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      Incubation periods of viral gastroenteritis: a systematic review

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          Abstract

          Background

          Accurate knowledge of incubation period is important to investigate and to control infectious diseases and their transmission, however statements of incubation period in the literature are often uncited, inconsistent, and/or not evidence based.

          Methods

          In a systematic review of the literature on five enteric viruses of public health importance, we found 256 articles with incubation period estimates, including 33 with data for pooled analysis.

          Results

          We fit a log-normal distribution to pooled data and found the median incubation period to be 4.5 days (95% CI 3.9-5.2 days) for astrovirus, 1.2 days (95% CI 1.1-1.2 days) for norovirus genogroups I and II, 1.7 days (95% CI 1.5-1.8 days) for sapovirus, and 2.0 days (95% CI 1.4-2.4 days) for rotavirus.

          Conclusions

          Our estimates combine published data and provide sufficient quantitative detail to allow for these estimates to be used in a wide range of clinical and modeling applications. This can translate into improved prevention and control efforts in settings with transmission or the risk of transmission.

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          Global Illness and Deaths Caused by Rotavirus Disease in Children

          Umesh D Parashar, Erik Hummelman, Joseph Bresee … (2003)
          To estimate the global illness and deaths caused by rotavirus disease, we reviewed studies published from 1986 to 2000 on deaths caused by diarrhea and on rotavirus infections in children. We assessed rotavirus-associated illness in three clinical settings (mild cases requiring home care alone, moderate cases requiring a clinic visit, and severe cases requiring hospitalization) and death rates in countries in different World Bank income groups. Each year, rotavirus causes approximately 111 million episodes of gastroenteritis requiring only home care, 25 million clinic visits, 2 million hospitalizations, and 352,000–592,000 deaths (median, 440,000 deaths) in children <5 years of age. By age 5, nearly every child will have an episode of rotavirus gastroenteritis, 1 in 5 will visit a clinic, 1 in 60 will be hospitalized, and approximately 1 in 293 will die. Children in the poorest countries account for 82% of rotavirus deaths. The tremendous incidence of rotavirus disease underscores the urgent need for interventions, such as vaccines, to prevent childhood deaths in developing nations.
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            Rotavirus and Severe Childhood Diarrhea

            Umesh D Parashar, Christopher Gibson, Joseph Bresee … (2006)
            Studies published between 1986 and 1999 indicated that rotavirus causes ≈22% (range 17%–28%) of childhood diarrhea hospitalizations. From 2000 to 2004, this proportion increased to 39% (range 29%–45%). Application of this proportion to the recent World Health Organization estimates of diarrhea-related childhood deaths gave an estimated 611,000 (range 454,000–705,000) rotavirus-related deaths.
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              Factors that make an infectious disease outbreak controllable.

              C. Fraser, S. Riley, R M Anderson … (2004)
              The aim of this study is to identify general properties of emerging infectious agents that determine the likely success of two simple public health measures in controlling outbreaks, namely (i) isolating symptomatic individuals and (ii) tracing and quarantining their contacts. Because these measures depend on the recognition of specific disease symptoms, we investigate the relative timing of infectiousness and the appearance of symptoms by using a mathematical model. We show that the success of these control measures is determined as much by the proportion of transmission occurring prior to the onset of overt clinical symptoms (or via asymptomatic infection) as the inherent transmissibility of the etiological agent (measured by the reproductive number R(0)). From published studies, we estimate these quantities for two moderately transmissible viruses, severe acute respiratory syndrome coronavirus and HIV, and for two highly transmissible viruses, smallpox and pandemic influenza. We conclude that severe acute respiratory syndrome and smallpox are easier to control using these simple public health measures. Direct estimation of the proportion of asymptomatic and presymptomatic infections is achievable by contact tracing and should be a priority during an outbreak of a novel infectious agent.
              Article 0 comments Cited 247 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Rachel M Lee
                Justin Lessler
                Rose A Lee
                Kara E Rudolph
                Nicholas G Reich
                Trish M Perl
                Derek AT Cummings
                Journal
                Journal ID (nlm-ta): BMC Infect Dis
                Journal ID (iso-abbrev): BMC Infect. Dis
                Title: BMC Infectious Diseases
                Publisher: BioMed Central
                ISSN (Electronic): 1471-2334
                Publication date Collection: 2013
                Publication date (Electronic): 25 September 2013
                Volume: 13
                Page: 446
                Affiliations
                [1 ]Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
                [2 ]Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
                [3 ]Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusettes Amherst, Amherst, USA
                [4 ]Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, USA
                Article
                Publisher ID: 1471-2334-13-446
                DOI: 10.1186/1471-2334-13-446
                PMC ID: 3849296
                PubMed ID: 24066865
                SO-VID: 55d96938-533f-462c-86db-c8459725d32c
                Copyright © Copyright © 2013 Lee et al.; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 6 March 2013
                Date accepted : 12 September 2013
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: incubation period,norovirus,rotavirus,caliciviruses,astrovirus,systematic review
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: incubation period, norovirus, rotavirus, caliciviruses, astrovirus, systematic review

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