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Background. Diarrhea remains an important cause of morbidity, but until the mid 1990s, hospital admissions for diarrhea in the US adult population were declining. We aimed to describe recent trends in gastroenteritis hospitalizations and to determine the contribution of norovirus. Methods. We analyzed all gastroenteritis-associated hospital discharges during 1996-2007 from a nationally representative data set of hospital inpatient stays. Annual rates of discharges by age were calculated. Time-series regression models were fitted using cause-specified discharges as explanatory variables; model residuals were analyzed to estimate norovirus- and rotavirus-associated discharges. We then calculated the annual hospital charges for norovirus-associated discharges. Results. Sixty-nine percent of all gastroenteritis discharges were cause-unspecified and rates increased by⩾50% in all adult and elderly age groups (⩾18 years of age) from 1996 through 2007. We estimate an annual mean of 71,000 norovirus-associated hospitalizations, costing $493 million per year, with surges to nearly 110,000 hospitalizations per year in epidemic seasons. We also estimate 24,000 rotavirus hospitalizations annually among individuals aged ⩾5 years. Conclusions. Gastroenteritis hospitalizations are increasing, and we estimate that norovirus is the cause of 10% of cause-unspecified and 7% of all-cause gastroenteritis discharges. Norovirus should be routinely considered as a cause of gastroenteritis hospitalization. [ABSTRACT FROM AUTHOR]

Noroviruses are generally believed to cause relatively mild gastroenteritis of short duration in otherwise healthy adults. However, outbreaks in health care settings are common and affect vulnerable populations. During 2002-2003, a total of 4 major hospitals, 11 community hospitals, and 135 nursing homes in the county of Avon, England, were prospectively monitored for outbreaks of gastroenteritis. For 482 hospital staff, 166 nursing home staff, and 266 nursing home residents, the median duration of norovirus gastroenteritis was 2 days, with 75% achieving complete recovery within 3 days. The median duration of norovirus gastroenteritis for 730 hospital patients was 3 days (75% of the patients achieved complete recovery within 5 days), which was significantly longer than that for all other groups (P< .001). Therefore, infection in hospitalized persons may be more severe than that in other groups in the community at large. This increased duration of acute illness should be considered when implementing measures to prevent transmission in hospital settings. [ABSTRACT FROM AUTHOR]

The author focuses on environmental transmission of norovirus due to vomiting on aircraft. He mentions that public vomiting in direct transmission can spread norovirus and can lead to outbreaks and from the time of vomiting norovirus occurs a week later. He also mentions that the use of sodium hypochlorite can least prevent the outbreak and he suggests for an additional study to find the needed disinfectants or sanitizer that are safe and effective when norovirus outbreak occur.

The article comments the study on the re-evaluation of epidemiological criteria for keying out outbreaks of acute gastroenteritis due to norovirus in the U.S. The author stressed that the data used in the study is limited that do not clearly reflect the overall occurrence of the outbreak. He asserted that the result of the study therefore fall short in providing the basic information about norovirus epidemiology.

In October 2009, a new genogroup II, type 4 (GII.4) norovirus variant was identified in the United States. We collected norovirus outbreak data from 30 states to assess whether this new strain was associated with increased acute gastroenteritis activity. No increase in norovirus outbreaks was observed during the 2009-2010 winter. [ABSTRACT FROM AUTHOR]

Norovirus generally causes a mild illness in the community. However, modeling routine hospital admission statistics, we estimate that ~3000 norovirus admissions to English hospitals occur per year, accounting for 0.3% and 0.1% of emergency admissions among elderly and adult patients, respectively, at times of peak activity. These admissions pose a risk for subsequent nosocomial infection outbreaks. [ABSTRACT FROM AUTHOR]