Greater Pathogenicity of Norovirus Strains in 2003? A Syndromic Approach

Although norovirus (NoV) is the most common cause of acute gastroenteritis (ewinter vomiting diseaseí), its contribution to mortality remains unknown and may be an unrecognized problem [1]. In Europe a genetic shift in circulating NoV strains was observed in 2002 which coincided with an unusually high number of NoV outbreaks in all but one country participating in the European NoV-surveillance network [2]. Covering a time period which included this outbreak peak, we used general practitioner (GP), hospital, and death-cause data in combination with NoV surveillance data to explore the association between NoV outbreaks and morbidity and mortality.