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Volume 9, Number 1—January 2003

Two Epidemiologic Patterns of Norovirus Outbreaks: Surveillance in England and Wales, 1992–2000

Ben Lopman*Comments to Author , Goutam K Adak*, Mark Reacher*, and David W.G. Brown*
Author affiliations: *Public Health Laboratory Service, London, United Kingdom

Main Article

Table 1

Primary modes of transmission of Norovirus outbreaks, England and Wales, 1992–2000

Setting of outbreak Foodbornea Person to persona Other/unknowna Total
Hospital 10 (1.3) 716 (95.0) 28 (3.7) 754
Residential facilities 33 (4.5) 658 (91.0) 32 (4.4) 723
School 4 (5.5) 65 (89.0) 4 (5.5) 73
Food outlet 70 (66.7) 23 (21.9) 12 (11.4) 105
Hotel 42 (28.6) 94 (63.9) 11 (7.5) 147
25 (33.8)
43 (58.1)
6 (8.1)
Total 184 (9.9) 1,599 (85.2) 93 (5.0) 1,877

aNo. of outbreaks (% of all outbreaks in setting).

Main Article

Appendix: Surveillance and analysis definitions

Outbreak: an incident in which two or more people, thought to have a common exposure, experience a similar illness or proven infection, at least one of them being ill (22).
General outbreak: an outbreak that affects members of more than one household, or residents of an institution (36).
General outbreak of Norovirus: a general outbreak in which Norovirus is determined to be the causative agent by electron microscopy, RT-PCR, or enzyme immunoassay in one or more affected persons.
Residential facilities: includes residential homes, which provide some assistance in day-to-day living, and nursing homes, which provide care for persons whose infirmity or illness requires nursing care on a regular basis.
Food outlets: commercial food retailers including restaurants, pubs, bars, cafeterias, mobile food vendors, and caterers.

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