{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T03:48:36Z","timestamp":1793159316789,"version":"4.5.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We estimate 900 deaths (95% confidence interval [CI], 650\u20131100), 109\u2005000 hospitalizations (95% CI, 80\u2005000\u2013145\u2005000), 465\u2005000 ED visits (95% CI, 348\u2005000\u2013610\u2005000), and 2.3 million ambulatory clinic encounters (95% CI, 1.7\u20132.9 million) annually due to norovirus, with an associated $430\u2013$740 million in healthcare charges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Norovirus causes a substantial health burden in the United States each year, and an effective vaccine could have important public health impact.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaa438","type":"journal-article","created":{"date-parts":[[2020,4,13]],"date-time":"2020-04-13T15:13:24Z","timestamp":1586790804000},"page":"e1-e8","source":"Crossref","is-referenced-by-count":70,"title":["Burden of Norovirus in the United States, as Estimated Based on Administrative Data: Updates for Medically Attended Illness and Mortality, 2001\u20132015"],"prefix":"10.1093","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5678-5826","authenticated-orcid":false,"given":"Rachel M","family":"Burke","sequence":"first","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire P","family":"Mattison","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talia","family":"Pindyck","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca M","family":"Dahl","sequence":"additional","affiliation":[{"name":"Maximus Federal, contracting agency to the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Rudd","sequence":"additional","affiliation":[{"name":"Maximus Federal, contracting agency to the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daoling","family":"Bi","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron T","family":"Curns","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umesh","family":"Parashar","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron J","family":"Hall","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,4,14]]},"reference":[{"key":"2021070111155239900_CIT0001","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1128\/JCM.01535-14","article-title":"Advances in laboratory methods for detection and typing of norovirus","volume":"53","author":"Vinj\u00e9","year":"2015","journal-title":"J Clin Microbiol"},{"key":"2021070111155239900_CIT0002","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1099\/jgv.0.001318","article-title":"Updated classification of norovirus genogroups and genotypes","volume":"100","author":"Chhabra","year":"2019","journal-title":"J Gen Virol"},{"key":"2021070111155239900_CIT0003","doi-asserted-by":"crossref","first-page":"e1001921","DOI":"10.1371\/journal.pmed.1001921","article-title":"World Health Organization estimates of the global and regional disease burden of 22 foodborne bacterial, protozoal, and viral diseases, 2010: a data 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Prepared under a collaborative arrangement with the U.S. Census Bureau. U.S. Census Bureau of the unbridged Vintage 2018 postcensal estimates by 5-year age group,","author":"National Center for Health Statistics","year":"2019"},{"key":"2021070111155239900_CIT0017","volume-title":"Bridged-race intercensal estimates of the resident population of the United States for July 1, 2000-July 1, 2009, by year, county, single-year of age (0, 1, 2, .., 85 years and over), bridged race, Hispanic origin, and sex. Prepared under a collaborative arrangement with the U.S. Census Bureau. U.S. Census Bureau of the revised unbridged postcensal estimates by 5-year age group","author":"National Center for Health Statistics"},{"key":"2021070111155239900_CIT0018","author":"Centers for Disease Control and Prevention"},{"key":"2021070111155239900_CIT0019","volume-title":"Bureau of Economic Analysis, US Department of Commerce"},{"key":"2021070111155239900_CIT0020","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1111\/1475-6773.12612","article-title":"Adjusting health expenditures for inflation: a review of measures for health services research in the United States","volume":"53","author":"Dunn","year":"2018","journal-title":"Health Serv Res"},{"key":"2021070111155239900_CIT0021","first-page":"41","article-title":"Norovirus activity\u2014United States, 2002","volume":"52","author":"Centers for Disease Control and Prevention","year":"2003","journal-title":"MMWR Morb Mortal Wkly 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