Predicting norovirus and rotavirus resurgence in the United States following the COVID-19 pandemic: a mathematical modelling study

Brooke L Lappe; Mary E Wikswo; Anita K Kambhampati; Sara A Mirza; Jacqueline E Tate; Alicia N M Kraay; Ben A Lopman

doi:10.1186/s12879-023-08224-w

Predicting norovirus and rotavirus resurgence in the United States following the COVID-19 pandemic: a mathematical modelling study

BMC Infect Dis. 2023 Apr 20;23(1):254. doi: 10.1186/s12879-023-08224-w.

Authors

Brooke L Lappe¹, Mary E Wikswo², Anita K Kambhampati², Sara A Mirza², Jacqueline E Tate², Alicia N M Kraay³, Ben A Lopman^{4

5}

Affiliations

¹ Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA. blappe@emory.edu.
² Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
³ Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
⁴ Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
⁵ Epidemiology Department, Rollins School of Public Health, Emory University, Atlanta, GA, USA.

Abstract

Background: To reduce the burden from the COVID-19 pandemic in the United States, federal and state local governments implemented restrictions such as limitations on gatherings, restaurant dining, and travel, and recommended non-pharmaceutical interventions including physical distancing, mask-wearing, surface disinfection, and increased hand hygiene. Resulting behavioral changes impacted other infectious diseases including enteropathogens such as norovirus and rotavirus, which had fairly regular seasonal patterns prior to the COVID-19 pandemic. The study objective was to project future incidence of norovirus and rotavirus gastroenteritis as contacts resumed and other NPIs are relaxed.

Methods: We fitted compartmental mathematical models to pre-pandemic U.S. surveillance data (2012-2019) for norovirus and rotavirus using maximum likelihood estimation. Then, we projected incidence for 2022-2030 under scenarios where the number of contacts a person has per day varies from70%, 80%, 90%, and full resumption (100%) of pre-pandemic levels.

Results: We found that the population susceptibility to both viruses increased between March 2020 and November 2021. The 70-90% contact resumption scenarios led to lower incidence than observed pre-pandemic for both viruses. However, we found a greater than two-fold increase in community incidence relative to the pre-pandemic period under the 100% contact scenarios for both viruses. With rotavirus, for which population immunity is driven partially by vaccination, patterns settled into a new steady state quickly in 2022 under the 70-90% scenarios. For norovirus, for which immunity is relatively short-lasting and only acquired through infection, surged under the 100% contact scenario projection.

Conclusions: These results, which quantify the consequences of population susceptibility build-up, can help public health agencies prepare for potential resurgence of enteric viruses.

Keywords: COVID-19; Mathematical modelling; Norovirus; Rotavirus; Seasonality; Surveillance; Transmission.

MeSH terms

COVID-19* / epidemiology
Caliciviridae Infections* / epidemiology
Enterovirus Infections* / epidemiology
Gastroenteritis* / epidemiology
Humans
Models, Theoretical
Norovirus*
Pandemics
Rotavirus Infections* / epidemiology
Rotavirus*
United States / epidemiology
Viruses*

Abstract

MeSH terms

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