The transmission dynamics of Norovirus in England: A genotype-specific modelling study

IF 2.4 3区医学 Q2 INFECTIOUS DISEASES

Epidemics Pub Date : 2025-12-01 Epub Date: 2025-11-27 DOI:10.1016/j.epidem.2025.100875

Juan F. Vesga , Amy Douglas , Cristina Celma , Edward S. Knock , Marc Baguelin , W. John Edmunds

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引用次数: 0

Abstract

Background

Norovirus is the leading cause of acute gastroenteritis cases in England and worldwide, with diverse co-circulating genotypes. Vaccine candidates targeting multiple genotypes are advancing. However, most transmission models still focus on single-strain dynamics, limiting their ability to assess the role of co-circulating strains on population burden.

Methods

We developed an age structured multistrain transmission model that integrates norovirus genotype diversity, waning immunity, and cross-protection within genogroups. We calibrate to case and genotyping surveillance time-series data with community-wide age structured incidence estimates and cross-sectional seroprevalence among English children to capture the transmission dynamics of the main co-circulating norovirus strains in England. Using a calibrated model, we examine the case of an emerging GII.4 variant under different scenarios of transmissibility.

Results

We found that on average the current GII.4 strain has an R₀ of 4.8 (CrI 4.5 – 5.01). We estimate the average number of lifetime norovirus episodes per person to be 5.2 (CrI 95 % 4.5 – 6.3) in the absence of new pandemic strains, with 66 % of children in England experiencing at least one symptomatic episode by the age of four. Our sensitivity analysis and model selection suggests that cross-protection within genogroups (between strains of the same genogroup), is very limited at conferring protection. Importantly, our modelling suggests that a potential emerging variant would cause a larger first epidemic season and return to baseline levels with an increase in relative contribution of GII.4. If such variant was more transmissible, the size of the initial peak could almost double the current average epidemic peak.

Conclusions

This approach addresses key limitations of single-strain frameworks and offers a more comprehensive understanding of norovirus dynamics, improving the capacity to assess the potential population-level effects of upcoming multivalent vaccine strategies.

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诺如病毒在英格兰的传播动力学：一项基因型特异性建模研究。

背景：诺如病毒是英国和世界范围内急性胃肠炎病例的主要原因，具有多种共循环基因型。针对多种基因型的候选疫苗正在推进。然而，大多数传播模型仍然侧重于单株动力学，限制了它们评估共传播菌株对种群负担的作用的能力。方法：我们建立了一个年龄结构的多株传播模型，该模型整合了诺如病毒基因型多样性、免疫减弱和基因群内的交叉保护。我们校准病例和基因分型监测时间序列数据，包括全社区年龄结构发病率估计和英国儿童的横断面血清患病率，以捕捉英国主要共循环诺如病毒株的传播动态。使用校准模型，我们在不同的传播情况下研究了新出现的GII.4变体的情况。结果：目前的GII.4菌株的平均R0为4.8 （CrI为4.5 ~ 5.01）。我们估计，在没有新的大流行毒株的情况下，每人一生中诺如病毒发作的平均次数为5.2次（CrI 95 % 4.5 - 6.3），英格兰有66 %的儿童在4岁之前至少经历一次症状发作。我们的敏感性分析和模型选择表明，基因组内（同一基因组的菌株之间）的交叉保护在提供保护方面非常有限。重要的是，我们的模型表明，一个潜在的新变种将导致更大的第一个流行季节，并随着全球免疫球蛋白的相对贡献的增加而回到基线水平。如果这种变异具有更强的传染性，初始峰值的规模可能几乎是当前平均流行峰值的两倍。结论：该方法解决了单株框架的主要局限性，并提供了对诺如病毒动力学更全面的了解，提高了评估即将到来的多价疫苗策略的潜在人群水平效应的能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epidemics INFECTIOUS DISEASES-

CiteScore

6.00

自引率

7.90%

发文量

审稿时长

140 days

期刊介绍： Epidemics publishes papers on infectious disease dynamics in the broadest sense. Its scope covers both within-host dynamics of infectious agents and dynamics at the population level, particularly the interaction between the two. Areas of emphasis include: spread, transmission, persistence, implications and population dynamics of infectious diseases; population and public health as well as policy aspects of control and prevention; dynamics at the individual level; interaction with the environment, ecology and evolution of infectious diseases, as well as population genetics of infectious agents.