Journal Article

Clinical Spectrum and Transmission Characteristics of Infection with Norwalk-Like Virus: Findings from a Large Community Outbreak in Sweden

Hannelore Götz, Karl Ekdahl, Johan Lindbäck, Birgitta de Jong, Kjell Olof Hedlund and Johan Giesecke

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 5, pages 622-628
Published in print September 2001 | ISSN: 1058-4838
Published online September 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/322608
Clinical Spectrum and Transmission Characteristics of Infection with Norwalk-Like Virus: Findings from a Large Community Outbreak in Sweden

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A large foodborne outbreak caused by Norwalk-like virus (NLV) among children and staff at 30 day care centers provided an opportunity to study symptomatology and attack rates among patients in different age groups, as well as secondary transmission rates in centers and households. A retrospective cohort study of 775 subjects from 13 randomly chosen centers was performed. Diarrhea was more common in adults than in children (P = .001), whereas the reverse was noted with regard to vomiting (P = .003). The primary attack rate was 27% (142 of 524 subjects): 54% of adults versus 19% of children (P < .001). The mean incubation time for foodborne cases of infection was 34 hours. The secondary attack rate was 17%. Risk factors for spread into households were the primary case being a child (relative risk [RR], 3.8; 95% confidence interval [CI], 1.9–7.6) and vomiting (RR, 2.4; 95% CI, 1.0–5.5). The incubation time for person-to-person transmission was approximated by a mean serial interval of 52 hours. This is the first reported outbreak of NLV infection in which secondary transmission into households by individuals has been studied.

Journal Article.  4958 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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