Burden of acute gastroenteritis caused by norovirus in China: A systematic review

J Infect. 2017 Sep;75(3):216-224. doi: 10.1016/j.jinf.2017.06.004. Epub 2017 Jun 17.

Abstract

Background: To understand the epidemiology and disease burden of norovirus (NoVs) gastroenteritis in China, a systematic review was conducted.

Methods: Studies on acute gastroenteritis (AGE) caused by NoVs from mainland China, published before 2017 were searched. All retrieved articles were screened and reviewed by a standardized algorithm. NoVs detection rates as well as strain variations by ages, seasonal variations and geographic locations were analyzed using random-effects model.

Results: A total of 225 articles were included in the final analysis. Similar detection rates at 21.0% and 19.8% were obtained from the North and the South, respectively. NoVs infection occurred year round, with a peak between October and January in the North and between August and November in the South. High detection rates (∼29%) of NoVs were found in adults and the elderly and in children aged 6-35 months (∼22%). The predominant strains were GII.4 (70.4%), followed by GII.3 (13.5%).

Conclusion: NoVs cause significant disease burden in China which warrants development of vaccines against NoVs, particularly for children and the elderly who are vulnerable to gastroenteritis diseases. To achieve a broad protection, continual monitoring NoV epidemics and strain variations for selection of proper vaccine strains is critical.

Keywords: Acute gastroenteritis; China; Disease burden; Norovirus; Systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Caliciviridae Infections / epidemiology*
  • Caliciviridae Infections / virology*
  • Child
  • Child, Preschool
  • China / epidemiology
  • Cost of Illness
  • Epidemics
  • Feces / virology
  • Female
  • Gastroenteritis / epidemiology*
  • Gastroenteritis / virology*
  • Genotype
  • Humans
  • Infant
  • Norovirus / genetics*
  • Norovirus / isolation & purification
  • Phylogeny
  • Prevalence
  • RNA, Viral / genetics
  • Seasons

Substances

  • RNA, Viral