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Peer reviewedOpen accessGastroenteritis

Shedding of norovirus in symptomatic and asymptomatic infections

Epidemiology and Infection·

P. F. M. TEUNIS, F. H. A. SUKHRIE, H. VENNEMA, J. BOGERMAN, M. F. C. BEERSMA, M. P. G. KOOPMANS

DOI
10.1017/s095026881400274x
PMID
25336060
PMCID
OpenAlex
W2151437043
Study type
Journal article
Publisher
Cambridge University Press (CUP)
Article type
journal-article
Integrity
current

Why this research matters now

The findings help quantify environmental viral deposition for transmission risk modeling in crowded settings like hospitals and nursing homes. Since symptomatic and asymptomatic individuals shed comparable viral loads, the greater transmission contribution of symptomatic cases likely stems from behavioral factors that increase spreading efficiency rather than differences in viral shedding itself.

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Structured evidence summary

Research question

The study quantifies norovirus shedding patterns and duration in symptomatic and asymptomatic individuals to inform transmission risk assessment.

Study design

A longitudinal quantitative modeling study analyzed fecal samples from 102 subjects (patients and staff) collected during enhanced surveillance of hospital norovirus outbreaks. Viral concentrations were measured by real-time PCR, and a multilevel Bayesian dynamic model was fitted to characterize shedding time-course and variability.

Population and setting

The study population comprised 102 symptomatic and asymptomatic norovirus shedders, including both hospital patients and staff, identified through enhanced outbreak surveillance in hospital settings.

Main findings

Asymptomatic and symptomatic subjects exhibited similar shedding patterns with substantial individual variation in peak viral loads (average range 10^5 to 10^9 per gram of feces) and shedding duration (average range 8 to 60 days). Patients appeared to shed slightly higher viral quantities for marginally longer periods than staff, though differences were not statistically significant.

Public-health relevance

The findings help quantify environmental viral deposition for transmission risk modeling in crowded settings like hospitals and nursing homes. Since symptomatic and asymptomatic individuals shed comparable viral loads, the greater transmission contribution of symptomatic cases likely stems from behavioral factors that increase spreading efficiency rather than differences in viral shedding itself.

Important limitations

This summary relies on the supplied single-article abstract and metadata. Full interpretation of study limitations, including sampling methods, detection thresholds, generalizability beyond hospital outbreaks, and model assumptions, requires access to the complete published article.

GIDS interpretation

This article was identified through classifier links to gastroenteritis, outbreak investigation, surveillance, and transmission dynamics. It provides quantitative shedding parameters useful for modeling environmental contamination and transmission risk in institutional outbreak settings, but does not itself represent or validate a surveillance signal.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 8 auditable classifier relationships to diseases, places, topics, and study design.

about diseaseaddresses topicaddresses topicaddresses topichas pathogen typestudied population settingstudies populationuses study design