Open Access Highly Accessed Research article

A summertime peak of "winter vomiting disease": Surveillance of noroviruses in England and Wales, 1995 to 2002

Ben A Lopman1*, Mark Reacher1, Chris Gallimore2, Goutam K Adak1, Jim J Gray2 and David WG Brown2

Author Affiliations

1 Public Health Laboratory Service Communicable Disease Surveillance Centre, Gastrointestinal Diseases Division, 61 Colindale Avenue, London NW9 5EQ, UK

2 Public Health Laboratory Service Central Public Health Laboratory, Enteric Respiratory and Neurological Virus Reference Unit, 61 Colindale Avenue London NW9 5EQ, UK

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BMC Public Health 2003, 3:13  doi:10.1186/1471-2458-3-13

Published: 24 March 2003



Noroviruses are the most common cause of gastroenteritis outbreaks in industrialised countries. Gastroenteritis caused by Norovirus infection has been described as a highly seasonal syndrome, often referred to as "winter vomiting disease".


The Public Health Laboratory Service Communicable Disease Surveillance Centre has systematically collected reports of laboratory confirmed cases of Norovirus-gastroenteritis since 1995. We analysed these data for annual and seasonal trends and age distribution.


A mid-summer peak in reported cases of Norovirus was observed in 2002, unlike all six previous years when there was a marked summer decline. Total reports from 2002 have also been higher than all previous years. From the first 10 months of 2002, a total of 3029 Norovirus diagnoses were reported compared the previous peak in 1996 of 2437 diagnoses for the whole 12-month period. The increase in 2002 was most marked in the 65 and older age group.


This surveillance data challenges the view that Noroviruses infections exclusively have wintertime seasonality.