What is the economic impact of Norovirus infections?

Norovirus is estimated to cost approximately $4.2 billion in health care costs and over $60 billion in societal costs globally each year. $60 billion is bigger than 70% of the world’s 180 economies by gross domestic product. $60 billion dollars could fund the United Nations for the next five years. $60 billion dollars can buy the world’s top 20 football clubs and the top 10 basketball clubs. I can go on and on but the bottom line is $ 60 billion is a huge amount of money.

What is norovirus?

Norovirus is the most common cause of acute gastroenteritis (AGE) across all settings and age groups worldwide in recent epidemiological studies. It is commonly transmitted through direct contact with an infected person, consumption of contaminated food or water, contact with contaminated surfaces or objects and aerosolization of the virus through a vomiting event. The virus affects members from all age groups and is usually characterized by inflammation of the stomach, diarrhoea and vomiting. Norovirus can cling to hard surfaces and research shows that it is very prevalent in cruise ships, aged-care facilities, hospitals and community sporting events due to the large amount of people confined within a small area. There are different methods of handling the infection and correct diagnosis will, in most cases, lead to a full recovery.However, despite the majority of people recovering after a few days of discomfort the virus has the potential to be highly fatal, especially to young children and the elderly.

How common is the norovirus infection?

In the US alone, it causes 20 million illnesses, contributes to 56,000 - 71,000 hospitalizations and 570 - 800 deaths. Globally, norovirus causes over 200,000 deaths annually and, as a result, can be a significant economic drain to societies where outbreaks of the virus are frequent. The US Department of Agriculture monitors food-borne illnesses and provides detailed data about the virus outcomes and estimates of subsequent costs in the US. Norovirus is five times as deadly and eight times as costly as the E. coli virus.

Numerous outbreaks have been documented. A recent outbreak showed the great extent of the havoc caused by norovirus. Over 200 people (about 22%) fell ill on the Royal Caribbean cruise ship carrying 917 voyagers. It has been estimated that about 20 hospitalizations were caused by norovirus out of every 10000 children under the age of five, on the average 53,000 hospitalizations is linked to norovirus yearly in the European Union.

Is norovirus just a problem of the developed world?

Norovirus is not just a first world problem. The stomach bug sickens nearly 700 million people all over the world every year. A group of researchers investigated data obtained from 14 African countries and concluded that Norovirus is a common pathogen in children suffering from diarrhoea in Africa and also that a considerable number of children carrying the virus are without symptoms. A study in Kenya found that the incidences of Norovirus are about twice the estimates of that from the US, UK, and the Netherlands. This and similar studies suggest a higher overall incidence of the virus in developing countries, due to poor hygiene practices and lack of basic healthcare facilities.

How does norovirus infection compare with other diarrheal diseases?

These cost estimates are conservative as many norovirus cases go unreported. In contrast, the burden of rotavirus, a diarrheal disease that kills many babies but rarely endangers patients over the age of five, was estimated at $2 billion a year before a vaccine was made available. There is currently no specific medication or vaccine for norovirus infection, although a vaccine is being developed.

Is there vaccine for norovirus?

There is no vaccine for norovirus at the moment. However, several vaccine strategies, mostly using virus-like particle antigens (VLPs) are under development and have shown proof of efficacy, the most advanced being the adjuvanted bivalent intramuscular norovirus virus-like particle (VLP) vaccine.

The importance of norovirus as a major gastrointestinal bug underscores the need for well-tolerated and effective vaccines. A vaccine to prevent another acute gastroenteritis AGE, rotavirus, has been proven to be successful in improving the health and well-being of children around the world by substantially reducing severe diarrhoea. Declines in hospitalizations and deaths due to rotavirus and all-cause diarrhoea have been observed in countries that have introduced rotavirus vaccines into their national immunization programs (NIP).