{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:32:51Z","timestamp":1791199971464,"version":"4.2.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"4","funder":[{"name":"CDC Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute gastroenteritis (AGE) causes a substantial burden in the United States, but its etiology frequently remains undetermined. Active surveillance within an integrated healthcare delivery system was used to estimate the prevalence and incidence of medically attended norovirus, rotavirus, sapovirus, and astrovirus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Active surveillance was conducted among all enrolled members of Kaiser Permanente Northwest during July 2014\u2013June 2016. An age-stratified, representative sample of AGE-associated medical encounters were recruited to provide a stool specimen to be tested for norovirus, rotavirus, sapovirus, and astrovirus. Medically attended AGE (MAAGE) encounters for a patient occurring within 30 days were grouped into 1 episode, and all-cause MAAGE incidence was calculated. Pathogen- and healthcare setting\u2013specific incidence estimates were calculated using age-stratified bootstrapping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall incidence of MAAGE was 40.6 episodes per 1000 person-years (PY), with most episodes requiring no more than outpatient care. Norovirus was the most frequently detected pathogen, with an incidence of 5.5 medically attended episodes per 1000 PY. Incidence of norovirus MAAGE was highest among children aged &amp;lt; 5 years (20.4 episodes per 1000 PY), followed by adults aged \u2265 65 years (4.5 episodes per 1000 PY). Other study pathogens showed similar patterns by age, but lower overall incidence (sapovirus: 2.4 per 1000 PY; astrovirus: 1.3 per 1000 PY; rotavirus: 0.5 per 1000 PY).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Viral enteropathogens, particularly norovirus, are important contributors to MAAGE, especially among children &amp;lt; 5 years of age. The present findings underline the importance of judicious antibiotics use for pediatric AGE and suggest that an effective norovirus vaccine could substantially reduce MAAGE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciab033","type":"journal-article","created":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T19:36:58Z","timestamp":1610653018000},"page":"e913-e920","source":"Crossref","is-referenced-by-count":63,"title":["Norovirus and Other Viral Causes of Medically Attended Acute Gastroenteritis Across the Age Spectrum: Results from the Medically Attended Acute Gastroenteritis Study in the United States"],"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":"Viral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, Georgia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire P","family":"Mattison","sequence":"additional","affiliation":[{"name":"Viral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, 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":"Zachary","family":"Marsh","sequence":"additional","affiliation":[{"name":"Viral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, 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":"Kayoko","family":"Shioda","sequence":"additional","affiliation":[{"name":"Viral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, 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":"Judy","family":"Donald","sequence":"additional","affiliation":[{"name":"Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S Bianca","family":"Salas","sequence":"additional","affiliation":[{"name":"Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison L","family":"Naleway","sequence":"additional","affiliation":[{"name":"Center for Health Research, Kaiser Permanente Northwest, Portland, 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