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an Economist Intelligence Unit business healthcare

ECDC Norovirus


European Centre of Disease Prevention and Control (ECDC)



The European Centre for Disease Control (ECDC) identifies and assesses current and emerging threats to human health from communicable disease. In July 2010 ECDC asked for evidence-based EU-wide guidance for the prevention and control of norovirus outbreaks in childcare facilities and schools. The aim of the produced guidance was to support the implementation of health communication activities in these settings.


The problem

Norovirus infections are common. Prior research had estimated that 12% of all cases of severe gastroenteritis among children aged less than 5 years old are due norovirus, and that each year in industrialised countries the virus is responsible for an estimated 64,000 episodes of diarrhoea requiring hospitalization and 900,000 primary care consultations among children. Research from Germany suggested that about 15% of all reported norovirus outbreaks occur in semi-closed childcare facilities or schools. There are, however, few guidelines available for this setting, and the primary research available in the area is known to be sparse.


Our solution

An innovative proposal was developed to review, grade and adapt existing primary and secondary research related to the prevention and control of norovirus. We used an extension of existing grading systems for public health evidence and a modified ADAPTE process to provide a synthesis of recommendations from guidelines related to the prevention of norovirus in both childcare and non-childcare settings. This was supplemented by a systematic review of primary research related to the epidemiology or norovirus, and effectiveness of control interventions. The report produced covered key areas of outbreak prevention, identification, control and  post-outbreak remediation planning, with graded evidence statements in each area. The report was presented at conference with ECDC members and external experts.


The outcome

A focus on the key messages in existing guidelines and their applicability to a range of countries and settings supported the health communication experts at ECDC to focus on the steps required for dissemination, implementation, and evaluation. This helped to facilitate the translation of what had been researched and evaluated to date into effective public health action.