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Wu Q, Wei X, Zhang J, Xin Z, Yang X, Zhang L, Qin M, Dong X, Yan H, Gao Z. Asymptomatic Norovirus Infection Among Children in Kindergartens and Primary Schools - Beijing Municipality, China, 2021. China CDC Wkly 2023; 5:171-175. [PMID: 37008672 PMCID: PMC10061736 DOI: 10.46234/ccdcw2023.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/20/2023] [Indexed: 04/04/2023] Open
Abstract
What is already known about this topic? Children in kindergartens and primary schools are the high-incidence groups of norovirus acute gastroenteritis. However, asymptomatic norovirus infection among them is seldom reported. What is added by this report? The norovirus positive rate was 3.48% among asymptomatic children in kindergartens and primary schools in Beijing Municipality in June 2021, the most common genotype was GII.4 Sydney, and no acute gastroenteritis outbreak was reported over the study period. What are the implications for public health practice? The asymptomatic norovirus infection was relatively low among kindergarten children and primary school students in summer. Norovirus genotypes in asymptomatic children were similar to those circulating in the symptomatic cases. Asymptomatic norovirus infection may play a limited role in causing acute gastroenteritis outbreaks.
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Affiliation(s)
- Qingrui Wu
- Fengtai District Center for Disease Control and Prevention, Beijing, China
| | - Xiuxia Wei
- Fengtai District Center for Disease Control and Prevention, Beijing, China
| | - Jianjun Zhang
- Fengtai District Center for Disease Control and Prevention, Beijing, China
| | - Zhenjiang Xin
- Fengtai District Center for Disease Control and Prevention, Beijing, China
| | - Xiaoxing Yang
- Fengtai District Center for Disease Control and Prevention, Beijing, China
| | - Ling Zhang
- Fengtai District Center for Disease Control and Prevention, Beijing, China
| | - Meng Qin
- Fengtai District Center for Disease Control and Prevention, Beijing, China
| | - Xiaogen Dong
- Fangzhuang Community Health Service Center, Beijing, China
| | - Hanqiu Yan
- Beijing Center for Disease Control and Prevention, Beijing, China
- Hanqiu Yan,
| | - Zhiyong Gao
- Beijing Center for Disease Control and Prevention, Beijing, China
- School of Public Health, Capital Medical University, Beijing, China
- Zhiyong Gao,
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Phattanawiboon B, Nonthabenjawan N, Boonyos P, Jetsukontorn C, Towayunanta W, Chuntrakool K, Ngaopravet K, Ruchusatsawat K, Uppapong B, Sangkitporn S, Mekada E, Matsuura Y, Tatsumi M, Mizushima H. Norovirus transmission mediated by asymptomatic family members in households. PLoS One 2020; 15:e0236502. [PMID: 32702014 PMCID: PMC7377487 DOI: 10.1371/journal.pone.0236502] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 07/07/2020] [Indexed: 12/12/2022] Open
Abstract
The transmission of human norovirus excreted from infected persons occasionally causes sporadic infections and outbreaks. Both symptomatic patients and asymptomatic carriers have been reported to contribute to norovirus transmission, but little is known about the magnitude of the contribution of asymptomatic carriers. We carried out a 1-year survey of residents of a district of Bangkok, Thailand to determine the percentage of norovirus transmissions originating from asymptomatic individuals. We screened 38 individuals recruited from 16 families from May 2018 to April 2019 for GI and GII genotypes. Norovirus was detected every month, and 101 of 716 stool samples (14.1%) from individuals with no symptoms of acute gastroenteritis were norovirus-positive. The average infection frequency was 2.4 times per person per year. Fourteen genotypes were identified from the positive samples, with GII.4 being detected most frequently. Notably, 89.1% of the norovirus-positive samples were provided by individuals with no diarrhea episode. Similar to cases of symptomatic infections in Thailand, asymptomatic infections were observed most frequently in December. We detected 4 cases of NV infection caused by household transmission, and 3 of the 4 transmissions originated from asymptomatic individuals. We also identified a case in which norovirus derived from an asymptomatic individual caused diarrhea in a family member. These results suggest that asymptomatic individuals play a substantial role in both the maintenance and spreading of norovirus in a community through household transmission.
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Affiliation(s)
- Benjarat Phattanawiboon
- Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Nonthaburi, Thailand
| | - Nutthawan Nonthabenjawan
- Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Nonthaburi, Thailand
| | - Patcharaporn Boonyos
- Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Nonthaburi, Thailand
| | - Chanya Jetsukontorn
- Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Nonthaburi, Thailand
| | | | | | | | - Kriangsak Ruchusatsawat
- Department of Medical Sciences, National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Ballang Uppapong
- Department of Medical Sciences, National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Somchai Sangkitporn
- Department of Medical Sciences, National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Eisuke Mekada
- Research and Education Promotion Foundation, Bangkok, Thailand
| | - Yoshiharu Matsuura
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Masashi Tatsumi
- Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Nonthaburi, Thailand
| | - Hiroto Mizushima
- Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Nonthaburi, Thailand
- * E-mail:
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Abstract
Enteric pathogens have been related to child undernutrition. Whereas there are lots of data on enteric bacterial microbiota and infections, much less is known about the incidence of prevalence of intestinal colonisation with viruses or important parasitic species. This study assessed the presence of selected viruses and parasites in stools of 469, 354, 468 Malawian children at 6, 12 and 18 months. We also assessed environmental predictors of the presence of viruses and parasites among 6-month infants. Microbial presence was documented using real-time polymerase chain reaction (PCR). Enteroviruses were identified in 68%, 80% and 81% of the stool samples at 6, 12 and 18 months children, rhinovirus in 28%, 18% and 31%, norovirus in 24%, 22% and 16%, parechovirus in 23%, 17% and 17%, rotavirus in 3%, 1% and 0.6%, Giardia lamblia in 9.6%, 23.5% and 26%, and Cryptosporidium (spp.) in 6%, 8% and 2% of the 6, 12 and 18 months stool samples. Dry season (May–October) was associated with a low infection rate of enterovirus, norovirus and Cryptosporidium (spp.). Higher father's education level, less number of person in the household and higher sanitation were associated with a low infection rate of enterovirus, norovirus and rotavirus, respectively. The results suggest that the prevalence of asymptomatic viral and parasitic infections is high among Malawian children and that the family's living conditions and seasonality influence the rate of infections.
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Abstract
Norovirus, a major cause of gastroenteritis in people of all ages worldwide, was first reported in South Korea in 1999. The most common causal agents of pediatric acute gastroenteritis are norovirus and rotavirus. While vaccination has reduced the pediatric rotavirus infection rate, norovirus vaccines have not been developed. Therefore, prediction and prevention of norovirus are very important. Norovirus is divided into genogroups GI-GVII, with GII.4 being the most prevalent. However, in 2012-2013, GII.17 showed a higher incidence than GII.4 and a novel variant, GII.P17-GII.17, appeared. In this study, 204 stool samples collected in 2013-2014 were screened by reverse transcriptase-polymerase chain reaction; 11 GI (5.39%) and 45 GII (22.06%) noroviruses were identified. GI.4, GI.5, GII.4, GII.6 and GII.17 were detected. The whole genomes of the three norovirus GII.17 were sequenced. The whole genome of GII.17 consists of three open reading frames of 5109, 1623 and 780 bp. Compared with 20 GII.17 strains isolated in other countries, we observed numerous changes in the protruding P2 domain of VP1 in the Korean GII.17 viruses. Our study provided genome information that might aid in epidemic prevention, epidemiology studies and vaccine development.
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Qi R, Huang YT, Liu JW, Sun Y, Sun XF, Han HJ, Qin XR, Zhao M, Wang LJ, Li W, Li JH, Chen C, Yu XJ. Global Prevalence of Asymptomatic Norovirus Infection: A Meta-analysis. EClinicalMedicine 2018; 2-3:50-58. [PMID: 31193628 PMCID: PMC6537540 DOI: 10.1016/j.eclinm.2018.09.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/30/2018] [Accepted: 09/03/2018] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Studies about asymptomatic norovirus infections have been frequently reported. We aim to assess the global prevalence of asymptomatic infections. METHOD We identified publications that included the proportion of asymptomatic norovirus infections by searching in PubMed, Ovid, Scopus, and Web of Science and by screening references from the articles reviewed. The principal summary data were the prevalence of asymptomatic norovirus infection. Random-effect models for meta-analysis were fitted to generate estimates of overall and subgroup prevalence. FINDINGS Of 81 studies included, asymptomatic norovirus prevalence was estimated at 7% (95% CI: 6%-9%). Africa, Meso America and South America had higher prevalence (15%, 14%, 11%, respectively) while the prevalence in Europe and North America was lower (4%). Prevalence was similar between community and hospital (9%). Prevalence was higher in children (8%) than adults (4%). For food handlers, prevalence was estimated at 3%. In context of outbreaks, prevalence estimated from 15 studies was as high as 18% (95% CI: 10%-30%). INTERPRETATION This knowledge could have an impact on the development of transmission prevention strategies in the future. The high prevalence indicated asymptomatic individuals must not be overlooked. OUTSTANDING QUESTIONS The high prevalence indicated asymptomatic individuals must not be overlooked. Asymptomatic individuals may play an important role in norovirus transmission. This knowledge could have an impact on the development of transmission prevention strategies.
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Affiliation(s)
- Rui Qi
- School of Health Sciences, State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei Province, China
| | - Yu-ting Huang
- School of Public Health, Shandong University, Jinan, Shandong Province, China
| | - Jian-wei Liu
- School of Health Sciences, State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei Province, China
| | - Yue Sun
- School of Public Health, Shandong University, Jinan, Shandong Province, China
| | - Xi-feng Sun
- School of Public Health, Shandong University, Jinan, Shandong Province, China
| | - Hui-Ju Han
- School of Health Sciences, State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei Province, China
| | - Xiang-Rong Qin
- School of Health Sciences, State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei Province, China
| | - Min Zhao
- School of Health Sciences, State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei Province, China
| | - Li-jun Wang
- School of Health Sciences, State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei Province, China
| | - Wenqian Li
- School of Public Health, Shandong University, Jinan, Shandong Province, China
| | - Jun-hong Li
- Changzhou Center for Disease Control and Prevention, Changzhou, Jiangsu Province, China
| | - Cong Chen
- Changzhou Center for Disease Control and Prevention, Changzhou, Jiangsu Province, China
| | - Xue-Jie Yu
- School of Health Sciences, State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei Province, China
- Departments of Pathology, University of Texas Medical Branch, Galveston, TX, USA
- Corresponding author at: School of Health Sciences and State Key Laboratory of Virology, Wuhan University, Wuhan, China, No. 115 Donghu Road, Wuhan, 430071, Hubei Province, China; Departments of Pathology, University of Texas Medical Branch, Galveston, TX 77555-0609, USA.
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Koo HS, Lee MO, Ku PT, Hwang SJ, Park DJ, Baik HS. Molecular epidemiology of norovirus in asymptomatic food handlers in Busan, Korea, and emergence of genotype GII.17. J Microbiol 2016; 54:686-94. [PMID: 27687231 DOI: 10.1007/s12275-016-6312-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/23/2016] [Accepted: 08/25/2016] [Indexed: 10/20/2022]
Abstract
The molecular epidemiology of norovirus infections was studied in food handlers without any symptoms from January to December 2015 in Busan city, Korea. A total of 2,174 fecal specimens from asymptomatic food handlers were analyzed, and 2.3% (49/2,174) were norovirus-positive. Fourteen of 335 samples (4.2%) were positive in January; fifteen of 299 samples (5.0%) in February, and seven of 189 samples (3.7%) in December. However, norovirus was rarely detected in other months. From sequencing analysis, 11 genotypes (five GI and six GII genotypes) were detected. Among the 42 capid gene sequences identified, 14 were from the GI genogroup, while 28 were from the GII genogroup. The most commonly detected genotype was GII.17, comprising 15 (35.7%) of positive samples. From January 2012 to December 2015, 5,138 samples were collected from gastroenteritis patients and outbreaks in Busan. The most detected genotype in 2012, 2013, and 2014 was GII.4 (121, 24, and 12 cases, respectively), but in 2015, GII.17 (25 cases) was the most common. The GII.4 genotype was the major cause of acute gastroenteritis from 2012 to 2014, but the GII.17 genotype became the most prevalent cause in 2015. Continued epidemiological surveillance of GII.17 is needed, together with assessment of the risk of norovirus infection.
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Affiliation(s)
- Hee Soo Koo
- Busan Metropolitan Government Research Institute of Health and Environment, Busan, 46616, Republic of Korea
| | - Mi Ok Lee
- Busan Metropolitan Government Research Institute of Health and Environment, Busan, 46616, Republic of Korea
| | - Pyeong Tae Ku
- Busan Metropolitan Government Research Institute of Health and Environment, Busan, 46616, Republic of Korea
| | - Su Jeong Hwang
- Busan Metropolitan Government Research Institute of Health and Environment, Busan, 46616, Republic of Korea
| | - Dong Ju Park
- Busan Metropolitan Government Research Institute of Health and Environment, Busan, 46616, Republic of Korea
| | - Hyung Suk Baik
- Department of Microbiology, Pusan National University, Busan, 46241, Republic of Korea.
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Determination of cut-off cycle threshold values in routine RT-PCR assays to assist differential diagnosis of norovirus in children hospitalized for acute gastroenteritis. Epidemiol Infect 2015; 143:3292-9. [PMID: 26418350 PMCID: PMC4594052 DOI: 10.1017/s095026881500059x] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Norovirus (NV) is an important cause of acute gastroenteritis in children, but is also frequently detected in asymptomatic children, which complicates the interpretation of NV detection results in both the clinical setting and population prevalence studies. A total of 807 faecal samples from children aged <5 years hospitalized for acute gastroenteritis were collected in Thai Binh, Vietnam, from January 2011 to September 2012. Real-time RT-PCR was used to detect and quantify NV-RNA in clinical samples. A bimodal distribution of cycle threshold (Ct) values was observed in which the lower peak was assumed to represent cases for which NV was the causal agent of diarrhoea, whereas the higher peak was assumed to represent cases involving an alternative pathogen other than NV. Under these assumptions, we applied finite-mixture modelling to estimate a threshold of Ct <21·36 (95% confidence interval 20·29-22·46) to distinguish NV-positive patients for which NV was the likely cause of diarrhoea. We evaluated the validity of the threshold through comparisons with NV antigen ELISA results, and comparisons of Ct values in patients co-infected with rotavirus. We conclude that the use of an appropriate cut-off value in the interpretation of NV real-time RT-PCR results may improve differential diagnosis of enteric infections, and could contribute to improved estimates of the burden of NV disease.
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8
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Chung JY, Kim MS, Jung TW, Kim SJ, Kang JH, Han SB, Kim SY, Rhim JW, Kim HM, Park JH, Jo DS, Ma SH, Jeong HS, Cheon DS, Kim JH. Detection of Rotavirus Genotypes in Korea 5 Years after the Introduction of Rotavirus Vaccines. J Korean Med Sci 2015; 30:1471-5. [PMID: 26425045 PMCID: PMC4575937 DOI: 10.3346/jkms.2015.30.10.1471] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 07/07/2015] [Indexed: 11/20/2022] Open
Abstract
Rotavirus (RV) is one of the most important viral etiologic agents of acute gastroenteritis (AGE) in children. Although effective RV vaccines (RVVs) are now used worldwide, novel genotypes and outbreaks resulting from rare genotype combinations have emerged. This study documented RV genotypes in a Korean population of children with AGE 5 yr after the introduction of RVV and assessed potential genotype differences based on vaccination status or vaccine type. Children less than 5-yr-old diagnosed with AGE between October 2012 and September 2013 admitted to 9 medical institutions from 8 provinces in Korea were prospectively enrolled. Stool samples were tested for RV by enzyme immunoassay and genotyped by multiplex reverse-transcription polymerase chain reaction. In 346 patients, 114 (32.9%) were RV-positive. Among them, 87 (76.3%) patients were infected with RV alone. Eighty-six of 114 RV-positive stool samples were successfully genotyped, and their combinations of genotypes were G1P[8] (36, 41.9%), G2P[4] (12, 14.0%), and G3P[8] (6, 7.0%). RV was detected in 27.8% of patients in the vaccinated group and 39.8% in the unvaccinated group (P=0.035). Vaccination history was available for 67 of 86 cases with successfully genotyped RV-positive stool samples; RotaTeq (20, 29.9%), Rotarix (7, 10.4%), unvaccinated (40, 59.7%). The incidence of RV AGE is lower in the RV-vaccinated group compared to the unvaccinated group with no evidence of substitution with unusual genotype combinations.
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Affiliation(s)
- Ju-Young Chung
- Department of Pediatrics, Sanggyepaik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Min-Sung Kim
- Department of Pediatrics, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Tae Woong Jung
- Department of Pediatrics, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Seong Joon Kim
- Department of Pediatrics, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jin-Han Kang
- Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung Beom Han
- Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang Yong Kim
- Department of Pediatrics, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Jung Woo Rhim
- Department of Pediatrics, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Hwang-Min Kim
- Department of Pediatrics, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jae Hong Park
- Department of Pediatrics, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Dae Sun Jo
- Department of Pediatrics, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
| | - Sang Hyuk Ma
- Department of Pediatrics, Changwon Fatima Hospital, Changwon, Korea
| | - Hye-Sook Jeong
- Division of Vaccine Research, Center for Infectious Diseases, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongwon, Korea
| | - Doo-Sung Cheon
- Division of Vaccine Research, Center for Infectious Diseases, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongwon, Korea
| | - Jong-Hyun Kim
- Department of Pediatrics, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
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9
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Lee M, Seo DJ, Seo J, Oh H, Jeon SB, Ha SD, Myoung J, Choi IS, Choi C. Detection of viable murine norovirus using the plaque assay and propidium-monoazide-combined real-time reverse transcription-polymerase chain reaction. J Virol Methods 2015; 221:57-61. [DOI: 10.1016/j.jviromet.2015.04.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 03/17/2015] [Accepted: 04/17/2015] [Indexed: 01/24/2023]
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10
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Norovirus prevention and the prevalence of asymptomatic norovirus infection in kindergartens and primary schools in Changzhou, China: Status of the knowledge, attitudes, behaviors, and requirements. Am J Infect Control 2015; 43:833-8. [PMID: 26026827 DOI: 10.1016/j.ajic.2015.04.182] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 04/09/2015] [Accepted: 04/09/2015] [Indexed: 01/12/2023]
Abstract
BACKGROUND We estimated the status of norovirus infection and prevention in kindergartens and primary schools and identified poor areas for which future education is needed. We evaluated the knowledge, attitude, behavior, requirements of outbreak prevention, and rate of asymptomatic carriers. METHODS Two self-administered questionnaires were conducted for data collection. Five hundred seventy-four teachers from kindergartens and primary schools and 3,114 students from primary schools in Changzhou city were sampled for questionnaire investigation. In addition, 511 rectal swabs from healthy children were taken for norovirus detection. RESULTS Twenty-one of 511 children were asymptomatically infected with norovirus. The rate of asymptomatic norovirus infection children in kindergartens was 2.7% and 4.7% in primary schools. Nineteen of 21 positive samples were GII strains, the other 2 were GI strains. In addition, we found that primary schools were less prepared to prevent norovirus outbreaks than kindergartens. Settings in the suburban counties needed more education on norovirus prevention. CONCLUSIONS The results of this study emphasize the need for training of primary schools and suburban schools about norovirus prevention. Asymptomatic norovirus infection should receive more attention.
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Nice TJ, Baldridge MT, McCune BT, Norman JM, Lazear HM, Artyomov M, Diamond MS, Virgin HW. Interferon-λ cures persistent murine norovirus infection in the absence of adaptive immunity. Science 2014; 347:269-73. [PMID: 25431489 DOI: 10.1126/science.1258100] [Citation(s) in RCA: 271] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Norovirus gastroenteritis is a major public health burden worldwide. Although fecal shedding is important for transmission of enteric viruses, little is known about the immune factors that restrict persistent enteric infection. We report here that although the cytokines interferon-α (IFN-α) and IFN-β prevented the systemic spread of murine norovirus (MNoV), only IFN-λ controlled persistent enteric infection. Infection-dependent induction of IFN-λ was governed by the MNoV capsid protein and correlated with diminished enteric persistence. Treatment of established infection with IFN-λ cured mice in a manner requiring nonhematopoietic cell expression of the IFN-λ receptor, Ifnlr1, and independent of adaptive immunity. These results suggest the therapeutic potential of IFN-λ for curing virus infections in the gastrointestinal tract.
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Affiliation(s)
- Timothy J Nice
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Megan T Baldridge
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Broc T McCune
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jason M Norman
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Helen M Lazear
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Maxim Artyomov
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Michael S Diamond
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA. Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA. Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Herbert W Virgin
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA.
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12
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First norovirus outbreaks associated with consumption of green seaweed (Enteromorpha spp.) in South Korea. Epidemiol Infect 2014; 143:515-21. [PMID: 24866366 DOI: 10.1017/s0950268814001332] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
In February 2012, an outbreak of gastroenteritis was reported in school A; a successive outbreak was reported at school B. A retrospective cohort study conducted in school A showed that seasoned green seaweed with radishes (relative risk 7·9, 95% confidence interval 1·1-56·2) was significantly associated with illness. Similarly, a case-control study of students at school B showed that cases were 5·1 (95% confidence interval 1·1-24·8) times more likely to have eaten seasoned green seaweed with pears. Multiple norovirus genotypes were detected in samples from students in schools A and B. Norovirus GII.6 isolated from schools A and B were phylogenetically indistinguishable. Green seaweed was supplied by company X, and norovirus GII.4 was isolated from samples of green seaweed. Green seaweed was assumed to be linked to these outbreaks. To our knowledge, this is the first reported norovirus outbreak associated with green seaweed.
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13
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Norman JM, Handley SA, Virgin HW. Kingdom-agnostic metagenomics and the importance of complete characterization of enteric microbial communities. Gastroenterology 2014; 146:1459-69. [PMID: 24508599 PMCID: PMC4009354 DOI: 10.1053/j.gastro.2014.02.001] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 01/27/2014] [Accepted: 02/03/2014] [Indexed: 12/13/2022]
Abstract
Advanced sequencing techniques have shown that bacteria are not the only complex and important microbes in the human intestine. Nonbacterial organisms, particularly the virome and the mycobiome, are important regulators of intestinal immunity and inflammation. The virome is mucosal and systemic; it can alter the host response to bacteria and interact with host genes and bacteria to contribute to disease pathogenesis. The human mycobiome is also complex and can contribute to intestinal inflammation. We review what has recently been learned about the nonbacterial and nonarchaeal microbes in the gastrointestinal tract, discussing their potential effects on health and disease and analytical approaches for their study. Studies of associations between the microbiome and intestinal pathology should incorporate kingdom-agnostic approaches if we are to fully understand intestinal health and disease.
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Affiliation(s)
| | | | - Herbert W. Virgin
- Reprint requests Address requests for reprints to: Herbert W. Virgin, MD, PhD, Washington University School of Medicine, Box 8118, 660 South Euclid Avenue, St Louis, Missouri 63110.
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14
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Mans J, van Zyl WB, Taylor MB, Page NA, Sobsey MD, Barnard TG, Potgieter N. Applicability of Bio-wipes for the collection of human faecal specimens for detection and characterisation of enteric viruses. Trop Med Int Health 2013; 19:293-300. [DOI: 10.1111/tmi.12251] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- J. Mans
- Department of Medical Virology; University of Pretoria; Pretoria South Africa
| | - W. B. van Zyl
- Department of Medical Virology; University of Pretoria; Pretoria South Africa
| | - M. B. Taylor
- Department of Medical Virology; University of Pretoria; Pretoria South Africa
- National Health Laboratory Service; Tswhane Academic Division; Pretoria South Africa
| | - N. A. Page
- Virology Division, Center for Enteric Diseases; National Institute for Communicable Diseases; Johannesburg South Africa
| | - M. D. Sobsey
- Department of Environmental Sciences and Engineering; University of North Carolina; Chapel Hill NC USA
| | - T. G. Barnard
- Water and Health Research Centre; University of Johannesburg; Doornfontein South Africa
| | - N. Potgieter
- Department of Microbiology; University of Venda; Thohoyandou South Africa
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15
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Lee MH, Lee BH, Jung JY, Cheon DS, Kim KT, Choi C. Antiviral effect of korean red ginseng extract and ginsenosides on murine norovirus and feline calicivirus as surrogates for human norovirus. J Ginseng Res 2013; 35:429-35. [PMID: 23717088 PMCID: PMC3659551 DOI: 10.5142/jgr.2011.35.4.429] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 08/22/2011] [Accepted: 08/22/2011] [Indexed: 11/30/2022] Open
Abstract
Korean red ginseng has been studied various biological activities such as immune, anti-oxidative, anti-microbial, and anticancer activities but antiviral mechanism needs further studies. In this study, we aimed to examine the antiviral effects of Korea red ginseng extract and ginsenosides on norovirus surrogate, including murine norovirus (MNV) and feline calicivirus (FCV). We evaluated the pre-, co-, and post-treatment effects of Korean red ginseng (KRG), ginsenosides Rb1 and Rg1. To measure the antiviral effect and cytotoxicity of KRG extract, and ginsenosides Rb1 and Rg1, we treated Crandell-Reese Feline Kidney for FCV or RAW264.7 cells for MNV with concentrations of 0, 5, 6.7, 10, 20 ug/mL total saponin. There was cytotoxic effect in the highest concentration 20 ug/mL of KRG extract so this concentration was excluded in this study. The FCV titer was significantly reduced to 0.23-0.83 log10 50% tissue culture infectious dose (TCID50)/mL in groups pre-treated with red ginseng extract or ginsenosides. The titer of MNV was significantly reduced to 0.37-1.48 log10 TCID50/mL in groups pre-treated with red ginseng extract or ginsenosides. However, there was no observed antiviral effect in groups co-treated or post-treated with KRG and its constituents. Our data suggest that KRG extract has an antiviral effect against norovirus surrogates. The antiviral mechanisms of KRG and ginsenosides should be addressed in future studies.
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Affiliation(s)
- Min Hwa Lee
- Department of Food and Nutrition, Graduate School, Chung-Ang University, Seoul 156-756, Korea
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Park S, Jung J, Oh S, Jung H, Oh Y, Cho S, Cho S, Cho S, Park H, Jo N, Bae K, Choi S, Kim B, Kim J, Chae Y, Jung H, Cheon D, Kim H. Characterization of norovirus infections in Seoul, Korea. Microbiol Immunol 2013; 56:700-7. [PMID: 22823184 DOI: 10.1111/j.1348-0421.2012.00494.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The present study has determined the detection rate of norovirus (NoV) with acute gastroenteritis (AGE) in hospitalized children and describes the molecular epidemiology of NoV circulating in Seoul, Korea. Six hundred and eighty-three (9.8%) of samples were positive for NoV. Of these, the NoV GII genogroup was the most commonly found, with a prevalence of 96.2% (683 of 710). Only 27 samples were positive for the NoV GI genogroup. Ten kinds of GI genotype (GI/1, GI/2, GI/3, GI/4, GI/5, GI/6, GI/7, GI/9, GI/12, and GI/13) and eight kinds of GII genotype (GII/2, GII/3, GII/4, GII/8, GII/14, GII/15, GII/16, and GII/17) were identified in children with AGE during the years 2008-2011.
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Affiliation(s)
- Sanghun Park
- Seoul Metropolitan Government Research Institute of Public Health and Environment, Microbiology Team, 202-3 Yangjae-Dong, Seocho-Gu, Korea.
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17
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Occurrence of norovirus infections in asymptomatic food handlers in South Korea. J Clin Microbiol 2012; 51:598-600. [PMID: 23175251 DOI: 10.1128/jcm.01856-12] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Prevalence of asymptomatic norovirus infection was investigated in food handlers in South Korea. Among 6,441 subjects, 66 (1.02%) had norovirus infections confirmed by reverse transcription (RT)-PCR (real time and nested). GII-12 and GII-4 were the prevalent genotypes. Our data suggest that infection of asymptomatic food handlers is an important transmission source in norovirus outbreaks.
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A single-amino-acid change in murine norovirus NS1/2 is sufficient for colonic tropism and persistence. J Virol 2012; 87:327-34. [PMID: 23077309 DOI: 10.1128/jvi.01864-12] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Human norovirus (HuNoV) is the major cause of acute nonbacterial gastroenteritis worldwide but has no clear animal reservoir. HuNoV can persist after the resolution of symptoms, and this persistence may be essential for viral maintenance within the population. Many strains of the related murine norovirus (MNV) also persist, providing a tractable animal model for studying norovirus (NoV) persistence. We have used recombinant cDNA clones of representative persistent (CR6) and nonpersistent (CW3) strains to identify a domain within the nonstructural gene NS1/2 that is necessary and sufficient for persistence. Furthermore, we found that a single change of aspartic acid to glutamic acid in CW3 NS1/2 was sufficient for persistence. This same conservative change also caused increased growth of CW3 in the proximal colon, which we found to be a major tissue reservoir of MNV persistence, suggesting that NS1/2 determines viral tropism that is necessary for persistence. These findings represent the first identified function for NoV NS1/2 during infection and establish a novel model system for the study of enteric viral persistence.
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Lee MH, Yoo SH, Ha SD, Choi C. Inactivation of feline calicivirus and murine norovirus during Dongchimi fermentation. Food Microbiol 2012; 31:210-4. [PMID: 22608225 DOI: 10.1016/j.fm.2012.04.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Revised: 03/16/2012] [Accepted: 04/04/2012] [Indexed: 12/11/2022]
Abstract
Among the traditional fermented vegetables in Korea, Dongchimi is a type of kimchi with a large water base. We aimed to investigate the survival of norovirus surrogates during Dongchimi fermentation. Dongchimi spiked with feline calicivirus (FCV) or murine norovirus (MNV) was prepared following a traditional recipe. Dongchimi was initially fermented at room temperature overnight and then kept at 4 °C. The number of lactic acid bacteria, pH, acidity, and virus titer were measured 0, 1, 2, 3, 5, 7, 10, 15, 20 days after fermentation. During the fermentation process, lactic acid bacteria and acidity increased. At the end of the fermentation, population of FCV and MNV decreased about 4.12 and 1.47 log units, respectively. Based on the significant reduction of norovirus surrogate during Dongchimi fermentation, we conclude that the risk of norovirus in Dongchimi may be low.
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Affiliation(s)
- Min Hwa Lee
- Department of Food and Nutrition, Chung-Ang University, Republic of Korea
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Ayukekbong J, Lindh M, Nenonen N, Tah F, Nkuo-Akenji T, Bergström T. Enteric viruses in healthy children in Cameroon: viral load and genotyping of norovirus strains. J Med Virol 2012; 83:2135-42. [PMID: 22012721 DOI: 10.1002/jmv.22243] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Data regarding prevalence of noroviruses (NoVs) among asymptomatic persons are scarce. The current study carried out on samples from Cameroon describes the asymptomatic shedding of NoVs and other enteric viruses in healthy children and in adults infected with HIV but lacking symptoms of gastroenteritis. Enteric viruses were common with a prevalence of 53.7% in the children, and 35.5% in the adult participants. Multiple enteric viruses (2-5 agents) were detected in fecal samples from 65% of the children, and co-infection with NoV was demonstrated in almost all cases of multiple infections. NoV viral loads in the healthy children were within disease causing range and significantly higher than those observed in the adults (P < 0.01). Sequencing and genotyping of NoV strains by phylogeny showed a marked diversity within two distinct genogroups, GI and GII, and strains clustered with genotypes GI.3, GII.17, GII.8, and GII.4. Genetic similarities to recent outbreak strains from other continents suggest a rapid circulation of NoVs that includes healthy children, who may constitute a reservoir for pathogenic NoVs.
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Affiliation(s)
- James Ayukekbong
- Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden
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