enrolled members of Kaiser Permanente Northwest during July 2014-June 2016. An age-stratified, representative sample of AGE-associated medical encounters were recruited to provide a stool specimen to be tested for norovirus, rotavirus, sapovirus, and astrovirus. Medically attended AGE (MAAGE) encounters for a patient occurring within 30 days were grouped into 1 episode, and all-cause MAAGE incidence was calculated. Pathogen- and healthcare setting-specific incidence estimates were calculated using age-stratified bootstrapping.

resultsThe overall incidence of MAAGE was 40.6 episodes per 1000 person-years (PY), with most episodes requiring no more than outpatient care. Norovirus was the most frequently detected pathogen, with an incidence of 5.5 medically attended episodes per 1000 PY. Incidence of norovirus MAAGE was highest among children aged < 5 years (20.4 episodes per 1000 PY), followed by adults aged ≥ 65 years (4.5 episodes per 1000 PY). Other study pathogens showed similar patterns by age, but lower overall incidence (sapovirus: 2.4 per 1000 PY; astrovirus: 1.3 per 1000 PY; rotavirus: 0.5 per 1000 PY).

conclusionsViral enteropathogens, particularly norovirus, are important contributors to MAAGE, especially among children < 5 years of age. The present findings underline the importance of judicious antibiotics use for pediatric AGE and suggest that an effective norovirus vaccine could substantially reduce MAAGE.

Indexed as

Caliciviridae InfectionsGastroenteritisNorovirusRotavirusRotavirus InfectionsSapovirusAdultChildFecesHumansInfantUnited Statesacute gastroenteritisdisease burdenhealthcare burdenpopulation-based surveillanceviral gastroenteritis

Identifiers

PMID34398953
PMCPMC8862749

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.