Significance of norovirus in occupational health: a review of published norovirus outbreaks in Central and Northern Euro
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REVIEW
Significance of norovirus in occupational health: a review of published norovirus outbreaks in Central and Northern Europe Felix Martin Hofmann1,2 · Edward Olawumi1 · Martina Michaelis1 · Ulrich Stößel1 · Friedrich Hofmann1 Received: 20 November 2019 / Accepted: 13 April 2020 © The Author(s) 2020
Abstract Objectives Globally, norovirus (NoV) is the leading cause of gastroenteritis infection among all ages. The development of prevention strategies in the field of occupational health requires a detailed knowledge about the impact of the disease on employees. This review article aims not only at evaluating the burden of NoV outbreaks on staff but also at discussing implications for future prevention strategies. Methods Published NoV outbreaks in Central and Northern Europe were identified via a systematic literature search. Additionally, published NoV outbreaks in Germany were detected via a manual literature search. Key epidemiological data, as the number of symptomatic staff, was then extracted. The proportion of affected employees was calculated for each dataset (single NoV outbreaks or aggregated data of multiple outbreaks). Results Overall, 116 datasets were extracted from 72 relevant articles. 144,852 persons were affected by NoV gastroenteritis, 25,408 out of them (17.5%) were employees. 23,874 (94.0%) of them fell sick during outbreaks in hospitals and related settings. NoV cases among personnel in food establishments were reported only sporadically (mean ratio: 0.01). Conclusions Employees in hospitals and community facilities seem quantitatively to be most vulnerable towards NoV epidemics. Therefore, high quality of prevention measures in these settings, respective compliance with prevention strategies should have the highest priority. The disease can be considered as an occupational disease, even regularly without long-term consequences. Following work safety rules, a vaccination for vulnerable groups should be recommended if the vaccine development turns out to be successful. Keywords Central/Northern Europe · Norovirus gastroenteritis · Occupational health · Outbreak
Introduction Norovirus (NoV) infection is the leading cause of sporadic disease and outbreaks of acute gastroenteritis worldwide (Glass et al. 2009; Lopman et al. 2015). The prevalence of NoV is highest in developing countries (Lanata et al. 2013). Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00420-020-01543-4) contains supplementary material, which is available to authorized users. Friedrich Hofmann: Deceased. * Felix Martin Hofmann [email protected] 1
Research Centre for Occupational and Social Medicine (FFAS), Bertoldstraße 63, 79098 Freiburg, Germany
Institute of Earth and Environmental Sciences, University of Freiburg, Albertstraße 23b, 79104 Freiburg, Germany
2
The extremely contagious virus affects individuals of all ages, but young children and the elderly remain the most vulnerable groups (Glass et al. 2009). An annual incidence rate in England as high a
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