Detection of norovirus infections in Denmark, 2011-2018

Epidemiol Infect. 2020 Feb 17:148:e52. doi: 10.1017/S0950268820000461.

Abstract

Norovirus (NoV) infections occur very frequently yet are rarely diagnosed. In Denmark, NoV infections are not under surveillance. We aimed to collect and describe existing laboratory-based NoV data. National NoV laboratory data were collected for 2011-2018, including information on patient identification number, age and sex, requesting physician, analysis date and result. We defined positive patient-episodes by using a 30-day time window and performed descriptive and time series analysis. Diagnostic methods used were assessed through a survey. We identified 15 809 patient-episodes (11%) out of 142 648 tested patients with an increasing trend, 9366 in 2011 vs. 32 260 in 2018. This corresponded with a gradual introduction of polymerase chain reaction analysis in laboratories. The highest positivity rate was in patients aged <5 years (15%) or >85 years (17%). There was a large difference in test performance over five Danish geographical regions and a marked seasonal variation with peaks from December to February. This is the first analysis of national NoV laboratory data in Denmark. A future laboratory-based surveillance system may benefit public health measures by describing trend, burden and severity of seasons and possibly pinpoint hospital outbreaks.

Keywords: Epidemiology; Norwalk agent and related viruses; hospital-acquired (nosocomial) infections; norovirus; surveillance.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Caliciviridae Infections* / diagnosis
  • Caliciviridae Infections* / epidemiology
  • Child
  • Child, Preschool
  • Denmark / epidemiology
  • Disease Outbreaks*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Seasons
  • Young Adult