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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 17, Issue 4, Pages 235-241
Original Articles

Syndromic Surveillance of Norovirus Using over the Counter Sales of Medications related to Gastrointestinal Illness

Victoria L Edge,1,2 Frank Pollari,1 Lai King,3 Pascal Michel,4 Scott A McEwen,2 Jeffrey B Wilson,1,2 Michael Jerrett,5,6 Paul N Sockett,2,7 and S Wayne Martin2

1Foodborne, Waterborne and Zoonotic Infections Division, Public Health Agency of Canada, Canada
2Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
3National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
4Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, St Hyacinthe, Quebec, Canada
5McMaster University, Hamilton, Ontario, Canada
6University of Southern California, Los Angeles, California, Canada
7Foodborne, Waterborne and Zoonotic Infections Division, Public Health Agency of Canada, Ottawa, Ontario, Canada

Received 1 February 2006; Accepted 7 April 2006

Copyright © 2006 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


OBJECTIVE: To assess whether over-the-counter (OTC) sales of gastrointestinal illness (GI)-related medications are associated with temporal trends of reportable community viral, bacterial and parasitic infections.

METHODS: The temporal patterns in weekly and seasonal sales of nonprescription products related to GI were compared with those of reportable viral, bacterial and parasitic infections in a Canadian province.

RESULTS: Temporal patterns of OTC product sales and Norovirus activity were similar, both having highest activity in the winter months. In contrast, GI cases from both bacterial and parasitic agents were highest from late spring through to early fall.

CONCLUSIONS: Nonprescription sales of antidiarrheal and antinauseant products are a good predictor of community Norovirus activity. Syndromic surveillance through monitoring of OTC product sales could be useful as an early indicator of the Norovirus season, allowing for appropriate interventions to reduce the number of infections.