Evaluating Age-specific rate of norovirus in German: a Bayesian Age-cohort analysis Open Access

Ou, Changrui (Spring 2023)

Permanent URL: https://etd.library.emory.edu/concern/etds/vt150k52k?locale=en


Noroviruses are the leading cause of acute gastroenteritis worldwide. The GII.4 genotype has been the dominant genotype worldwide. While infants and young children are known to be susceptible to all noroviruses, the impact of novel GII.4 strain on adult’s immunity response is not fully investigated. To examine the age-specific pattern of norovirus incidence in general population, we conducted a Bayesian Age-cohort model reporting age and cohort effect that accounts for the change of incidence among individuals who were born after 1995 in Germany. In terms of birth cohort, we found a significant signal of immune escape from the difference in incidence rate at age 5-15 between Cohort born in 2002, 2004, 2006, and the one born in 2012. In terms of age effect, incidence rate has the greatest decrease at age 7, while it has the greatest increase at age 1. These results have implications for future public health interventions and vaccine development to understand the further impact of early exposure of GII.4 strains on later experience of norovirus infection. 

Table of Contents

Chapter I: Background & Literature Review.. 1

Disease Burden. 1

Epidemiology. 2

Genetic and Molecular Epidemiology. 3

Chapter II: Manuscript 7

Abstract 7

Introduction. 7

Methods. 9

Results. 13

Discussion. 16

References. 18

Tables & Figures. 27

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