A systematic review and meta-analysis of the global seasonality of norovirus.
A systematic review and meta-analysis of the global seasonality of norovirus.
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DOI：
10.1371/journal.pone.0075922
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Levy K
中科院分区：
文献类型：
--
作者：
Ahmed SM;Lopman BA;Levy K
诺如病毒是全世界各年龄段急性胃肠炎的最常见病因。这些病原体通常被理解为表现出冬季季节性，尽管在现代诊断时代尚未对季节性模式进行系统评估。我们对Pubmed Medline数据库中1997年至2011年间发表的文章进行了系统回顾，以确定并从报告诺如病毒每月计数的文章中提取数据。我们进行了描述性分析，以记录诺如病毒疾病的季节性模式，我们还构建了多变量线性模型，以确定与诺如病毒季节性强度相关的因素。检索到293篇独特的文章，产生38例病例和29例疫情数据系列。在这些数据序列中，52.7%的病例和41.2%的暴发发生在冬季月份，78.9%的病例和71.0%的暴发发生在凉爽月份。病例和暴发研究都表明，2002- 2003年的季节性高峰较早，但在出现新的II型基因组4型变异的2006- 2007年的季节性高峰没有出现。对于暴发，在双变量和多变量分析中，诺如病毒季节强度与最潮湿月份的平均降雨量呈正相关，与粗出生率呈负相关。在某些情况下，没有一个协变量与季节强度相关。当病例和疫情同时出现时，最潮湿月份的平均降雨量与季节强度呈正相关。诺如病毒是一种冬季现象，至少在可获得大多数数据的温带北半球是如此。我们的研究结果表明，季节强度与最潮湿月份的降雨和粗出生率之间可能存在关联。
Noroviruses are the most common cause of acute gastroenteritis across all ages worldwide. These pathogens are generally understood to exhibit a wintertime seasonality, though a systematic assessment of seasonal patterns has not been conducted in the era of modern diagnostics. We conducted a systematic review of the Pubmed Medline database for articles published between 1997 and 2011 to identify and extract data from articles reporting on monthly counts of norovirus. We conducted a descriptive analysis to document seasonal patterns of norovirus disease, and we also constructed multivariate linear models to identify factors associated with the strength of norovirus seasonality. The searched identified 293 unique articles, yielding 38 case and 29 outbreak data series. Within these data series, 52.7% of cases and 41.2% of outbreaks occurred in winter months, and 78.9% of cases and 71.0% of outbreaks occurred in cool months. Both case and outbreak studies showed an earlier peak in season-year 2002-03, but not in season-year 2006-07, years when new genogroup II type 4 variants emerged. For outbreaks, norovirus season strength was positively associated with average rainfall in the wettest month, and inversely associated with crude birth rate in both bivariate and multivariate analyses. For cases, none of the covariates examined was associated with season strength. When case and outbreaks were combined, average rainfall in the wettest month was positively associated with season strength. Norovirus is a wintertime phenomenon, at least in the temperate northern hemisphere where most data are available. Our results point to possible associations of season strength with rain in the wettest month and crude birth rate.