| Autor: |
Rushton SP; 1 Modelling, Evidence and Policy Research Group, School of Natural and Environmental Science, Newcastle University , Newcastle upon Tyne NE1 7RU , UK., Sanderson RA; 1 Modelling, Evidence and Policy Research Group, School of Natural and Environmental Science, Newcastle University , Newcastle upon Tyne NE1 7RU , UK., Reid WDK; 2 Ecology Research Group, School of Natural and Environmental Science, Newcastle University , Newcastle upon Tyne NE1 7RU , UK., Shirley MDF; 1 Modelling, Evidence and Policy Research Group, School of Natural and Environmental Science, Newcastle University , Newcastle upon Tyne NE1 7RU , UK., Harris JP; 3 Public Health and Policy, University of Liverpool , Liverpool L69 3GL , UK.; 4 National Institute for Health Research, Health Protection Research Unit in Gastrointestinal Infections , Liverpool L69 3GL , UK., Hunter PR; 4 National Institute for Health Research, Health Protection Research Unit in Gastrointestinal Infections , Liverpool L69 3GL , UK.; 5 Norwich Medical School, University of East Anglia , Norwich 33 NR4 7TJ , UK., O'Brien SJ; 1 Modelling, Evidence and Policy Research Group, School of Natural and Environmental Science, Newcastle University , Newcastle upon Tyne NE1 7RU , UK.; 2 Ecology Research Group, School of Natural and Environmental Science, Newcastle University , Newcastle upon Tyne NE1 7RU , UK.; 4 National Institute for Health Research, Health Protection Research Unit in Gastrointestinal Infections , Liverpool L69 3GL , UK. |
| Abstrakt: |
Norovirus (NoV) is the most commonly recognized cause of acute gastroenteritis, with over a million cases globally per year. While usually self-limiting, NoV poses a substantial economic burden because it is highly contagious and there are multiple transmission routes. Infection occurs through inhalation of vomitus; faecal-oral spread; and food, water and environmental contamination. While the incidence of the disease is predictably seasonal, much less is known about the relative contribution of the various exposure pathways in causing disease. Additionally, asymptomatic excretion and viral shedding make forecasting disease burden difficult. We develop a novel stochastic dynamic network model to investigate the contributions of different transmission pathways in multiple coupled social networks representing schools, hospitals, care-homes and family households in a community setting. We analyse how the networks impact on transmission. We used ward-level demographic data from Northumberland, UK to create a simulation cohort. We compared the results with extant data on NoV cases from the IID2 study. Connectivity across the simulated cohort was high. Cases of NoV showed marked seasonality, peaking in early winter and declining through the summer. For the first time, we show that fomites and food appear to be the most important exposure routes in determining the population burden of disease. This article is part of the theme issue 'Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control'. This theme issue is linked with the earlier issue 'Modelling infectious disease outbreaks in humans, animals and plants: approaches and important themes'. |
