Article Category:
Research Article

Incidence of Norovirus-Associated Acute Gastroenteritis across Age Groups in a Peruvian Andean Community

Wesley R. Campbell U.S. Naval Medical Research Unit SOUTH, Lima, Peru;
Division of Infectious Diseases, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland;

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Joan Neyra U.S. Naval Medical Research Unit SOUTH, Lima, Peru;

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Laura E. Calderwood National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;
Cherokee Nation Operational Solutions, Tulsa, Oklahoma;

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Candice Romero Facultad de Medicina Humana, Universidad Nacional de la Amazonía Peruana, Iquitos, Peru;
Vysnova Partners, Inc., Alexandria, Virginia

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Giselle Soto U.S. Naval Medical Research Unit SOUTH, Lima, Peru;

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Anita K. Kambhampati National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;

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Aron J. Hall National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;

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Diana Ponce Vysnova Partners, Inc., Alexandria, Virginia

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Patricia Galván U.S. Naval Medical Research Unit SOUTH, Lima, Peru;

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Yeny O. Tinoco U.S. Naval Medical Research Unit SOUTH, Lima, Peru;

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Jan Vinjé National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;

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Umesh D. Parashar National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;

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Sara A. Mirza National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;

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DOI:
https://doi.org/10.4269/ajtmh.24-0331
Volume/Issue:
Ahead of Print
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Norovirus is the leading cause of acute gastroenteritis (AGE) globally. Few longitudinal studies have assessed norovirus-associated AGE incidence across age groups in community settings in Latin America. During April 2015–April 2019, active surveillance for AGE among community members of all ages was conducted through household visits two to three times per week in San Jeronimo, Cusco, Peru. An asymptomatic control household was selected for every fifth AGE case. Stool specimens were collected from AGE cases, asymptomatic household members, and control household members, and they were tested for norovirus using real-time reverse transcriptase polymerase chain reaction. Data on illness characteristics were collected from AGE cases during a 15-day follow-up period. Annual means of 247 households and 1,555 participants were enrolled during each April–March surveillance year, accounting for 4,176 person-years (PY) of observation. Of 1,099 AGE events reported, 1,014 stool specimens were tested, and 186 (18%) were norovirus positive. Norovirus AGE incidence was 4.4/100 PY (95% CI: 3.9–5.1); incidence was highest among those younger than 2 years old (60.9/100 PY; 95% CI: 46.8–79.4). Among 672 stool specimens from asymptomatic controls, 56 (8%) tested positive for norovirus. Odds of norovirus detection were significantly higher among cases compared with controls (odds ratio: 2.2; 95% CI: 1.6–3.1). Age-stratified norovirus incidence in this periurban community aligns with previously published estimates and was highest among those younger than 2 years old. Establishing baseline norovirus incidence in specific communities is crucial to identify target populations and assess effectiveness of future interventions, such as vaccines.

Author Notes

Financial support: This work was supported by an Interagency Agreement NMR-169868, between NAMRU SOUTH and the United States Centers for Disease Control and Prevention.

Disclosures: The views expressed in this article are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, the Department of Defense, or the U.S. Government. The study protocol was approved by the U.S. Naval Medical Research Unit SOUTH Institutional Review Board (Protocol NAMRU6.2012.0013) in compliance with all applicable federal regulations governing the protection of human subjects. Some authors are military service members and employees of the U.S. Government. This work was prepared as part of their official duties. Title 17 U.S.C. §105 provides that “Copyright protection under this title is not available for any work of the United States Government.” Title 17 U.S.C. §101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties.

Current contact information: Wesley R. Campbell, Division of Infectious Diseases, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD, E-mail: wesley.r.campbell.mil@health.mil. Joan Neyra, Giselle Soto, Patricia Galván, and Yeny O. Tinoco, U.S. Naval Medical Research Unit SOUTH, Lima, Peru, E-mails: joan.m.neyra2.ln@health.mil, giselle.m.soto.ln@health.mil, patricia.galvan2.ln@health.mil, and yeny.o.tinoco.ln@health.mil. Laura E. Calderwood, Cherokee Nation Operational Solutions, Tulsa, OK, and National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: ofc1@cdc.gov. Candice Romero, Facultad de Medicina Humana, Universidad Nacional de la Amazonía Peruana, Iquitos, Peru, and Vysnova Partners, Inc., Alexandria, VA, E-mail: candice.romero.ctr@health.mil. Anita K. Kambhampati, Aron J. Hall, Jan Vinjé, Umesh D. Parashar, and Sara A. Mirza, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: wyc4@cdc.gov, esg3@cdc.gov, ahx8@cdc.gov, uap2@cdc.gov, and zjk4@cdc.gov. Diana Ponce, Vysnova Partners, Inc., Alexandria, VA, E-mail: diana.m.ponce.ctr@health.mil.

Address correspondence to Sara A. Mirza, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333. E-mail: zjk4@cdc.gov
Copyright:
© American Society of Tropical Medicine and Hygiene 2025
Received:
17 May 2024
|
Accepted:
22 Sep 2024
|
Published Online:
07 Jan 2025
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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