Estimating the under-reporting of norovirus illness in Germany utilizing enhanced awareness of diarrhoea during a large outbreak of Shiga toxin-producing E. coli O104:H4 in 2011--a time series analysis.
BMC Infect Dis
; 14: 116, 2014 Mar 01.
Article
en En
| MEDLINE
| ID: mdl-24580831
ABSTRACT
BACKGROUND:
Laboratory-confirmed norovirus illness is reportable in Germany since 2001. Reported case numbers are known to be undercounts, and a valid estimate of the actual incidence in Germany does not exist. An increase of reported norovirus illness was observed simultaneously to a large outbreak of Shiga toxin-producing E. coli O104H4 in Germany in 2011--likely due to enhanced (but not complete) awareness of diarrhoea at that time. We aimed at estimating age- and sex-specific factors of that excess, which should be interpretable as (minimal) under-reporting factors of norovirus illness in Germany.METHODS:
We used national reporting data on laboratory-confirmed norovirus illness in Germany from calendar week 31 in 2003 through calendar week 30 in 2012. A negative binomial time series regression model was used to describe the weekly counts in 8â2 age-sex strata while adjusting for secular trend and seasonality. Overall as well as age- and sex-specific factors for the excess were estimated by including additional terms (either an O104H4 outbreak period indicator or a triple interaction term between outbreak period, age and sex) in the model.RESULTS:
We estimated the overall under-reporting factor to be 1.76 (95% CI 1.28-2.41) for the first three weeks of the outbreak before the outbreak vehicle was publicly communicated. Highest under-reporting factors were here estimated for 20-29 year-old males (2.88, 95% CI 2.01-4.11) and females (2.67, 95% CI 1.87-3.79). Under-reporting was substantially lower in persons aged <10 years and 70 years or older.CONCLUSIONS:
These are the first estimates of (minimal) under-reporting factors for norovirus illness in Germany. They provide a starting point for a more detailed investigation of the relationship between actual incidence and reporting incidence of norovirus illness in Germany.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Infecciones por Caliciviridae
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Norovirus
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Monitoreo Epidemiológico
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Gastroenteritis
Tipo de estudio:
Incidence_studies
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Prognostic_studies
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Screening_studies
Límite:
Adolescent
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Adult
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Aged
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Middle aged
País como asunto:
Europa
Idioma:
En
Año:
2014
Tipo del documento:
Article