{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:26:18Z","timestamp":1787009178941,"version":"build-2736575974"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T00:00:00Z","timestamp":1681862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016469","name":"Takeda Pharmaceuticals International","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016469","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute gastroenteritis (AGE) is a major medical condition for travellers worldwide, particularly travellers to low- and middle-income countries. Norovirus (NoV) is the most common cause of viral AGE in older children and adults, but data on prevalence and impact amongst travellers is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective, multi-site, observational cohort study conducted 2015\u20132017, amongst adult international travellers from the US and Europe to areas of moderate to high risk of travel-acquired AGE. Participants provided self-collected pre-travel stool samples and self-reported AGE symptoms whilst travelling. Post-travel stool samples were requested from symptomatic subjects and a sample of asymptomatic travellers within 14\u00a0days of return. Samples were tested for NoV by RT-qPCR, genotyped if positive and tested for other common enteric pathogens by Luminex xTAG GPP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 1109 participants included, 437 (39.4%) developed AGE symptoms resulting in an overall AGE incidence of 24.7 per 100 person-weeks [95% confidence interval (CI): 22.4; 27.1]. In total, 20 NoV-positive AGE cases (5.2% of those tested) were identified at an incidence of 1.1 per 100 person-weeks (95% CI: 0.7; 1.7). NoV-positive samples belonged mostly to genogroup GII (18, 85.7%); None of the 13 samples sequenced belonged to genotype GII.4. Clinical severity of AGE was higher for NoV-positive than for NoV-negative cases (mean modified Vesikari Score 6.8 vs 4.9) with more cases classified as severe or moderate (25% vs 6.8%). In total, 80% of NoV-positive participants (vs 38.9% in NoV-negative) reported at least moderate impact on travel plans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AGE is a prevalent disease amongst travellers with a small proportion associated with NoV. Post-travel stool sample collection timing might have influenced the low number of NoV cases detected; however, NoV infections resulted in high clinical severity and impact on travel plans. These results may contribute to targeted vaccine development and the design of future studies on NoV epidemiology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jtm\/taad051","type":"journal-article","created":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T09:45:22Z","timestamp":1681897522000},"source":"Crossref","is-referenced-by-count":11,"title":["Norovirus acute gastroenteritis amongst US and European travellers to areas of moderate to high risk of travellers\u2019 diarrhoea: a prospective cohort study"],"prefix":"10.1093","volume":"31","author":[{"given":"Martin","family":"Alberer","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, University Hospital , LMU Munich, Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine L","family":"Moe","sequence":"additional","affiliation":[{"name":"Hubert Department of Global Health , Rollins School of Public Health, , Atlanta, GA ,","place":["USA"]},{"name":"Emory University , Rollins School of Public Health, , Atlanta, GA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Hatz","sequence":"additional","affiliation":[{"name":"Epidemiology , Biostatistics and Prevention Institute, WHO Collaborating Center for Travellers\u2019 Health, , Zurich ,","place":["Switzerland"]},{"name":"University of Zurich , Biostatistics and Prevention Institute, WHO Collaborating Center for Travellers\u2019 Health, , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Kling","sequence":"additional","affiliation":[{"name":"University of Zurich Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Center for Travellers\u2019 Health, , Zurich,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy E","family":"Kirby","sequence":"additional","affiliation":[{"name":"Hubert Department of Global Health , Rollins School of Public Health, , Atlanta, GA ,","place":["USA"]},{"name":"Emory University , Rollins School of Public Health, , Atlanta, GA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Lindsay","sequence":"additional","affiliation":[{"name":"P95 Pharmacovigilance and Epidemiology Services , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans D","family":"Nothdurft","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"Riera-Montes","sequence":"additional","affiliation":[{"name":"P95 Pharmacovigilance and Epidemiology Services , Leuven 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