Outbreaks of Acute Gastroenteritis Transmitted by Person-to-Person Contact — United States, 2009–2010
During 2009–2010, a total of 2,259 person-to-person AGE  outbreaks were reported in NORS from 42 states and the District of  Columbia (USA)
136 Deaths
These outbreaks resulted in 81,491 reported illnesses, 1,339  hospitalizations, and 136 deaths. No etiology was reported in  approximately 40% (n = 840) of outbreaks.
82% of outbreaks caused by Norovirus
Of the remaining 1,419  outbreaks with a reported etiology, 1,270 (89%) were either suspected or  confirmed to be caused solely by norovirus. Other reported etiologies  included 
Shigella (n = 86), 
Salmonella (n = 16), Shiga toxin-producing 
Escherichia coli  (STEC) (n = 11), and rotavirus (n = 10). Most (82%) of the 1,723  outbreaks caused by norovirus or an unknown etiology occurred during the  winter months, and outbreaks caused by 
Shigella or another  suspected or confirmed etiology most often occurred during the spring or  summer months (62%, N = 53 and 60%, N = 38, respectively).
Nursing homes and long-term-care facilities account for 80% 
A setting  was reported for 1,187 (53%) of total outbreaks. Among these reported  settings, nursing homes and other long-term–care facilities were most  common (80%), followed by childcare centers (6%), hospitals (5%), and  schools (5%).  
 
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Interpretation: NORS provides the first national data on AGE outbreaks spread primarily through person-to-person transmission and describes the frequency of this mode of transmission. Norovirus is the most commonly reported cause of these outbreaks and, on the basis of epidemiologic characteristics, likely accounts for a substantial portion of the reported outbreaks of unknown etiology. In the United States, sporadic and outbreak-associated norovirus causes an estimated 800 deaths and 70,000 hospitalizations annually, which could increase by an additional 50% during epidemic years. During 2009–2010, norovirus outbreaks accounted for the majority of deaths and health-care visits in person-to-person AGE outbreaks reported to NORS.
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