New Norovirus Variants on Cruise Ships
Author Information
Author(s): Verhoef Linda, Depoortere Evelyn, Boxman Ingeborg, Duizer Erwin, van Duynhoven Yvonne, Harris John, Johnsen Christina, Kroneman Annelies, Le Guyader Soizick, Lim Wilina, Maunula Leena, Meldal Hege, Ratcliff Rod, Reuter Gábor, Schreier Eckart, Siebenga Joukje, Vainio Kirsti, Varela Carmen, Vennema Harry, Koopmans Marion
Primary Institution: National Institute for Public Health and the Environment
Hypothesis
Are new norovirus variants emerging on cruise ships and how can we predict winter epidemics?
Conclusion
The emergence of new norovirus variants on cruise ships is linked to increased outbreaks in the community, suggesting a need for an early warning reporting system.
Supporting Evidence
- 43 outbreaks were reported from 13 vessels during the study period.
- The overall attack rates varied from <1% to 41%, with the highest rates for passengers at 48%.
- A significant correlation was found between off-season outbreaks and subsequent seasonal outbreaks.
Takeaway
Norovirus can spread easily on cruise ships, and new types of the virus can lead to more sickness in the winter. We need a better way to track these outbreaks.
Methodology
Epidemiologic, virologic, and baseline data were collected from various sources including health authorities and laboratories.
Potential Biases
Reporting bias may have occurred due to media attention and the nature of outbreak investigations.
Limitations
Data collection was incomplete and delayed, which may have affected the analysis of outbreaks.
Participant Demographics
Outbreaks occurred on cruise ships with passengers and crew, but specific demographics were not detailed.
Statistical Information
P-Value
p<0.001
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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