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Burden of Norovirus in the United States, as Estimated Based on Administrative Data: Updates for Medically Attended Illness and Mortality, 2001-2015.
Clin Infect Dis. 2021 07 01; 73(1):e1-e8.CI

Abstract

BACKGROUND

Up-to-date estimates of the burden of norovirus, a leading cause of acute gastroenteritis (AGE) in the United States, are needed to assess the potential value of norovirus vaccines in development. We aimed to estimate the rates, annual counts, and healthcare charges of norovirus-associated ambulatory clinic encounters, emergency department (ED) visits, hospitalizations, and deaths in the United States.

METHODS

We analyzed administrative data on AGE outcomes from 1 July 2001 through 30 June 2015. Data were sourced from IBM MarketScan Commercial and Medicare Supplemental Databases (ambulatory clinic and ED visits), the Healthcare Utilization Project National Inpatient Sample (hospitalizations), and the National Center for Health Statistics multiple-cause-of-mortality data (deaths). Outcome data (ambulatory clinic and ED visits, hospitalizations, or deaths) were summarized by month, age group, and setting. Healthcare charges were estimated based on insurance claims. Monthly counts of cause-unspecified gastroenteritis-associated outcomes were modeled as functions of cause-specified outcomes, and model residuals were analyzed to estimate norovirus-associated outcomes. Healthcare charges were estimated by applying average charges per cause-unspecified gastroenteritis encounter to the estimated number of norovirus encounters.

RESULTS

We estimate 900 deaths (95% confidence interval [CI], 650-1100), 109 000 hospitalizations (95% CI, 80 000-145 000), 465 000 ED visits (95% CI, 348 000-610 000), and 2.3 million ambulatory clinic encounters (95% CI, 1.7-2.9 million) annually due to norovirus, with an associated $430-$740 million in healthcare charges.

CONCLUSIONS

Norovirus causes a substantial health burden in the United States each year, and an effective vaccine could have important public health impact.

Links

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Authors+Show Affiliations

Burke RM
Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Mattison CP
Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA.
Pindyck T
Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Dahl RM
Maximus Federal, contracting agency to the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Rudd J
Maximus Federal, contracting agency to the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Bi D
Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Curns AT
Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Parashar U
Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Hall AJ
Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

MeSH

AgedCaliciviridae InfectionsGastroenteritisHospitalizationHumansIncidenceMedicareNorovirusUnited States

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32291450

Citation

Burke, Rachel M., et al. "Burden of Norovirus in the United States, as Estimated Based On Administrative Data: Updates for Medically Attended Illness and Mortality, 2001-2015." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 73, no. 1, 2021, pp. e1-e8.
Burke RM, Mattison CP, Pindyck T, et al. Burden of Norovirus in the United States, as Estimated Based on Administrative Data: Updates for Medically Attended Illness and Mortality, 2001-2015. Clin Infect Dis. 2021;73(1):e1-e8.
Burke, R. M., Mattison, C. P., Pindyck, T., Dahl, R. M., Rudd, J., Bi, D., Curns, A. T., Parashar, U., & Hall, A. J. (2021). Burden of Norovirus in the United States, as Estimated Based on Administrative Data: Updates for Medically Attended Illness and Mortality, 2001-2015. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 73(1), e1-e8. https://doi.org/10.1093/cid/ciaa438
Burke RM, et al. Burden of Norovirus in the United States, as Estimated Based On Administrative Data: Updates for Medically Attended Illness and Mortality, 2001-2015. Clin Infect Dis. 2021 07 1;73(1):e1-e8. PubMed PMID: 32291450.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Burden of Norovirus in the United States, as Estimated Based on Administrative Data: Updates for Medically Attended Illness and Mortality, 2001-2015. AU - Burke,Rachel M, AU - Mattison,Claire P, AU - Pindyck,Talia, AU - Dahl,Rebecca M, AU - Rudd,Jessica, AU - Bi,Daoling, AU - Curns,Aaron T, AU - Parashar,Umesh, AU - Hall,Aron J, PY - 2020/02/19/received PY - 2020/04/13/accepted PY - 2020/4/16/pubmed PY - 2021/7/8/medline PY - 2020/4/16/entrez KW - United States KW - gastroenteritis KW - norovirus KW - norovirus incidence SP - e1 EP - e8 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 73 IS - 1 N2 - BACKGROUND: Up-to-date estimates of the burden of norovirus, a leading cause of acute gastroenteritis (AGE) in the United States, are needed to assess the potential value of norovirus vaccines in development. We aimed to estimate the rates, annual counts, and healthcare charges of norovirus-associated ambulatory clinic encounters, emergency department (ED) visits, hospitalizations, and deaths in the United States. METHODS: We analyzed administrative data on AGE outcomes from 1 July 2001 through 30 June 2015. Data were sourced from IBM MarketScan Commercial and Medicare Supplemental Databases (ambulatory clinic and ED visits), the Healthcare Utilization Project National Inpatient Sample (hospitalizations), and the National Center for Health Statistics multiple-cause-of-mortality data (deaths). Outcome data (ambulatory clinic and ED visits, hospitalizations, or deaths) were summarized by month, age group, and setting. Healthcare charges were estimated based on insurance claims. Monthly counts of cause-unspecified gastroenteritis-associated outcomes were modeled as functions of cause-specified outcomes, and model residuals were analyzed to estimate norovirus-associated outcomes. Healthcare charges were estimated by applying average charges per cause-unspecified gastroenteritis encounter to the estimated number of norovirus encounters. RESULTS: We estimate 900 deaths (95% confidence interval [CI], 650-1100), 109 000 hospitalizations (95% CI, 80 000-145 000), 465 000 ED visits (95% CI, 348 000-610 000), and 2.3 million ambulatory clinic encounters (95% CI, 1.7-2.9 million) annually due to norovirus, with an associated $430-$740 million in healthcare charges. CONCLUSIONS: Norovirus causes a substantial health burden in the United States each year, and an effective vaccine could have important public health impact. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/32291450/Burden_of_Norovirus_in_the_United_States_as_Estimated_Based_on_Administrative_Data:_Updates_for_Medically_Attended_Illness_and_Mortality_2001_2015_ DB - PRIME DP - Unbound Medicine ER -