{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:22:15Z","timestamp":1793118135768,"version":"4.5.0"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100007723","name":"Takeda Pharmaceuticals U.S.A.","doi-asserted-by":"publisher","award":["IISR-2015-101015"],"award-info":[{"award-number":["IISR-2015-101015"]}],"id":[{"id":"10.13039\/100007723","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007723","name":"Takeda Pharmaceuticals U.S.A.","doi-asserted-by":"publisher","award":["IISR-2017-101938"],"award-info":[{"award-number":["IISR-2017-101938"]}],"id":[{"id":"10.13039\/100007723","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>While acute gastroenteritis (AGE) occurs year-round, norovirus has a winter seasonality in the United States.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>We analyzed norovirus seasonality within a US integrated healthcare delivery system from 2016\u20132019.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Electronic medical records were collected for acute gastroenteritis (AGE) encounters with specific ICD-9\/10 codes or clinical stool testing. Norovirus percent positivity was calculated as the 8-week centered rolling average. Temperature and absolute humidity data were measured via weather station. The relationship between these factors and weekly norovirus episodes were modeled via negative binomial models.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>From 2016\u20132019, there were 198,181 AGE episodes reported; among the 18,998 episodes tested, 892 (5%) were norovirus positive. Norovirus percent positivity peaked in epidemiologic week 7 at 9%. Two negative binomial models showed significant inverse relationships between weekly number of norovirus episodes and both temperature and absolute humidity.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Norovirus AGE exhibited winter seasonality from 2016\u20132019, associated with lower temperatures and humidity. Understanding this seasonality may help predict peak transmission periods and their impact on healthcare resources.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0318077","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T17:25:43Z","timestamp":1746811543000},"page":"e0318077","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Seasonality of medically attended norovirus gastroenteritis and its association with climatic factors within an US integrated healthcare system, 2016\u20132019"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8558-8779","authenticated-orcid":true,"given":"Claire P.","family":"Mattison","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2670-8028","authenticated-orcid":true,"given":"Laura E.","family":"Calderwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan E.","family":"Cates","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy","family":"Donald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7250-1013","authenticated-orcid":true,"given":"Aron J.","family":"Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara A.","family":"Mirza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"pone.0318077.ref001","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S1473-3099(18)30362-1","article-title":"Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries: a systematic analysis for the Global Burden of Disease Study 2016","volume":"18","author":"GBD 2016 Diarrhoeal Disease Collaborators","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"pone.0318077.ref002","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1001\/jamapediatrics.2018.1960","article-title":"Rotavirus Vaccination and the Global Burden of Rotavirus Diarrhea Among Children Younger Than 5 Years","volume":"172","author":"C Troeger","year":"2018","journal-title":"JAMA Pediatr"},{"key":"pone.0318077.ref003","doi-asserted-by":"crossref","first-page":"105259","DOI":"10.1016\/j.micpath.2021.105259","article-title":"Global prevalence of norovirus in cases of acute gastroenteritis from 1997 to 2021: An updated systematic review and meta-analysis","volume":"161","author":"Y Liao","year":"2021","journal-title":"Microb Pathog"},{"issue":"4","key":"pone.0318077.ref004","doi-asserted-by":"crossref","DOI":"10.1097\/INF.0b013e31827d3b68","article-title":"Global Seasonality of Rotavirus Disease","volume":"32","author":"MM Patel","year":"2013","journal-title":"The Pediatric Infectious Disease Journal"},{"key":"pone.0318077.ref005","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1056\/NEJMsa1206589","article-title":"Norovirus and medically attended gastroenteritis in U.S. children","volume":"368","author":"DC Payne","year":"2013","journal-title":"N Engl J Med"},{"issue":"6","key":"pone.0318077.ref006","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1093\/infdis\/119.6.668","article-title":"Winter vomiting disease","volume":"119","author":"JL Adler","year":"1969","journal-title":"J Infect Dis"},{"key":"pone.0318077.ref007","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1093\/cid\/ciac627","article-title":"Spatiotemporal Trends in Norovirus Outbreaks in the United States, 2009-2019","volume":"76","author":"AK Kambhampati","year":"2023","journal-title":"Clin Infect Dis"},{"key":"pone.0318077.ref008","author":"NREVSS, CDC"},{"issue":"24","key":"pone.0318077.ref009","doi-asserted-by":"crossref","first-page":"539","DOI":"10.15585\/mmwr.mm6824a2","article-title":"Trends in the Laboratory Detection of Rotavirus Before and After Implementation of Routine Rotavirus Vaccination - 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