Characteristics of norovirus infection in Serbia

Tijana Relić; Ivana Begović-Lazarević; Nevenka Pavlović; Nevenka Ilić; Hranislav Kačarević; Dara Jovanović; Gordana Kostić; Ivana Lazarević

doi:10.2298/5431

Tijana Relić Institute of Public Health of Belgrade, Belgrade, Serbia
Ivana Begović-Lazarević Institute of Public Health of Belgrade, Belgrade, Serbia
Nevenka Pavlović Institute of Public Health of Belgrade, Belgrade, Serbia
Nevenka Ilić Institute of Public Health of Kragujevac, Kragujevac, Serbia
Hranislav Kačarević Institute of Public Health of Belgrade, Belgrade, Serbia
Dara Jovanović Institute of Public Health of Belgrade, Belgrade, Serbia
Gordana Kostić Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia
Ivana Lazarević Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

DOI: https://doi.org/10.2298/5431

Keywords: norovirus, gastroenteritis, incidence, risk assessment, disease outbreaks, serbia,

Abstract

Background/Aim. Norovirus (NoV), formerly Norwalk-like virus is the most common cause of acute gastroenteritis in humans of all ages. It is known that 90% of viral gastroenteritis and about 60–85% of all outbreaks of gastroenteritis, especially in the territory of United States of America, Europe and Japan are caused by this virus. For the countries of the northern hemisphere, individual cases and outbreaks of acute NoV gastroenteritis appear in seasonal pattern, mainly during the winter months. The aim of this study was to describe characteristics of acute gastroenteritis with the established NoV etiology in Serbia. Methods. The study group included 88 patients with the symptoms of acute gastroenteritis, throughout the year 2010 and 2011. From all the patients, stool samples were taken less than three days from the onset of symptoms. Detection of NoV in stool samples was performed by commercial qualitative immunochromatography assay. Statistical analysis included application of χ² test, Mann–Whitney U-test, Kruskal-Wallis's test, Spearman’s rank correlation test and logistic regression analysis. Results. Outbreaks of acute gastroenteritis caused by NoV were recorded to be the most common in children with the incidence of infection of 50% in the age group 0–15 years. Analysis of individual symptoms in the NoV proven infection, showed that diarrhea was the most common symptom, followed by vomiting especially in small children, while abdominal pain was most common in elderly (≥ 65 years). The presence of frequent vomiting, more than 4 times/day, indicated NoV infection in the women, while for men the infection was always presented with diarrhea. Conclusion. The obtained results confirmed that small children and elderly are the most susceptible to NoV infection and that outbreaks are more frequent in the winter months. Those who consumed food in restaurants and other public facilities were not at higher risk for NoV infection.

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