A Narrative Review of the Norovirus Burden in Closed and Semi-Closed Structural Settings

Noroviruses pose a major public health challenge in structurally closed or semi-closed settings where person-to-person contact, shared environment, and high-risk populations facilitate rapid transmission. This narrative review synthesizes epidemiological evidence on the burden of norovirus infection in closed and semi-closed settings, such as long-term care facilities (LTCFs), healthcare facilities, schools, childcare centers, and cruise ships, where norovirus transmission risk is elevated. Priority populations frequently experiencing high attack rates and patterns of key factors related to norovirus transmission are summarized for each context. Reported attack rates varied substantially both within and across settings, with elevated attack rates reported in LTCFs, healthcare facilities, childcare settings, and several other closed or semi-closed settings. Norovirus outbreaks are frequent and severe in closed and semi-closed settings, highlighting the need for targeted prevention and control measures in these contexts.