The unwelcome houseguest: Secondary household transmission of norovirus

Z. A. Marsh*, S. P. Grytdal, J. C. Beggs, E. Leshem, P. A. Gastanãduy, B. Rha, M. Nyaku, B. A. Lopman, A. J. Hall

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Norovirus is the leading cause of acute gastroenteritis in the USA. Although secondary household transmission of norovirus is frequently reported in outbreaks, little is known about specific risk factors for susceptibility and infectiousness in the household. Three norovirus outbreaks were investigated and data were collected on individuals exposed in the primary outbreak setting and their household members. Potential individual- A nd household-level risk factors for susceptibility and infectiousness were assessed using univariate and multivariate generalised linear mixed models. In the univariate models, the secondary attack rate (SAR) was significantly higher when living in a household with two or more primary cases (incidence rate ratio (IRR) = 2·1; 95% confidence interval (CI) 1·37-3·29), more than one primary case with vomiting (IRR = 1·9; CI 1·11-3·37), and at least one primary case with diarrhoea (IRR = 3·0; CI 1·46-6·01). After controlling for other risk factors in the multivariate models, the SAR was significantly higher among those living in a household with two or more primary cases (adjusted IRR = 2·0; CI 1·17-3·47) and at least one primary case with diarrhoea (adjusted IRR = 2·8; CI 1·35-5·93). These findings underscore the importance of maintaining proper hygiene and isolating ill household members to prevent norovirus transmission in the household.

Original languageEnglish
Pages (from-to)159-167
Number of pages9
JournalEpidemiology and Infection
Volume146
Issue number2
DOIs
StatePublished - 1 Jan 2018
Externally publishedYes

Funding

FundersFunder number
SORT
Centers for Disease Control and Prevention
Oak Ridge Institute for Science and Education
Los Angeles County Department of Public Health
Department of Energy and Climate Change
Michigan Department of Health and Human Services
Rollins School of Public Health

    Keywords

    • Caliciviruses
    • modelling
    • norovirus
    • outbreaks
    • secondary household transmission

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