1648. Incidence of norovirus and rotavirus from multisite active surveillance in Veteran’s Affairs hospitals, December 2016–February 2018: results from the SUPERNOVA network
Session: Oral Abstract Session: Respiratory and Gastroenteritis Viruses
Friday, October 5, 2018: 3:00 PM
Room: W 2002
Background: Viruses are frequently implicated in acute gastroenteritis (AGE) outbreaks, yet the endemic burden of norovirus and rotavirus disease in adult populations is not well characterized. In 2016, we implemented a multisite AGE surveillance platform capturing cases and controls in 4 VA hospitals (Atlanta, Bronx, Houston and Los Angeles), collectively serving >320,000 patients annually.

Methods: Inpatient AGE cases and age- and time-matched controls were identified through prospective screening of admissions via standardized case definitions. Outpatient cases were passively identified using stool samples submitted for routine clinical microbiological diagnostics. Samples were tested with the FilmArray Gastrointestinal Panel, followed by genotyping of virus positives. Incidence was estimated using population denominators of unique patients served annually by site.

Results: From December 1, 2016─February 28, 2018, 875 cases (496 inpatient, 379 outpatient), and 374 controls were enrolled. Norovirus and rotavirus prevalence was highest among outpatient AGE cases (11.6% and 2.9%, respectively) followed by inpatient cases (3.4% and 1.6%, respectively); few controls were positive (norovirus, 1.3%; rotavirus, 0%). Norovirus-associated inpatient incidence was 15.2 per 100,000 population (range by site: 10.7-19.9/100,000) and rotavirus-associated inpatient incidence was 7.5 per 100,000 population (range by site: 0-12.8/100,000). The predominant norovirus genotype was GII.P16-GII.4 Sydney (50%), and rotavirus genotype was G12P[8] (83%). Norovirus was detected every calendar month and peaked in December-January, while rotavirus peaked in April. Nine deaths were documented among AGE inpatient cases, including one norovirus-associated death.

Conclusion: Implementation of a multisite AGE surveillance platform captured a wide spectrum of illness for norovirus and rotavirus in US Veterans including outpatient visits, inpatient hospitalizations, and one norovirus-associated death. Norovirus was the leading viral pathogen and was detected year-round. Ongoing surveillance using this platform will allow for further characterization of the pathogen distribution and associated AGE disease burden in adults.

Cristina V. Cardemil, MD, MPH1, Anita Kambhampati, MPH2, Scott Grytdal, MPH1, Maria C. Rodriguez-Barradas, MD3, Blanca Vargas, MD4, David Beenhouwer, MD5, Karen Evangelista, PhD6, Vincent Marconi, MD7, Kathryn Meagley, MPH7, Sheldon Brown, MD8, Adrienne Perea, BS9, Cynthia Lucero, MD10, Mark Holodniy, MD, FIDSA, FSHEA10, Hannah Browne, BS11, Rashi Gautam, PhD12, Michael D. Bowen, PhD1, Jan Vinje, PhD1, Umesh D. Parashar, MBBS, MPH1 and Aron J. Hall, DVM, MSPH13, (1)Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, (2)IHRC, Inc., contracting agency to the Division of Viral Diseases, Centers for Diseases Control and Prevention, Atlanta, GA, Atlanta, GA, (3)Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, (4)Infectious Diseases Section, Michael E. DeBakey VA Medical Center, Houston, TX, (5)VA Greater Los Angeles Healthcare System, Los Angeles, CA, (6)VA Greater Los Angeles Healthcare System, Los Angeles, CA, Los Angeles, CA, (7)Atlanta VA Medical Center, Atlanta, GA, (8)Mt Sinai School of Medicine, Bronx, NY, (9)James J. Peters VA Medical Center, Bronx, NY, (10)Public Health Surveillance and Research, Department of Veterans Affairs, Palo Alto, CA, (11)Oak Ridge Institute for Science and Education, Oak Ridge, TN, (12)IHRC, Inc., Atlanta, GA, (13)Centers for Disease Control and Prevention, Atlanta, GA


C. V. Cardemil, None

A. Kambhampati, None

S. Grytdal, None

M. C. Rodriguez-Barradas, None

B. Vargas, None

D. Beenhouwer, None

K. Evangelista, None

V. Marconi, ViiV: Investigator , Research support and Salary . Bayer: Investigator , Research support . Gilead: Investigator , Research support .

K. Meagley, None

S. Brown, None

A. Perea, None

C. Lucero, None

M. Holodniy, None

H. Browne, None

R. Gautam, None

M. D. Bowen, None

J. Vinje, None

U. D. Parashar, None

A. J. Hall, None

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