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Riller Q, Schmutz M, Fourgeaud J, Fischer A, Neven B. Protective role of antibodies in enteric virus infections: Lessons from primary and secondary immune deficiencies. Immunol Rev 2024. [PMID: 39340232 DOI: 10.1111/imr.13402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2024]
Abstract
Enteric viruses are the main cause of acute gastroenteritis worldwide with a significant morbidity and mortality, especially among children and aged adults. Some enteric viruses also cause disseminated infections and severe neurological manifestations such as poliomyelitis. Protective immunity against these viruses is not well understood in humans, with most knowledge coming from animal models, although the development of poliovirus and rotavirus vaccines has extended our knowledge. In a classical view, innate immunity involves the recognition of foreign DNA or RNA by pathogen recognition receptors leading to the production of interferons and other inflammatory cytokines. Antigen uptake and presentation to T cells and B cells then activate adaptive immunity and, in the case of the mucosal immunity, induce the secretion of dimeric IgA, the more potent immunoglobulins in viral neutralization. The study of Inborn errors of immunity (IEIs) offers a natural opportunity to study nonredundant immunity toward pathogens. In the case of enteric viruses, patients with a defective production of antibodies are at risk of developing neurological complications. Moreover, a recent description of patients with low or absent antibody production with protracted enteric viral infections associated with hepatitis reinforces the prominent role of B cells and immunoglobulins in the control of enteric virus.
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Affiliation(s)
- Quentin Riller
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Imagine Institute, Université Paris Cité, INSERM UMR 1163, Paris, France
- IHU-Imagine, Paris, France
| | - Muriel Schmutz
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Imagine Institute, Université Paris Cité, INSERM UMR 1163, Paris, France
- IHU-Imagine, Paris, France
| | - Jacques Fourgeaud
- Université Paris Cité, FETUS, Paris, France
- Microbiology Department, AP-HP, Hôpital Necker, Paris, France
| | - Alain Fischer
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker-Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- INSERM UMRS 1163, Institut Imagine, Paris, France
- Collège de France, Paris, France
| | - Bénédicte Neven
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Imagine Institute, Université Paris Cité, INSERM UMR 1163, Paris, France
- IHU-Imagine, Paris, France
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker-Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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2
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Scott G, Ryder D, Buckley M, Hill R, Treagus S, Stapleton T, Walker DI, Lowther J, Batista FM. Long Amplicon Nanopore Sequencing for Dual-Typing RdRp and VP1 Genes of Norovirus Genogroups I and II in Wastewater. FOOD AND ENVIRONMENTAL VIROLOGY 2024:10.1007/s12560-024-09611-5. [PMID: 39240456 DOI: 10.1007/s12560-024-09611-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 08/15/2024] [Indexed: 09/07/2024]
Abstract
Noroviruses (NoVs) are the leading cause of non-bacterial gastroenteritis with societal costs of US$60.3 billion per annum. Development of a long amplicon nanopore-based method for dual-typing the RNA-dependent RNA polymerase (RdRp) and major structural protein (VP1) regions from a single RNA fragment could improve existing norovirus typing methods. Application to wastewater-based epidemiology (WBE) and environmental testing could enable the discovery of novel types and improve outbreak tracking and source apportionment. Here, we have developed such a method with a consensus-based bioinformatics pipeline and optimised reverse transcription (RT) and PCR procedures. Inhibitor removal and LunaScript® RT gave robust amplification of the ≈ 1000 bp RdRP + VP1 amplicon for both the GI and GII PCR assays. Platinum™ Taq polymerase showed good sensitivity and reduced levels non-specific amplification (NSA) when compared to other polymerases. Optimised PCR annealing temperatures significantly reduced NSA (51.3 and 42.4% for GI and GII), increased yield (86.5% for GII) and increased taxa richness (57.7%) for GII. Analysis of three NoV positive faecal samples showed 100% nucleotide similarity with Sanger sequencing. Eight GI genotypes, 11 polymerase types (p-types) and 13 combinations were detected in wastewater along with 4 GII genotypes, 4 p-types and 8 combinations; highlighting the diversity of norovirus taxa present in wastewater in England. The most common genotypes detected in clinical samples were all detected in wastewater while we also frequently detected several GI genotypes not reported in the clinical data. Application of this method into a WBE scheme, therefore, may allow for more accurate measurement of norovirus diversity within the population.
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Affiliation(s)
- G Scott
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, UK.
| | - D Ryder
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, UK
| | - M Buckley
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, UK
| | - R Hill
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, UK
| | - S Treagus
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, UK
- UK Health Security Agency, Salisbury, UK
| | - T Stapleton
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, UK
| | - D I Walker
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, UK
| | - J Lowther
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, UK
| | - F M Batista
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, UK
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3
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Chigor VN, Digwo DC, Adediji A, Chidebelu PE, Chigor CB, Ugwu KO, Ibangha IAI, Street R, Farkas K. Epidemiology of norovirus infection in Nigeria: a systematic review and meta-analysis. Arch Virol 2024; 169:138. [PMID: 38847856 DOI: 10.1007/s00705-024-06056-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/23/2024] [Indexed: 06/13/2024]
Abstract
Human norovirus (HuNoV) is responsible for most cases of gastroenteritis worldwide, but information about the prevalence and diversity of HuNoV infections in lower-income settings is lacking. In order to provide more information about the burden and distribution of norovirus in Nigeria, we systematically reviewed original published research articles on the prevalence of HuNoV in Nigeria by accessing databases, including PubMed, Web of Science, ScienceDirect, Google Scholar, and African Journals Online (AJOL). The protocol for the review was registered on PROSPERO (registration number CRD42022308857). Thirteen relevant articles were included in the review, and 10 of them were used for meta-analysis. The pooled prevalence of HuNoV-associated gastroenteritis among children below 5 years of age in Nigeria, determined using the random-effects model, was 10.9% (95% CI, 6.7-16.7%). Among children below the age of 5 presenting with HuNoV infections, the highest prevalence was in children ≤2 years old (n = 127, 83%). The prevalence of HuNoV infections was seen to decrease with increasing age. In addition, HuNoV was detected in asymptomatic food handlers, bats, and seafoods. A total of 85 sequences of HuNoV isolates from Nigeria have been determined, and based on those sequences, the most prevalent norovirus genogroup was GII (84%). Genotypes GII.4 and GI.3 were the most frequently identified genotypes, with GII.4 constituting 46% of all of the HuNoVs identified in Nigeria. These results suggest a risk associated with cocirculation of emerging variants with known genotypes because of their recombination potential. Larger molecular epidemiological studies are still needed to fully understand the extent and pattern of circulation of HuNoVs in Nigeria.
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Affiliation(s)
- Vincent N Chigor
- Water and Public Health Research Group (WPHRG), Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, 410001, Nigeria.
| | - Daniel C Digwo
- Water and Public Health Research Group (WPHRG), Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, 410001, Nigeria
| | - Adedapo Adediji
- Water and Public Health Research Group (WPHRG), Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, 410001, Nigeria
| | - Paul E Chidebelu
- Water and Public Health Research Group (WPHRG), Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, 410001, Nigeria
| | - Chinyere B Chigor
- Water and Public Health Research Group (WPHRG), Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, 410001, Nigeria
| | - Kenneth O Ugwu
- Water and Public Health Research Group (WPHRG), Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, 410001, Nigeria
| | - Ini-Abasi I Ibangha
- Water and Public Health Research Group (WPHRG), Department of Microbiology, Faculty of Biological Sciences, University of Nigeria, Nsukka, 410001, Nigeria
| | - Renee Street
- South African Medical Research Council, Environment & Health Research Unit, Durban, KwaZulu-Natal, South Africa
| | - Kata Farkas
- School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey, LL59 5AB, United Kingdom
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4
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Sekiya S, Masuoka H, Mizuno Y, Kibe M, Kosaka S, Natsuhara K, Hirayama K, Inthavong N, Kounnavong S, Tomita S, Takayasu L, Suda W, Yagyu F, Umezaki M. Asymptomatic Enteric Virus Infections and Association with the Gut Microbiome in Rural Residents of Northern Laos. Am J Trop Med Hyg 2024; 110:759-767. [PMID: 38471149 PMCID: PMC10993851 DOI: 10.4269/ajtmh.23-0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 12/03/2023] [Indexed: 03/14/2024] Open
Abstract
Viral gastrointestinal infections are an important public health concern, and the occurrence of asymptomatic enteric virus infections makes it difficult to prevent and control their spread. This study aimed to determine the prevalence of and factors associated with asymptomatic enteric virus infection in adults in northern Laos. Fecal samples were collected from apparently healthy participants who did not report diarrhea or high fever at the time of the survey in northern Laos, and enteric viruses were detected using polymerase chain reaction (PCR) and reverse transcription (RT)-PCR. Individual characteristics, including the gut microbiome, were compared between asymptomatic carriers and noncarriers of each enteric virus. Of the participants (N = 255), 12 (4.7%) were positive for norovirus genogroup I (GI), 8 (3.1%) for human adenovirus, and 1 (0.4%) for norovirus GII; prevalence tended to be higher in less-modernized villages. Gut microbial diversity (evaluated by the number of operational taxonomic units) was higher in asymptomatic carriers of norovirus GI or human adenovirus than in their noncarriers. Gut microbiome compositions differed significantly between asymptomatic carriers and noncarriers of norovirus GI or human adenovirus (permutational analysis of variance, P <0.05). These findings imply an association between asymptomatic enteric virus infection and modernization and/or the gut microbiome in northern Laos.
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Affiliation(s)
- Sae Sekiya
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroaki Masuoka
- Laboratory for Microbiome Science, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Yuki Mizuno
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mihoko Kibe
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoko Kosaka
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Kazuhiro Hirayama
- Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Nouhak Inthavong
- Ministry of Health, Lao Tropical and Public Health Institute, Vientiane, Laos
| | | | - Shinsuke Tomita
- Graduate School of Environmental Studies, Nagoya University, Nagoya, Japan
| | - Lena Takayasu
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Wataru Suda
- Laboratory for Microbiome Science, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Fumihiro Yagyu
- Graduate School of International Development and Cooperation, Kibi International University, Hyogo, Japan
| | - Masahiro Umezaki
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Victor CP, Leon JS, Williams AM. Vitamin A biomarkers were associated with α(1)-acid glycoprotein and C-reactive protein over the course of a human norovirus challenge infection. Br J Nutr 2024; 131:482-488. [PMID: 37694547 PMCID: PMC10784129 DOI: 10.1017/s0007114523002076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/26/2023] [Accepted: 09/06/2023] [Indexed: 09/12/2023]
Abstract
Retinol binding protein (RBP) is used as a proxy for retinol in population-based assessments of vitamin A deficiency (VAD) for cost-effectiveness and feasibility. When the cut-off of < 0·7 μmol/l for retinol is applied to RBP to define VAD, an equivalence of the two biomarkers is assumed. Evidence suggests that the relationship between retinol and RBP is not 1:1, particularly in populations with a high burden of infection or inflammation. The goal of this analysis was to longitudinally evaluate the retinol:RBP ratio over 1 month of follow-up among fifty-two individuals exposed to norovirus (n 26 infected, n 26 uninfected), test whether inflammation (measured as α-1-acid glycoprotein (AGP) and C-reactive protein (CRP)) affects retinol, RBP and the ratio between the two and assess whether adjusting vitamin A biomarkers for AGP or CRP improves the equivalence of retinol and RBP. We found that the median molar ratio between retinol and RBP was the same among infected (0·68) and uninfected (0·68) individuals. AGP was associated with the ratio and RBP individually, controlling for CRP, and CRP was associated with both retinol and RBP individually, controlling for AGP over 1 month of follow-up. Adjusting for inflammation led to a slight increase in the ratio among infected individuals (0·71) but remained significantly different from the expected value of one. These findings highlight the need for updated recommendations from the WHO on a cut-off value for RBP and an appropriate method for measuring and adjusting for inflammation when using RBP in population assessments of VAD.
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Affiliation(s)
- Courtney P. Victor
- Hubert Department of Global Health, Emory University, Atlanta, GA30322, USA
| | - Juan S. Leon
- Hubert Department of Global Health, Emory University, Atlanta, GA30322, USA
| | - Anne M. Williams
- Hubert Department of Global Health, Emory University, Atlanta, GA30322, USA
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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6
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Wang J, Ji ZH, Zhang SB, Yang ZR, Sun XQ, Zhang H. Asymptomatic norovirus infection during outbreaks in China: A systematic review and meta-analysis. J Med Virol 2024; 96:e29393. [PMID: 38235934 DOI: 10.1002/jmv.29393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/05/2023] [Accepted: 01/01/2024] [Indexed: 01/19/2024]
Abstract
Acute gastroenteritis outbreaks may be caused by the excretion of norovirus (NoV) from asymptomatic individuals. Despite numerous studies involving asymptomatic NoV infection during outbreaks in China, a comprehensive assessment of its role has not been conducted, which is critical for emergency management. Our objective was to assess the prevalence of asymptomatic NoV infection during outbreaks in China. We conducted a comprehensive search of multiple databases, including PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, China Wanfang, and China Weipu, between January 1, 1997 and June 19, 2023. The retrieved articles and their references underwent screening, which utilized polymerase chain reaction-based assays for the detection of NoV in asymptomatic individuals during outbreaks that occurred in China. The primary summary data were the prevalence of asymptomatic NoV infection in outbreaks. We generated pooled estimates of asymptomatic prevalence in the population as a whole and in subgroups by using random-effect models. Of the 97 articles included, the pooled asymptomatic prevalence of NoV among 5117 individuals in outbreaks was 17.6% (95% confidence interval [CI]: 14.1-21.3). The asymptomatic prevalence of NoV GII (17.1%, 95% CI: 12.9-21.5) was similar to that of NoV GI (22.0%, 95% CI: 12.8-32.4). However, the proportion of asymptomatic individuals involved in NoV GII (57.44%) was significantly higher than that of NoV GI (5.12%), and NoV GII (75.26%) was reported much more frequently than NoV GI (14.43%) in the included articles. Meta-regression analysis of 11 possible influencing factors (geographic region, setting, season, sample type, genotype, transmission route, occupation, age, per capita income, study quality, and cases definition) showed that the source of heterogeneity might be related to the outbreak settings, per capita income, and study quality (p = 0.037, 0.058, and 0.026, respectively). Of particular note was the asymptomatic prevalence peaked in preschoolers (27.8%), afterward, it fell into trough in elementary and junior school children (10.5%), before the second peak located in adults (17.8%), and the elderly (25.2%). Prevalent genotypes reported include GII.4, followed by GII.17, GII.2, GII.3, GII.6, and so forth. The estimated asymptomatic prevalence of NoV during outbreaks in China was as high as 17.6%, with NoV GII dominating. In addition, genetic subtypes of NoV in outbreaks should be detected whenever possible. The role of asymptomatic individuals in NoV outbreaks cannot be ignored. This knowledge will help governments develop public health policies and emergency response strategies for outbreaks, assess the burden, and develop vaccines.
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Affiliation(s)
- Jun Wang
- Department of Clinical Laboratory, Jiaozhou Central Hospital, Qingdao, Shandong, China
| | - Zhen-Hao Ji
- Department of Prevention of Infectious Diseases, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Shao-Bai Zhang
- Institute for Prevention and Control of Viral Diseases, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Zu-Rong Yang
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, Shaanxi, China
| | - Xue-Qiang Sun
- Department of Surgery Emergency, Jiaozhou Hospital, East Hospital Affiliated to Tongji University, Qingdao, Shandong, China
| | - Hui Zhang
- Department of Prevention of Infectious Diseases, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, China
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Pliego Zamora A, Kim J, Vajjhala PR, Thygesen SJ, Watterson D, Modhiran N, Bielefeldt-Ohmann H, Stacey KJ. Kinetics of severe dengue virus infection and development of gut pathology in mice. J Virol 2023; 97:e0125123. [PMID: 37850747 PMCID: PMC10688336 DOI: 10.1128/jvi.01251-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/12/2023] [Indexed: 10/19/2023] Open
Abstract
IMPORTANCE Dengue virus, an arbovirus, causes an estimated 100 million symptomatic infections annually and is an increasing threat as the mosquito range expands with climate change. Dengue epidemics are a substantial strain on local economies and health infrastructure, and an understanding of what drives severe disease may enable treatments to help reduce hospitalizations. Factors exacerbating dengue disease are debated, but gut-related symptoms are much more frequent in severe than mild cases. Using mouse models of dengue infection, we have shown that inflammation and damage are earlier and more severe in the gut than in other tissues. Additionally, we observed impairment of the gut mucus layer and propose that breakdown of the barrier function exacerbates inflammation and promotes severe dengue disease. This idea is supported by recent data from human patients showing elevated bacteria-derived molecules in dengue patient serum. Therapies aiming to maintain gut integrity may help to abrogate severe dengue disease.
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Affiliation(s)
- Adriana Pliego Zamora
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Jaehyeon Kim
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Parimala R. Vajjhala
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Sara J. Thygesen
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Daniel Watterson
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, Queensland, Australia
| | - Naphak Modhiran
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Helle Bielefeldt-Ohmann
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, Queensland, Australia
| | - Katryn J. Stacey
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, Queensland, Australia
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Wang J, Gao Z, Yang ZR, Liu K, Zhang H. Global prevalence of asymptomatic norovirus infection in outbreaks: a systematic review and meta-analysis. BMC Infect Dis 2023; 23:595. [PMID: 37700223 PMCID: PMC10496210 DOI: 10.1186/s12879-023-08519-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/07/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Although many studies on asymptomatic norovirus infection in outbreaks have been conducted globally, structured data (important for emergency management of outbreaks) on the prevalence of this epidemic are still not available. This study assessed the global prevalence of asymptomatic norovirus infection in outbreaks. METHODS We identified publications on asymptomatic infections from norovirus outbreaks by searching the PubMed, Embase, Cochrane Library, Medline, and Web of Science databases and screening references from the articles reviewed. Prevalence of asymptomatic norovirus infection in outbreaks was employed as the primary summary data. The random-effects model of the meta-analysis was fitted to generate estimates of the prevalence in the overall and subgroup populations. RESULTS In total, 44 articles with a sample size of 8,115 asymptomatic individuals were included. The estimated pooled prevalence of asymptomatic norovirus infection in outbreaks was 21.8% (95%CI, 17.4-27.3). The asymptomatic prevalence of norovirus GII (20.1%) was similar to that of GI (19.8%); however, the proportion prevalence of asymptomatic individuals involved in the former (33.36%) was significantly higher than that of in the latter (0.92%) and the former (93.18%) was reported much more frequently than the latter (15.91%) in the included articles. These studies had significant heterogeneity (I2 = 92%, τ2 = 0.4021, P < 0.01). However, the source of heterogeneity could not be identified even after subgroup analysis of 10 possible influencing factors (geographical area, outbreak settings, outbreak seasons, sample types, norovirus genotypes, transmission routes, subjects' occupations, subjects' age, per capita national income, and clear case definition). Meta-regression analysis of these 10 factors demonstrated that the geographical area could be partly responsible for this heterogeneity (P = 0.012). CONCLUSIONS The overall pooled asymptomatic prevalence of norovirus in outbreaks was high, with genome II dominating. Asymptomatic individuals may play an important role in norovirus outbreaks. This knowledge could help in developing control strategies and public health policies for norovirus outbreaks.
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Affiliation(s)
- Jun Wang
- Department of Clinical Laboratory, Jiaozhou Central Hospital, 29 Xuzhou Road, Qingdao, Shandong, 266300, P.R. China
| | - Zhao Gao
- Department of Clinical Laboratory, Jinan Second Peoples' Hospital, 148 Jingyi Road, Jinan, Shandong, 250000, P.R. China
| | - Zu-Rong Yang
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, 169 Changle west Road, Xi'an, Shaanxi, 710032, P.R. China
| | - Kun Liu
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, 169 Changle west Road, Xi'an, Shaanxi, 710032, P.R. China.
| | - Hui Zhang
- Department of Prevention of Infectious Diseases, Xi'an Center for Disease Control and Prevention, 599 Xiying Road, Xi'an, Shaanxi, 710054, P.R. China.
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Chen LN, Wang SJ, Wang SM, Fu XL, Zheng WJ, Hao ZY, Zhou HS, Zhang XJ, Zhao YL, Qiu C, von Seidlein L, Qiu TY, Wang XY. Molecular epidemiology analysis of symptomatic and asymptomatic norovirus infections in Chinese infants. Virol J 2023; 20:60. [PMID: 37016444 PMCID: PMC10074819 DOI: 10.1186/s12985-023-02024-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/28/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Norovirus is a leading cause of acute gastroenteritis among children. Previous studies based on symptomatic infections indicated that mutations, rather than recombination drove the evolution of the norovirus ORF2. These characteristics were found in hospital-based symptomatic infections, whereas, asymptomatic infections are frequent and contribute significantly to transmission. METHODS We conducted the first norovirus molecular epidemiology analysis covering both symptomatic and asymptomatic infections derived from a birth cohort study in the northern China. RESULTS During the study, 14 symptomatic and 20 asymptomatic norovirus infections were detected in 32 infants. Out of the 14 strains that caused symptomatic infections, 12 strains were identified as GII.3[P12], and others were GII.4[P31]. Conversely, 17 asymptomatic infections were caused by GII.4[P31], two by GII.2[P16], and one by GII.4[P16]. Regardless of symptomatic and asymptomatic infections, the mutations were detected frequently in the ORF2 region, and almost all recombination were identified in the RdRp-ORF2 region. The majority of the mutations were located around the predefined epitope regions of P2 subdomain indicating a potential for immune evasion. CONCLUSION The role of symptomatic as well as asymptomatic infections in the evolution of norovirus needs to be evaluated continuously.
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Affiliation(s)
- Li-Na Chen
- Key Laboratory of Medical Molecular Virology of MoE & MoH and Institutes of Biomedical Sciences, Fudan University, 138 Yi Xue Yuan Rd., Shanghai, 200032, People's Republic of China
| | - Si-Jie Wang
- Key Laboratory of Medical Molecular Virology of MoE & MoH and Institutes of Biomedical Sciences, Fudan University, 138 Yi Xue Yuan Rd., Shanghai, 200032, People's Republic of China
| | - Song-Mei Wang
- Laboratory of Molecular Biology, Training Center of Medical Experiments, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, People's Republic of China
| | - Xiao-Li Fu
- Key Laboratory of Medical Molecular Virology of MoE & MoH and Institutes of Biomedical Sciences, Fudan University, 138 Yi Xue Yuan Rd., Shanghai, 200032, People's Republic of China
| | - Wen-Jing Zheng
- Key Laboratory of Medical Molecular Virology of MoE & MoH and Institutes of Biomedical Sciences, Fudan University, 138 Yi Xue Yuan Rd., Shanghai, 200032, People's Republic of China
| | - Zhi-Yong Hao
- Zhengding County Center for Disease Control and Prevention, Zhengding, 050800, People's Republic of China
| | - Hai-Song Zhou
- Zhengding County Center for Disease Control and Prevention, Zhengding, 050800, People's Republic of China
| | - Xin-Jiang Zhang
- Zhengding County Center for Disease Control and Prevention, Zhengding, 050800, People's Republic of China
| | - Yu-Liang Zhao
- Hebei Province Center for Disease Control and Prevention, Shijiazhuang, 050021, People's Republic of China
| | - Chao Qiu
- Key Laboratory of Medical Molecular Virology of MoE & MoH and Institutes of Biomedical Sciences, Fudan University, 138 Yi Xue Yuan Rd., Shanghai, 200032, People's Republic of China
| | - Lorenz von Seidlein
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 73170, Thailand
| | - Tian-Yi Qiu
- Institute of Clinical Science, ZhongShan Hospital, Fudan University, 180 Feng Ling Road, Shanghai, People's Republic of China.
| | - Xuan-Yi Wang
- Key Laboratory of Medical Molecular Virology of MoE & MoH and Institutes of Biomedical Sciences, Fudan University, 138 Yi Xue Yuan Rd., Shanghai, 200032, People's Republic of China.
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, 200032, People's Republic of China.
- Children's Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
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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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11
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He T, Chen X, Deng Y, Li B, Wang H, Wang Q, Zhai A, Shi L, Chen Y, Wu C. Development and validation of an efficient nomogram for risk assessment of norovirus infection in pediatric patients. Eur J Clin Microbiol Infect Dis 2022; 41:1433-1443. [PMID: 36282340 PMCID: PMC9592877 DOI: 10.1007/s10096-022-04510-8] [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: 08/04/2022] [Accepted: 10/14/2022] [Indexed: 11/27/2022]
Abstract
This study aimed to establish a predictive model and nomogram based on routine laboratory blood indicators and clinical symptoms, subsequently providing a rapid risk assessment of norovirus (NoV) infection in children. This retrospective study enrolled 307 pediatric patients with symptoms of acute gastroenteritis and detected NoV using real-time quantitative polymerase chain reaction. Significant indicators selected by multivariate logistic regression, including routine blood tests and consultation symptoms, were used to develop the nomogram. We divided the sample into training and internal validation sets and performed external validation of the final model. Furthermore, we evaluated the clinical performance using the Akaike information criterion (AIC), area under the curve (AUC), calibration curve, decision curve analysis (DCA), sensitivity, specificity, concordance rate, positive predictive value, and negative predictive value. Overall, 153 cases were NoV-PCR-positive, and 154 were negative. The multivariate logistic regression included five predictors of NoV infection, including symptoms of vomiting, upper respiratory tract infection, and indicators of white blood cells, lymphocyte absolute counts, and platelet counts. The nomogram showed a significant predictive value with overall internal set diagnosis, with an AUC of 0.827 (95% confidence interval (CI): 0.785–0.868), and 0.812 (95% CI: 0.755–0.869) with 0.799 (95% CI: 0.705–0.894) in the training and internal validation sets, respectively. Nevertheless, the AUC in the external validation set was higher (0.915; 95% CI: 0.862–0.968). This nomogram is a useful tool for risk assessment for NoV infection. Moreover, the evaluated indicators are accessible, substantially reducing the time for laboratory testing.
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Affiliation(s)
- Taojun He
- Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518033 Guangdong Province China
| | - Xiaohua Chen
- Department of Digestive Endoscopy Center, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518033 Guangdong Province China
| | - Yilin Deng
- Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518033 Guangdong Province China
| | - Bin Li
- Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518033 Guangdong Province China
| | - Hongmei Wang
- Department of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, 518000 Guangdong Province China
| | - Qinjin Wang
- Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518033 Guangdong Province China
| | - Aixia Zhai
- Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518033 Guangdong Province China
| | - Liang Shi
- Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518033 Guangdong Province China
| | - Ying Chen
- Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518033 Guangdong Province China
| | - Chao Wu
- Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518033 Guangdong Province China
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12
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Guo Y, Li J, O'Brien J, Sivakumar M, Jiang G. Back-estimation of norovirus infections through wastewater-based epidemiology: A systematic review and parameter sensitivity. WATER RESEARCH 2022; 219:118610. [PMID: 35598472 DOI: 10.1016/j.watres.2022.118610] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 04/20/2022] [Accepted: 05/12/2022] [Indexed: 06/15/2023]
Abstract
The amount of norovirus RNA (Ribonucleic Acid) in raw wastewater, collected from a wastewater treatment plant (WWTP), can provide an indication of disease prevalence within the sampled catchment. However, an accurate back-estimation might be impeded by the uncertainties from in-sewer/in-sample degradation of viral RNA, variable shedding magnitude, and difficulties in measurement within raw wastewater. The current study reviewed the published literature regarding the factors of norovirus shedding, viral RNA decay in wastewater, and the occurrence of norovirus RNA in raw wastewater based on molecular detection. Sensitivity analysis for WBE back-estimation was conducted using the reported data of the factors mentioned above considering different viral loads in wastewater samples. It was found that the back-estimation is more sensitive to analytical detection uncertainty than shedding variability for norovirus. Although seasonal temperature change can lead to variation of decay rates and may influence the sensitivity of this pathogen-specific parameter, decay rates of norovirus RNA contribute negligibly to the variance in estimating disease prevalence, based on the available data from decay experiments in bulk wastewater under different temperatures. However, the effects of in-sewer transportation on viral RNA decay and retardation by sewer biofilms on pipe surfaces are largely unknown. Given the highest uncertainty from analytical measurement by molecular methods and complexity of in-sewer processes that norovirus experienced during the transportation to WWTP, future investigations are encouraged to improve the accuracy of viral RNA detection in wastewater and delineate viral retardation/interactions with wastewater biofilms in real sewers.
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Affiliation(s)
- Ying Guo
- School of Civil, Mining and Environmental Engineering, University of Wollongong, Wollongong, Australia
| | - Jiaying Li
- Advanced Water Management Centre, The University of Queensland, St. Lucia, Queensland 4072, Australia; Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland 4102, Australia
| | - Jake O'Brien
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland 4102, Australia
| | - Muttucumaru Sivakumar
- School of Civil, Mining and Environmental Engineering, University of Wollongong, Wollongong, Australia
| | - Guangming Jiang
- School of Civil, Mining and Environmental Engineering, University of Wollongong, Wollongong, Australia; Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, Australia.
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13
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Risk-Based Evaluation of Improvements in Drinking Water Treatment Using Cost-Benefit Analysis. WATER 2022. [DOI: 10.3390/w14050782] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Reliable and safe drinking water supply requires adequate risk management. Decision support models can aid decisionmakers to effectively evaluate risk mitigation measures and allocate societal resources. Here, a Swedish case study illustrates how the installation of ultrafiltration membranes can be evaluated by combining risk assessment and cost-benefit analysis. Quantitative microbial risk assessment was used to assess several contamination sources and estimate the achieved risk reduction from waterborne pathogens using Campylobacter, Norovirus, and Cryptosporidium as reference pathogens. The societal value of the improved water quality was estimated in the cost-benefit analysis by monetising the gained quality adjusted life years and aesthetic water quality improvements. The calculated net present value (mean of 7 MEUR) indicated that the installation of the ultrafiltration membranes was a sound investment from a societal economic perspective. The ultrafiltration membranes reduced the annual probability of infection from 3 × 10−2 to 10−7, well below the U.S. EPA’s acceptable level, as well as improving the aesthetic quality of the drinking water. The results provide a novel example of the importance for water distributors to consider not only health-related metrics when evaluating treatment options or monitoring the drinking water quality, but to also consider the aesthetic quality of the drinking water.
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14
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Magwira CA, Steele D, Seheri ML. Norovirus diarrhea is significantly associated with higher counts of fecal histo-blood group antigen expressing Enterobacter cloacae among black South African infants. Gut Microbes 2022; 13:1979876. [PMID: 34586017 PMCID: PMC8489948 DOI: 10.1080/19490976.2021.1979876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The study tested the hypothesis that harboring high levels of histo-blood group antigen-expressing Enerobactero cloacae is a risk factor for norovirus diarrhea. The fecal E. cloacae abundance in diarrheic norovirus positive (DNP), non-diarrheic norovirus negative (NDNN), diarrhea norovirus negative (DNN), and non-diarrhea norovirus positive (NDNP) infants was determined by qPCR, and the risk of norovirus diarrhea was assessed by logistical regression. DNP infants contained significantly higher counts of E. cloacae than NDNN and DNN infants, p = .0294, and 0.0001, respectively. The risk of norovirus diarrhea was significantly high in infants with higher counts of E. cloacae than those with lower counts, p = .009. Harboring higher counts of E. cloacae is a risk factor for norovirus diarrhea.
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Affiliation(s)
- Cliff A Magwira
- Diarrheal Pathogens Research Unit (Dpru), Department of Medical Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa,CONTACT Cliff A Magwira ; Department of Medical Virology, School of Medicine, Sefako Makgatho Health Sciences University, Molotlegi St, Ga-Rankuwa, 0208, Pretoria, South Africa. (012) 521 3036
| | - Duncan Steele
- Diarrheal Pathogens Research Unit (Dpru), Department of Medical Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - ML Seheri
- Diarrheal Pathogens Research Unit (Dpru), Department of Medical Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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15
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Lucero Y, Matson DO, Ashkenazi S, George S, O’Ryan M. Norovirus: Facts and Reflections from Past, Present, and Future. Viruses 2021; 13:v13122399. [PMID: 34960668 PMCID: PMC8707792 DOI: 10.3390/v13122399] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 02/07/2023] Open
Abstract
Human Norovirus is currently the main viral cause of acute gastroenteritis (AGEs) in most countries worldwide. Nearly 50 years after the discovery of the "Norwalk virus" by Kapikian and colleagues, the scientific and medical community continue to generate new knowledge on the full biological and disease spectrum of Norovirus infection. Nevertheless, several areas remain incompletely understood due to the serious constraints to effectively replicate and propagate the virus. Here, we present a narrated historic perspective and summarize our current knowledge, including insights and reflections on current points of interest for a broad medical community, including clinical and molecular epidemiology, viral-host-microbiota interactions, antivirals, and vaccine prototypes. We also include a reflection on the present and future impacts of the COVID-19 pandemic on Norovirus infection and disease.
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Affiliation(s)
- Yalda Lucero
- Microbiology and Mycology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile; (Y.L.); (S.G.)
- Hospital Dr. Roberto del Río Hospital, Department of Pediatrics and Pediatric Surgery (Northern Campus), Faculty of Medicine, Universidad de Chile, Santiago 8380418, Chile
- Clínica Alemana de Santiago, Faculty of Medicine, Universidad del Desarrollo-Clínica Alemana, Santiago 7650568, Chile
| | - David O. Matson
- Eastern Shore Health Department, Virginia Department of Public Health, Accomack County, VA 23301, USA;
| | - Shai Ashkenazi
- Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
- Department of Pediatrics A, Schneider Children’s Medical Center, Petach Tikva 49202, Israel
| | - Sergio George
- Microbiology and Mycology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile; (Y.L.); (S.G.)
| | - Miguel O’Ryan
- Microbiology and Mycology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Chile; (Y.L.); (S.G.)
- Correspondence:
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16
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Sobolik JS, Newman KL, Jaykus LA, Bihn EA, Leon JS. Norovirus transmission mitigation strategies during simulated produce harvest and packing. Int J Food Microbiol 2021; 357:109365. [PMID: 34488004 PMCID: PMC8510003 DOI: 10.1016/j.ijfoodmicro.2021.109365] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 08/04/2021] [Accepted: 08/15/2021] [Indexed: 02/07/2023]
Abstract
In the agricultural setting, core global food safety elements, such as hand hygiene and worker furlough, should reduce the risk of norovirus contamination on fresh produce. However, the effect of these practices has not been characterized. Using a quantitative microbial risk model, we evaluated the individual and combined effect of farm-based hand hygiene and worker furlough practices on the maximum risk of norovirus infection from three produce commodities (open leaf lettuce, vine tomatoes, and raspberries). Specifically, we tested two scenarios where a harvester's and packer's norovirus infection status was: 1) assumed positive; or 2) assigned based on community norovirus prevalence estimates. In the first scenario with a norovirus-positive harvester and packer, none of the individual interventions modeled reduced produce contamination to below the norovirus infectious dose. However, combined interventions, particularly high handwashing compliance (100%) and efficacy (6 log10 virus removal achieved using soap and water for 30 s), reduced produce contamination to <1-82 residual virus. Translating produce contamination to maximum consumer infection risk, 100% handwashing with a 5 log10 virus removal was necessary to achieve an infection risk below the threshold of 0.032 infections per consumption event. When community-based norovirus prevalence estimates were applied to the harvester and packer, the single interventions of 100% handwashing with 3 log10 virus removal (average 0.02 infection risk per consumption event) or furlough of the packer (average 0.03 infection risk per consumption event) reduced maximum infection risk to below the 0.032 threshold for all commodities. Bundled interventions (worker furlough, 100% glove compliance, and 100% handwashing with 1-log10 virus reduction) resulted in a maximum risk of 0.02 per consumption event across all commodities. These results advance the evidence-base for global produce safety standards as effective norovirus contamination and risk mitigation strategies.
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Affiliation(s)
- Julia S Sobolik
- Emory University, Gangarosa Department of Environmental Health, Atlanta, GA 30322, USA.
| | - Kira L Newman
- Emory University, Hubert Department of Global Health, Atlanta, GA 30322, USA
| | - Lee-Ann Jaykus
- North Carolina State University, Food, Bioprocessing, & Nutrition Sciences, Raleigh, NC 27695, USA
| | - Elizabeth A Bihn
- Cornell University, Department of Food Science, Ithaca, NY 14853, USA
| | - Juan S Leon
- Emory University, Hubert Department of Global Health, Atlanta, GA 30322, USA
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17
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Sekiguchi K, Koba R, Oka T, Tohya Y. Caliciviruses induce mRNA of tumor necrosis factor α via their protease activity. Virus Res 2021; 306:198595. [PMID: 34637812 DOI: 10.1016/j.virusres.2021.198595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 09/22/2021] [Accepted: 10/02/2021] [Indexed: 11/18/2022]
Abstract
Calicivirus infection in patients and animals is associated with the production of multiple inflammatory cytokines, including tumor necrosis factor α (TNF-α). Here we studied the feline calicivirus (FCV) non-structural proteins and found that the FCV protease was a key factor for TNF-α gene expression in cultured cells. The expression of the TNF-α gene in cells expressing FCV, human norovirus, and rabbit hemorrhagic disease virus protease was compared, revealing that the induction of TNF-α could be a common phenomenon during the infection by the viruses in the Caliciviridae. The level of TNF-α mRNA in the cells expressing mutant proteases that lacked the active site was measured. These data indicate that the protease activity is crucial for TNF-α expression. These findings provide new insight into the induction of inflammation during calicivirus infection.
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Affiliation(s)
- Kei Sekiguchi
- Laboratory of Veterinary Microbiology, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan; Department of Molecular Virology, Graduate School of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Ryota Koba
- Laboratory of Veterinary Microbiology, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan.
| | - Tomoichiro Oka
- Department of Virology II, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama, Tokyo, 208-0011, Japan
| | - Yukinobu Tohya
- Laboratory of Veterinary Microbiology, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
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18
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Misumi M, Nishiura H. Long-term dynamics of Norovirus transmission in Japan, 2005-2019. PeerJ 2021; 9:e11769. [PMID: 34306831 PMCID: PMC8280881 DOI: 10.7717/peerj.11769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/22/2021] [Indexed: 11/20/2022] Open
Abstract
Norovirus continues to evolve, adjusting its pathogenesis and transmissibility. In the present study, we systematically collected datasets on Norovirus outbreaks in Japan from 2005 to 2019 and analyzed time-dependent changes in the asymptomatic ratio, the probability of virus detection, and the probability of infection given exposure. Reports of 1,728 outbreaks were published, and feces from all involved individuals, including those with asymptomatic infection, were tested for virus in 434 outbreaks. We found that the outbreak size did not markedly change over this period, but the variance in outbreak size increased during the winter (November–April). Assuming that natural history parameters did not vary over time, the asymptomatic ratio, the probability of virus detection, and the probability of infection given exposure were estimated to be 18.6%, 63.3% and 84.5%, respectively. However, a model with time-varying natural history parameters yielded better goodness-of-fit and suggested that the asymptomatic ratio varied by year. The asymptomatic ratio was as high as 25.8% for outbreaks caused by genotype GII.4 noroviruses. We conclude that Norovirus transmissibility has not changed markedly since 2005, and that yearly variation in the asymptomatic ratio could potentially be explained by the circulating dominant genotype.
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Affiliation(s)
- Megumi Misumi
- Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.,Rumoi City Hospital, Rumoi, Hokkaido, Japan
| | - Hiroshi Nishiura
- Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.,School of Public Health, Kyoto University, Kyoto, Japan
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19
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Li Y, Handley SA, Baldridge MT. The dark side of the gut: Virome-host interactions in intestinal homeostasis and disease. J Exp Med 2021; 218:e20201044. [PMID: 33760921 PMCID: PMC8006857 DOI: 10.1084/jem.20201044] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 12/19/2022] Open
Abstract
The diverse enteric viral communities that infect microbes and the animal host collectively constitute the gut virome. Although recent advances in sequencing and analysis of metaviromes have revealed the complexity of the virome and facilitated discovery of new viruses, our understanding of the enteric virome is still incomplete. Recent studies have uncovered how virome-host interactions can contribute to beneficial or detrimental outcomes for the host. Understanding the complex interactions between enteric viruses and the intestinal immune system is a prerequisite for elucidating their role in intestinal diseases. In this review, we provide an overview of the enteric virome composition and summarize recent findings about how enteric viruses are sensed by and, in turn, modulate host immune responses during homeostasis and disease.
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Affiliation(s)
- Yuhao Li
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO
- Edison Family Center for Genome Sciences & Systems Biology, Washington University School of Medicine, St. Louis, MO
| | - Scott A. Handley
- Edison Family Center for Genome Sciences & Systems Biology, Washington University School of Medicine, St. Louis, MO
- Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO
| | - Megan T. Baldridge
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO
- Edison Family Center for Genome Sciences & Systems Biology, Washington University School of Medicine, St. Louis, MO
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20
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Chan JC, Mohammad KN, Zhang LY, Wong SH, Chan MCW. Targeted Profiling of Immunological Genes during Norovirus Replication in Human Intestinal Enteroids. Viruses 2021; 13:v13020155. [PMID: 33494515 PMCID: PMC7910953 DOI: 10.3390/v13020155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/14/2021] [Accepted: 01/18/2021] [Indexed: 12/18/2022] Open
Abstract
Norovirus is the leading cause of acute gastroenteritis worldwide. The pathogenesis of norovirus and the induced immune response remain poorly understood due to the lack of a robust virus culture system. The monolayers of two secretor-positive Chinese human intestinal enteroid (HIE) lines were challenged with two norovirus pandemic GII.4 Sydney strains. Norovirus RNA replication in supernatants and cell lysates were quantified by RT-qPCR. RNA expression levels of immune-related genes were profiled using PCR arrays. The secreted protein levels of shortlisted upregulated genes were measured in supernatants using analyte-specific enzyme-linked immunosorbent assay (ELISA). Productive norovirus replications were achieved in three (75%) out of four inoculations. The two most upregulated immune-related genes were CXCL10 (93-folds) and IFI44L (580-folds). Gene expressions of CXCL10 and IFI44L were positively correlated with the level of norovirus RNA replication (CXCL10: Spearman’s r = 0.779, p < 0.05; IFI44L: r = 0.881, p < 0.01). The higher level of secreted CXCL10 and IFI44L proteins confirmed their elevated gene expression. The two genes have been reported to be upregulated in norovirus volunteer challenges and natural human infections by other viruses. Our data suggested that HIE could mimic the innate immune response elicited in natural norovirus infection and, therefore, could serve as an experimental model for future virus-host interaction and antiviral studies.
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Affiliation(s)
- Jenny C.M. Chan
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.C.M.C.); (K.N.M.); (L.-Y.Z.)
| | - Kirran N. Mohammad
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.C.M.C.); (K.N.M.); (L.-Y.Z.)
| | - Lin-Yao Zhang
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.C.M.C.); (K.N.M.); (L.-Y.Z.)
| | - Sunny H. Wong
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Martin Chi-Wai Chan
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.C.M.C.); (K.N.M.); (L.-Y.Z.)
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
- Correspondence:
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21
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Pattekar A, Mayer LS, Lau CW, Liu C, Palko O, Bewtra M, Consortium HPAP, Lindesmith LC, Brewer-Jensen PD, Baric RS, Betts MR, Naji A, Wherry EJ, Tomov VT. Norovirus-Specific CD8 + T Cell Responses in Human Blood and Tissues. Cell Mol Gastroenterol Hepatol 2021; 11:1267-1289. [PMID: 33444817 PMCID: PMC8010716 DOI: 10.1016/j.jcmgh.2020.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/26/2020] [Accepted: 12/15/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Noroviruses (NoVs) are the leading cause of acute gastroenteritis worldwide and are associated with significant morbidity and mortality. Moreover, an asymptomatic carrier state can persist following acute infection, promoting NoV spread and evolution. Thus, defining immune correlates of NoV protection and persistence is needed to guide the development of future vaccines and limit viral spread. Whereas antibody responses following NoV infection or vaccination have been studied extensively, cellular immunity has received less attention. Data from the mouse NoV model suggest that T cells are critical for preventing persistence and achieving viral clearance, but little is known about NoV-specific T-cell immunity in humans, particularly at mucosal sites. METHODS We screened peripheral blood mononuclear cells from 3 volunteers with an overlapping NoV peptide library. We then used HLA-peptide tetramers to track virus-specific CD8+ T cells in peripheral, lymphoid, and intestinal tissues. Tetramer+ cells were further characterized using markers for cellular trafficking, exhaustion, cytotoxicity, and proliferation. RESULTS We defined 7 HLA-restricted immunodominant class I epitopes that were highly conserved across pandemic strains from genogroup II.4. NoV-specific CD8+ T cells with central, effector, or tissue-resident memory phenotypes were present at all sites and were especially abundant in the intestinal lamina propria. The properties and differentiation states of tetramer+ cells varied across donors and epitopes. CONCLUSIONS Our findings are an important step toward defining the breadth, distribution, and properties of human NoV T-cell immunity. Moreover, the molecular tools we have developed can be used to evaluate future vaccines and engineer novel cellular therapeutics.
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Affiliation(s)
- Ajinkya Pattekar
- Department of Medicine, Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lena S. Mayer
- Department of Medicine, Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania,Department of Medicine II: Gastroenterology, Hepatology, Endocrinology, and Infectious Disease, University Medical Center Freiburg, Freiburg, Germany
| | - Chi Wai Lau
- Department of Medicine, Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Chengyang Liu
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Olesya Palko
- Department of Medicine, Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania,Department of Orthopedic Surgery, Montefiore Medical Center, Bronx, New York
| | - Meenakshi Bewtra
- Department of Medicine, Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania,Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Lisa C. Lindesmith
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Paul D. Brewer-Jensen
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Ralph S. Baric
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Michael R. Betts
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ali Naji
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - E. John Wherry
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania,Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania,Parker Institute for Cancer Immunotherapy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Vesselin T. Tomov
- Department of Medicine, Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania,Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania,Correspondence Address correspondence to: Vesselin Tomov, MD, PhD, Department of Medicine, Division of Gastroenterology, University of Pennsylvania, Perelman School of Medicine, 421 Curie Boulevard, BRB 313, Philadelphia, Pennsylvania 19103. fax: (215) 349-5915.
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22
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Characterization of a hospital-based gastroenteritis outbreak caused by GII.6 norovirus in Jinshan, China. Epidemiol Infect 2020; 148:e289. [PMID: 33292874 PMCID: PMC7770467 DOI: 10.1017/s0950268820002538] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
An acute gastroenteritis (AGE) outbreak caused by a norovirus occurred at a hospital in Shanghai, China, was studied for molecular epidemiology, host susceptibility and serological roles. Rectal and environmental swabs, paired serum samples and saliva specimens were collected. Pathogens were detected by real-time polymerase chain reaction and DNA sequencing. Histo-blood group antigens (HBGA) phenotypes of saliva samples and their binding to norovirus protruding proteins were determined by enzyme-linked immunosorbent assay. The HBGA-binding interfaces and the surrounding region were analysed by the MegAlign program of DNAstar 7.1. Twenty-seven individuals in two care units were attacked with AGE at attack rates of 9.02 and 11.68%. Eighteen (78.2%) symptomatic and five (38.4%) asymptomatic individuals were GII.6/b norovirus positive. Saliva-based HBGA phenotyping showed that all symptomatic and asymptomatic cases belonged to A, B, AB or O secretors. Only four (16.7%) out of the 24 tested serum samples showed low blockade activity against HBGA-norovirus binding at the acute phase, whereas 11 (45.8%) samples at the convalescence stage showed seroconversion of such blockade. Specific blockade antibody in the population played an essential role in this norovirus epidemic. A wide HBGA-binding spectrum of GII.6 supports a need for continuous health attention and surveillance in different settings.
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23
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Xie D, Chen J, Yu J, Pei F, Koroma MM, Wang L, Qiu M, Hou Y, Yu D, Zhang XF, Dai YC. Characterization of Antigenic Relatedness Among GI Norovirus Genotypes Using Serum Samples From Norovirus-Infected Patients and Mouse Sera. Front Microbiol 2020; 11:607723. [PMID: 33363528 PMCID: PMC7752868 DOI: 10.3389/fmicb.2020.607723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/11/2020] [Indexed: 12/03/2022] Open
Abstract
Characterizing diversity and the antigenic relatedness of norovirus remains a primary focus in understanding its biological properties and vaccine designs. The precise antigenic and serological features of GI genotypes have not been studied. The study represented an investigation on a gastroenteritis outbreak related to GI.3 norovirus and the three most detected GI genotypes, GI.2 (belonging to immunotype B), GI.3 and GI.9 (belonging to immunotype C), were selected to characterize their phylogenetic relationship, HBGA binding profiles and antigenic relatedness within (intra-immunotype), and between (inter-immunotypes) genotypes using mouse sera and patient’s serum samples from the GI.3 related outbreak. Wide HBGA binding profiles and evolution of binding affinity were observed in the three GI genotypes studied. A low specific blockade antibody to GI.3 in the population generated the pool of susceptible individuals and supported virus spread in the outbreak. We found strong blockade immune response in homologous strains, moderate intra-immunotype blockade but weak inter-immunotypes blockade in humans following GI.3 norovirus infections. These findings further support the immunotypes grouping and will be valuable for optimizing the design of norovirus vaccine.
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Affiliation(s)
- Dongjie Xie
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Junrui Chen
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Jingrong Yu
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Fuyu Pei
- Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Mark Momoh Koroma
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Lu Wang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Mengsi Qiu
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yuzhen Hou
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Dexian Yu
- Guangzhou Military Command Center for Disease Control and Prevention, Guangzhou, China
| | - Xu-Fu Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Ying-Chun Dai
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
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24
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Detection of Norovirus in Saliva Samples from Acute Gastroenteritis Cases and Asymptomatic Subjects: Association with Age and Higher Shedding in Stool. Viruses 2020; 12:v12121369. [PMID: 33266188 PMCID: PMC7761458 DOI: 10.3390/v12121369] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/26/2020] [Accepted: 11/28/2020] [Indexed: 12/11/2022] Open
Abstract
Norovirus infections are a leading cause of acute gastroenteritis outbreaks worldwide and across all age groups, with two main genogroups (GI and GII) infecting humans. The aim of our study was to investigate the occurrence of norovirus in saliva samples from individuals involved in outbreaks of acute gastroenteritis in closed and semiclosed institutions, and its relationship with the virus strain, virus shedding in stool, the occurrence of symptoms, age, and the secretor status of the individual. Epidemiological and clinical information was gathered from norovirus outbreaks occurring in Catalonia, Spain during 2017–2018, and stool and saliva samples were collected from affected and exposed resident individuals and workers. A total of 347 saliva specimens from 25 outbreaks were analyzed. Further, 84% of individuals also provided a paired stool sample. For GII infections, norovirus was detected in 17.9% of saliva samples from symptomatic cases and 5.2% of asymptomatic individuals. Positivity in saliva occurred in both secretors and nonsecretors. None of the individuals infected by norovirus GI was positive for the virus in saliva. Saliva positivity did not correlate with any of the studied symptoms but did correlate with age ≥ 65 years old. Individuals who were positive in saliva showed higher levels of virus shedding in stool. Mean viral load in positive saliva was 3.16 ± 1.08 log10 genome copies/mL, and the predominance of encapsidated genomes was confirmed by propidium monoazide (PMA)xx-viability RTqPCR assay. The detection of norovirus in saliva raises the possibility of oral-to-oral norovirus transmission during the symptomatic phase and, although to a lesser extent, even in cases of asymptomatic infections.
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25
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Patin NV, Peña-Gonzalez A, Hatt JK, Moe C, Kirby A, Konstantinidis KT. The Role of the Gut Microbiome in Resisting Norovirus Infection as Revealed by a Human Challenge Study. mBio 2020; 11:e02634-20. [PMID: 33203758 PMCID: PMC7683401 DOI: 10.1128/mbio.02634-20] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/16/2020] [Indexed: 12/11/2022] Open
Abstract
Norovirus infections take a heavy toll on worldwide public health. While progress has been made toward understanding host responses to infection, the role of the gut microbiome in determining infection outcome is unknown. Moreover, data are lacking on the nature and duration of the microbiome response to norovirus infection, which has important implications for diagnostics and host recovery. Here, we characterized the gut microbiomes of subjects enrolled in a norovirus challenge study. We analyzed microbiome features of asymptomatic and symptomatic individuals at the genome (population) and gene levels and assessed their response over time in symptomatic individuals. We show that the preinfection microbiomes of subjects with asymptomatic infections were enriched in Bacteroidetes and depleted in Clostridia relative to the microbiomes of symptomatic subjects. These compositional differences were accompanied by differences in genes involved in the metabolism of glycans and sphingolipids that may aid in host resilience to infection. We further show that microbiomes shifted in composition following infection and that recovery times were variable among human hosts. In particular, Firmicutes increased immediately following the challenge, while Bacteroidetes and Proteobacteria decreased over the same time. Genes enriched in the microbiomes of symptomatic subjects, including the adenylyltransferase glgC, were linked to glycan metabolism and cell-cell signaling, suggesting as-yet unknown roles for these processes in determining infection outcome. These results provide important context for understanding the gut microbiome role in host susceptibility to symptomatic norovirus infection and long-term health outcomes.IMPORTANCE The role of the human gut microbiome in determining whether an individual infected with norovirus will be symptomatic is poorly understood. This study provides important data on microbes that distinguish asymptomatic from symptomatic microbiomes and links these features to infection responses in a human challenge study. The results have implications for understanding resistance to and treatment of norovirus infections.
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Affiliation(s)
- N V Patin
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - A Peña-Gonzalez
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, USA
- Max Planck Tandem Group in Computational Biology, Department of Biological Sciences, Universidad de los Andes, Bogotá, Colombia
| | - J K Hatt
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - C Moe
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - A Kirby
- Waterborne Disease Prevention Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - K T Konstantinidis
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, USA
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
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26
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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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27
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Lindesmith LC, Brewer-Jensen PD, Mallory ML, Jensen K, Yount BL, Costantini V, Collins MH, Edwards CE, Sheahan TP, Vinjé J, Baric RS. Virus-Host Interactions Between Nonsecretors and Human Norovirus. Cell Mol Gastroenterol Hepatol 2020; 10:245-267. [PMID: 32289501 PMCID: PMC7301201 DOI: 10.1016/j.jcmgh.2020.03.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Human norovirus infection is the leading cause of acute gastroenteritis. Genetic polymorphisms, mediated by the FUT2 gene (secretor enzyme), define strain susceptibility. Secretors express a diverse set of fucosylated histoblood group antigen carbohydrates (HBGA) on mucosal cells; nonsecretors (FUT2-/-) express a limited array of HBGAs. Thus, nonsecretors have less diverse norovirus strain infections, including resistance to the epidemiologically dominant GII.4 strains. Because future human norovirus vaccines will comprise GII.4 antigen and because secretor phenotype impacts GII.4 infection and immunity, nonsecretors may mimic young children immunologically in response to GII.4 vaccination, providing a needed model to study cross-protection in the context of limited pre-exposure. METHODS By using specimens collected from the first characterized nonsecretor cohort naturally infected with GII.2 human norovirus, we evaluated the breadth of serologic immunity by surrogate neutralization assays, and cellular activation and cytokine production by flow cytometry. RESULTS GII.2 infection resulted in broad antibody and cellular immunity activation that persisted for at least 30 days for T cells, monocytes, and dendritic cells, and for 180 days for blocking antibody. Multiple cellular lineages expressing interferon-γ and tumor necrosis factor-α dominated the response. Both T-cell and B-cell responses were cross-reactive with other GII strains, but not GI strains. To promote entry mechanisms, inclusion of bile acids was essential for GII.2 binding to nonsecretor HBGAs. CONCLUSIONS These data support development of within-genogroup, cross-reactive antibody and T-cell immunity, key outcomes that may provide the foundation for eliciting broad immune responses after GII.4 vaccination in individuals with limited GII.4 immunity, including young children.
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Affiliation(s)
- Lisa C Lindesmith
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Paul D Brewer-Jensen
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Michael L Mallory
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Kara Jensen
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Boyd L Yount
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Veronica Costantini
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Matthew H Collins
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Decatur, Georgia
| | - Caitlin E Edwards
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Timothy P Sheahan
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Jan Vinjé
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ralph S Baric
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina.
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28
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Sroga P, Safronetz D, Stein DR. Nanobodies: a new approach for the diagnosis and treatment of viral infectious diseases. Future Virol 2020. [DOI: 10.2217/fvl-2019-0167] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
With the rise of viral infections and antibiotic resistance, there is a constant need for the development of more sensitive and effective treatment and diagnostic tools. Since their discovery in the early 1990s, Camelidae antibodies have been investigated as potential tools due to their unique structure and favorable characteristics. Members of this family produce conventional IgG antibodies as well as heavy-chain only IgG antibodies that do not possess light chains. The variable domain (VHH), or nanobody, demonstrates unique antigen-binding capabilities, enhanced stability, and its small size allows for delivery into the body using a nebulizer, thereby eliminating the unfavorable use of injections. In addition, the cost-effective and easy in vitro production of these antibodies are an attractive quality in terms of mass production. This review covers the past and current nanobody treatment and diagnostic developments aimed at viral infectious diseases, including a brief overview of protozoal, bacterial, and veterinary viral approaches.
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Affiliation(s)
- Patrycja Sroga
- Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - David Safronetz
- Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
- Zoonotic Diseases & Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
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29
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Williams AM, Ladva CN, Leon JS, Lopman BA, Tangpricha V, Whitehead RD, Armitage AE, Wray K, Morovat A, Pasricha SR, Thurnham D, Tanumihardjo SA, Shahab-Ferdows S, Allen L, Flores-Ayala RC, Suchdev PS. Changes in micronutrient and inflammation serum biomarker concentrations after a norovirus human challenge. Am J Clin Nutr 2019; 110:1456-1464. [PMID: 31504095 PMCID: PMC6885472 DOI: 10.1093/ajcn/nqz201] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/25/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To accurately assess micronutrient status, it is necessary to characterize the effects of inflammation and the acute-phase response on nutrient biomarkers. OBJECTIVE Within a norovirus human challenge study, we aimed to model the inflammatory response of C-reactive protein (CRP) and α-1-acid glycoprotein (AGP) by infection status, model kinetics of micronutrient biomarkers by inflammation status, and evaluate associations between inflammation and micronutrient biomarkers from 0 to 35 d post-norovirus exposure. METHODS Fifty-two healthy adults were enrolled into challenge studies in a hospital setting and followed longitudinally; all were exposed to norovirus, half were infected. Post hoc analysis of inflammatory and nutritional biomarkers was performed. Subjects were stratified by inflammation resulting from norovirus exposure. Smoothed regression models analyzed the kinetics of CRP and AGP by infection status, and nutritional biomarkers by inflammation. Linear mixed-effects models were used to analyze the independent relations between CRP, AGP, and biomarkers for iron, vitamin A, vitamin D, vitamin B-12, and folate from 0 to 35 d post-norovirus exposure. RESULTS Norovirus-infected subjects had median (IQR) peak concentrations for CRP [16.0 (7.9-29.5) mg/L] and AGP [0.9 (0.8-1.2) g/L] on day 3 and day 4 postexposure, respectively. Nutritional biomarkers that differed (P < 0.05) from baseline within the inflamed group were ferritin (elevated day 3), hepcidin (elevated days 2, 3), serum iron (depressed days 2-4), transferrin saturation (depressed days 2-4), and retinol (depressed days 3, 4, and 7). Nutritional biomarker concentrations did not differ over time within the uninflamed group. In mixed models, CRP was associated with ferritin (positive) and serum iron and retinol (negative, P < 0.05). CONCLUSION Using an experimental infectious challenge model in healthy adults, norovirus infection elicited a time-limited inflammatory response associated with altered serum concentrations of certain iron and vitamin A biomarkers, confirming the need to consider adjustments of these biomarkers to account for inflammation when assessing nutritional status. These trials were registered at clinicaltrials.gov as NCT00313404 and NCT00674336.
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Affiliation(s)
- Anne M Williams
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA,McKing Consulting Corporation, Atlanta, GA, USA,Address correspondence to AMW (e-mail: )
| | | | - Juan S Leon
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA
| | - Ben A Lopman
- Department of Epidemiology, Emory University, Atlanta, GA, USA
| | - Vin Tangpricha
- Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA,Atlanta VA Medical Center, Decatur, GA, USA
| | | | - Andrew E Armitage
- Medical Research Council (MRC) Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Katherine Wray
- Department of Clinical Biochemistry, Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
| | - Alireza Morovat
- Department of Clinical Biochemistry, Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
| | - Sant-Rayn Pasricha
- Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia,Departments of Medical Biology and Medicine and Radiology, University of Melbourne, Parkville, Victoria, Australia
| | - David Thurnham
- School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Sherry A Tanumihardjo
- Interdepartmental Graduate Program in Nutritional Sciences, Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Setti Shahab-Ferdows
- USDA, Agricultural Research Service Western Human Nutrition Research Center, Davis, CA, USA
| | - Lindsay Allen
- USDA, Agricultural Research Service Western Human Nutrition Research Center, Davis, CA, USA
| | | | - Parminder S Suchdev
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA,Nutrition Branch, CDC, Atlanta, GA, USA,Emory Global Health Institute, Atlanta, GA, USA
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30
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Hassan E, Baldridge MT. Norovirus encounters in the gut: multifaceted interactions and disease outcomes. Mucosal Immunol 2019; 12:1259-1267. [PMID: 31501514 PMCID: PMC7479810 DOI: 10.1038/s41385-019-0199-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/20/2019] [Indexed: 02/04/2023]
Abstract
Noroviruses are major causes of gastroenteritis, with epidemic outbreaks occurring frequently. They are an important global health concern, especially for pediatric and immunocompromised populations, and are challenging pathogens to target immunologically due to their rapid rates of genetic and antigenic evolution and failure to stimulate durable protective immunity. In this Review, we summarize our current understanding of norovirus pathogenesis, noting the prominent role of murine norovirus as a small animal model for norovirus research. We highlight intriguing data supporting the possible involvement of norovirus in sequelae including irritable bowel syndrome and inflammatory bowel diseases, and describe the innate and adaptive immune mechanisms involved in control of both human and murine norovirus infection. Furthermore, we discuss the potential implications of recent discoveries regarding norovirus interactions with the gut microbiota, and briefly detail current understanding of noroviral evolution and its influence on viral pathogenesis. Our mechanistic understanding of norovirus pathogenesis continues to improve with increasing availability of powerful model systems, which will ultimately facilitate development of effective preventive and therapeutic approaches for this pathogen.
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Affiliation(s)
- Ebrahim Hassan
- Division of Infectious Diseases, Department of Medicine, Edison Family Center for Genome Sciences & Systems Biology, Washington University School of Medicine, St. Louis, MO, USA
| | - Megan T. Baldridge
- Division of Infectious Diseases, Department of Medicine, Edison Family Center for Genome Sciences & Systems Biology, Washington University School of Medicine, St. Louis, MO, USA.,Correspondence: Megan T. Baldridge, MD, PhD, Phone: 314-273-1212, Fax: 314-362-2156,
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31
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Abstract
PURPOSE OF REVIEW Noroviruses are a major cause of gastroenteritis. This review summarizes new information on noroviruses that may lead to the development of improved measures for limiting their human health impact. RECENT FINDINGS GII.4 strains remain the most common human noroviruses causing disease, although GII.2 and GII.17 strains have recently emerged as dominant strains in some populations. Histo-blood group antigen (HBGA) expression on the gut mucosa drives susceptibility to different norovirus strains. Antibodies that block virus binding to these glycans correlate with protection from infection and illness. Immunocompromised patients are significantly impacted by norovirus infection, and the increasing availability of molecular diagnostics has improved infection recognition. Human noroviruses can be propagated in human intestinal enteroid cultures containing enterocytes that are a significant primary target for initiating infection. Strain-specific requirements for replication exist with bile being essential for some strains. Several vaccine candidates are progressing through preclinical and clinical development and studies of potential antiviral interventions are underway. SUMMARY Norovirus epidemiology is complex and requires continued surveillance to track the emergence of new strains and recombinants, especially with the continued progress in vaccine development. Humans are the best model to study disease pathogenesis and prevention. New in-vitro cultivation methods should lead to better approaches for understanding virus-host interactions and ultimately to improved strategies for mitigation of human norovirus-associated disease.
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32
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Wu QS, Xuan ZL, Liu JY, Zhao XT, Chen YF, Wang CX, Shen XT, Wang YX, Wang L, Hu Y. Norovirus shedding among symptomatic and asymptomatic employees in outbreak settings in Shanghai, China. BMC Infect Dis 2019; 19:592. [PMID: 31286917 PMCID: PMC6613243 DOI: 10.1186/s12879-019-4205-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 06/19/2019] [Indexed: 12/05/2022] Open
Abstract
Background Norovirus (NoV) is recognized as a leading cause of acute gastroenteritis (AGE) outbreaks in settings globally. Studies have shown that employees played an important role in the transmission mode during some NoV outbreaks. This study aimed to investigate the prevalence of NoV infection and duration of NoV shedding among employees during NoV outbreaks, as well as factors affecting shedding duration. Methods Specimens and epidemiological data were collected from employees who were suspected of being involved in the transmission or with AGE symptoms during NoV outbreaks in Xuhui District, Shanghai, from 2015 to 2017. Specimens were detected using real-time RT-PCR to determine whether or not employees had become infected with NoV. Specimens were collected every 3–7 days from NoV-infected employees until specimens became negative for NoV. Results A total of 421 employees were sampled from 49 NoV outbreaks, and nearly 90% of them (377/421) were asymptomatic. Symptomatic employees showed significantly higher prevalence of NoV infection than asymptomatic ones (70.5% vs. 17.0%, P < 0.01). The average duration of NoV shedding was 6.9 days (95% confidence interval: 6.1–7.7 days) among 88 NoV-infected individuals, and was significantly longer in symptomatic individuals than in asymptomatic ones (9.8 days vs. 5.6 days, P < 0.01). In Cox proportional-hazards model, after adjusting age and gender, symptoms was the only factor associated with duration of NoV shedding. Conclusions Compared with asymptomatic employees, symptomatic employees had higher prevalence of NoV infection and longer durations of NoV shedding. Since NoV shedding duration among NoV-infected employees tends to be longer than their isolation time during outbreaks, reinforcement of hygiene practices among these employees is especially necessary to reduce the risk of virus secondary transmissions after their return to work.
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Affiliation(s)
- Qiang-Song Wu
- Xuhui Center for Disease Control and Prevention, Shanghai, China
| | - Ze-Liang Xuan
- Xuhui Center for Disease Control and Prevention, Shanghai, China
| | - Jing-Yi Liu
- Xuhui Center for Disease Control and Prevention, Shanghai, China
| | - Xue-Tao Zhao
- Xuhui Center for Disease Control and Prevention, Shanghai, China
| | - Yuan-Fang Chen
- Xuhui Center for Disease Control and Prevention, Shanghai, China
| | - Chen-Xi Wang
- Xuhui Center for Disease Control and Prevention, Shanghai, China
| | - Xiao-Ting Shen
- Xuhui Center for Disease Control and Prevention, Shanghai, China
| | - Ya-Xin Wang
- Xuhui Center for Disease Control and Prevention, Shanghai, China
| | - Lan Wang
- Xuhui District Health and Family Planning Commission, Shanghai, China
| | - Yi Hu
- Department of Epidemiology, China and Key Laboratory of Public Health Safety, (Fudan University), School of Public Health, Fudan University, Ministry of Education, No.130 Dongan Road, Xuhui District, Shanghai, 200032, China.
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Tesson V, Belliot G, Estienney M, Wurtzer S, Renault P. Vomiting symptom of acute gastroenteritis estimated from epidemiological data can help predict river contamination by human pathogenic enteric viruses. ENVIRONMENT INTERNATIONAL 2019; 123:114-123. [PMID: 30508731 DOI: 10.1016/j.envint.2018.11.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 11/21/2018] [Accepted: 11/22/2018] [Indexed: 06/09/2023]
Abstract
Contamination of fresh water bodies by human enteric viruses from wastewater discharge is a well-established phenomenon. Here we propose a model of viral contamination of rivers based on acute gastroenteritis epidemiology and assess how well it can simulate in situ experimental monitoring. Noroviruses, rotaviruses, enteroviruses, adenoviruses and hepatitis A viruses were quantified by molecular methods after water concentration. Water flows were obtained from the Hydro databank and wastewater treatment plant (WWTP) data. Acute gastroenteritis cases based on medical prescriptions were recorded by the French public health agency. We estimated the total number of daily viral acute gastroenteritis cases and modeled virus shedding and fate in WWTPs and rivers. Simulated virus concentrations were compared to the weighted sum of measured concentrations. Seasonal variations in viral acute gastroenteritis were predicted from vomiting occurrence. All viruses except hepatitis A virus were widely detected in wastewaters and river, in concentrations reaching 10+6 genome copies·L-1 for adenoviruses in the Artière River. We were able to predict virus load in raw wastewater and in the Artière River. Estimated weighting coefficients showed the high impact of noroviruses GII. This model can thus serve to compare water treatment, discharge and reuse scenarios.
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Affiliation(s)
- Vincent Tesson
- INRA, UMR 1114 EMMAH, 228 route de l'Aérodrome, CS 40 509, 84914 Avignon Cedex 9, France
| | - Gaël Belliot
- CNR des Virus des Gastro-Entérites, CHU François Mitterrand, 2 rue Angélique Ducoudray, BP37013, 21070 Dijon Cedex, France; Université de Bourgogne/AgroSup Dijon, UMR PAM A 02.102, 7 boulevard Jeanne-d'Arc, 21000 Dijon, France
| | - Marie Estienney
- CNR des Virus des Gastro-Entérites, CHU François Mitterrand, 2 rue Angélique Ducoudray, BP37013, 21070 Dijon Cedex, France
| | - Sébastien Wurtzer
- Eau de Paris, DRDQE, R&D Biologie, 33 avenue Jean Jaurès, 94200 Ivry-sur-Seine, France
| | - Pierre Renault
- INRA, UMR 1114 EMMAH, 228 route de l'Aérodrome, CS 40 509, 84914 Avignon Cedex 9, France.
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Lindsay L, DuPont HL, Moe CL, Alberer M, Hatz C, Kirby AE, Wu HM, Verstraeten T, Steffen R. Estimating the incidence of norovirus acute gastroenteritis among US and European international travelers to areas of moderate to high risk of traveler's diarrhea: a prospective cohort study protocol. BMC Infect Dis 2018; 18:605. [PMID: 30509202 PMCID: PMC6276235 DOI: 10.1186/s12879-018-3461-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 10/31/2018] [Indexed: 12/31/2022] Open
Abstract
Background Acute gastroenteritis (AGE) is the leading cause of illness among returning travelers seeking medical care. Multiple types of enteric pathogens can cause travel-acquired AGE and, while bacterial pathogens have a predominant role, the importance of viruses, such as norovirus, is increasingly recognized. There is a lack of information on travel-acquired norovirus incidence among symptomatic and asymptomatic individuals irrespective of healthcare-seeking behavior. Our aim is to estimate the incidence of travel-acquired AGE due to norovirus and to characterize the burden of disease among international travelers from the United States and Europe. Methods We describe a prospective cohort study implemented in five US and European sites to estimate the role of AGE due to norovirus among adult international travelers. We enrolled individuals aged 18 years and older who are traveling to regions of moderate-high risk of AGE, or via cruise ship with an international port stop, with a trip duration of 3–15 days. The study will generate a wide range of health and travel-related data for pre-, during, and up to 6-months post-travel. We will identify laboratory-confirmed travel-acquired norovirus infections among both symptomatic and asymptomatic individuals from self-collected whole stool samples tested via quantitative RT-PCR. Coinfections will be identified in a subset of travelers with AGE using a multiplex molecular-based assay. Discussion This study is unique in design and breadth of data collected. The prospective collection of health and behavioral data, as well as biologic samples from travelers irrespective of symptoms, will provide useful data to better understand the importance of norovirus AGE among international travelers. This study will provide data to estimate the incidence of norovirus infections and AGE and the risk of post-infectious sequelae in the 6-month post-travel period serving as a baseline for future norovirus AGE vaccination studies. This study will contribute valuable information to better understand the role of norovirus in travel-acquired AGE risk and the impact of these infections on a broad set of outcomes.
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Affiliation(s)
- Lisa Lindsay
- P95 Pharmacovigilance and Epidemiology Services, Koning Leopold III Laan 1, 3001, Leuven, Belgium.
| | - Herbert L DuPont
- University of Texas McGovern Medical School and School of Public Health, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Christine L Moe
- Emory University, Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Martin Alberer
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Leopoldstrasse 5, 80802, Munich, Germany
| | - Christoph Hatz
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4056, Basel, Switzerland.,University of Basel, Petersplatz 1, 4001, Basel, Switzerland.,University of Zurich; Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Centre for Travellers' Health, Hirschengraben 84, 8001, Zurich, Switzerland
| | - Amy E Kirby
- Emory University, Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Henry M Wu
- Emory University, Division of Infectious Diseases, Department of Medicine, 550 Peachtree Street NE MOT 7, Atlanta, GA, 30308, USA
| | - Thomas Verstraeten
- P95 Pharmacovigilance and Epidemiology Services, Koning Leopold III Laan 1, 3001, Leuven, Belgium
| | - Robert Steffen
- University of Texas McGovern Medical School and School of Public Health, 1200 Pressler Street, Houston, TX, 77030, USA.,University of Zurich; Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Centre for Travellers' Health, Hirschengraben 84, 8001, Zurich, Switzerland
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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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Bányai K, Estes MK, Martella V, Parashar UD. Viral gastroenteritis. Lancet 2018; 392:175-186. [PMID: 30025810 PMCID: PMC8883799 DOI: 10.1016/s0140-6736(18)31128-0] [Citation(s) in RCA: 257] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 05/09/2018] [Accepted: 05/15/2018] [Indexed: 12/20/2022]
Abstract
Enteric viruses, particularly rotaviruses and noroviruses, are a leading cause of gastroenteritis worldwide. Rotaviruses primarily affect young children, accounting for almost 40% of hospital admissions for diarrhoea and 200 000 deaths worldwide, with the majority of deaths occurring in developing countries. Two vaccines against rotavirus were licensed in 2006 and have been implemented in 95 countries as of April, 2018. Data from eight high-income and middle-income countries showed a 49-89% decline in rotavirus-associated hospital admissions and a 17-55% decline in all-cause gastroenteritis-associated hospital admissions among children younger than 5 years, within 2 years of vaccine introduction. Noroviruses affect people of all ages, and are a leading cause of foodborne disease and outbreaks of gastroenteritis worldwide. Prevention of norovirus infection relies on frequent hand hygiene, limiting contact with people who are infected with the virus, and disinfection of contaminated environmental surfaces. Norovirus vaccine candidates are in clinical trials; whether vaccines will provide durable protection against the range of genetically and antigenically diverse norovirus strains remains unknown. Treatment of viral gastroenteritis is based primarily on replacement of fluid and electrolytes.
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Affiliation(s)
- Krisztián Bányai
- Institute for Veterinary Medical Research, Centre for Agricultural Research, Hungarian Academy of Sciences, Budapest, Hungary.
| | - Mary K Estes
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Vito Martella
- Department of Veterinary Medicine, University Aldo Moro of Bari, Provincial Road to Casamassima, Valenzano, Italy
| | - Umesh D Parashar
- Viral Gastroenteritis Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Levenson EA, Martens C, Kanakabandi K, Turner CV, Virtaneva K, Paneru M, Ricklefs S, Sosnovtsev SV, Johnson JA, Porcella SF, Green KY. Comparative Transcriptomic Response of Primary and Immortalized Macrophages to Murine Norovirus Infection. THE JOURNAL OF IMMUNOLOGY 2018; 200:4157-4169. [PMID: 29735480 DOI: 10.4049/jimmunol.1700384] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 04/16/2018] [Indexed: 01/10/2023]
Abstract
Murine norovirus (NoV) is genetically similar to human NoV and offers both an efficient in vitro cell culture system and an animal model by which to investigate the molecular basis of replication. In this study, we present a detailed global view of host alterations to cellular pathways that occur during the progression of a NoV infection. This was accomplished for both Mus musculus BALB/c-derived RAW264.7 (RAW) cells, an immortalized cell line widely used in in vitro replication studies, and primary bone marrow-derived macrophages (BMDM), representing a permissive in vivo target cell in the host. Murine NoV replicated in both cell types, although detected genome copies were approximately one log lower in BMDM compared with RAW cells. RAW and BMDM cells shared an IRF3/7-based IFN response that occurred early in infection. In RAW cells, transcriptional upregulation and INF-β expression were not coupled in that a significant delay in the detection of secreted INF-β was observed. In contrast, primary BMDM showed an early upregulation of transcripts and immediate release of INF-β that might account for lower virus yield. Differences in the transcriptional pathway responses included a marked decrease in expression of key genes in the cell cycle and lipid pathways in RAW cells compared with that of BMDM. Our comparative analysis indicates the existence of varying host responses to virus infection in populations of permissive cells. Awareness of these differences at the gene level will be important in the application of a given permissive culture system to the study of NoV immunity, pathogenesis, and drug development.
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Affiliation(s)
- Eric A Levenson
- Caliciviruses Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and
| | - Craig Martens
- Rocky Mountain Laboratories Genomics Unit, Research Technologies Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT 59840
| | - Kishore Kanakabandi
- Rocky Mountain Laboratories Genomics Unit, Research Technologies Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT 59840
| | - Charles V Turner
- Rocky Mountain Laboratories Genomics Unit, Research Technologies Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT 59840
| | - Kimmo Virtaneva
- Rocky Mountain Laboratories Genomics Unit, Research Technologies Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT 59840
| | - Monica Paneru
- Rocky Mountain Laboratories Genomics Unit, Research Technologies Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT 59840
| | - Stacy Ricklefs
- Rocky Mountain Laboratories Genomics Unit, Research Technologies Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT 59840
| | - Stanislav V Sosnovtsev
- Caliciviruses Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and
| | - Jordan A Johnson
- Caliciviruses Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and
| | - Stephen F Porcella
- Rocky Mountain Laboratories Genomics Unit, Research Technologies Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT 59840
| | - Kim Y Green
- Caliciviruses Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and
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Leung KY, Trapman P, Britton T. Who is the infector? Epidemic models with symptomatic and asymptomatic cases. Math Biosci 2018; 301:190-198. [PMID: 29654792 DOI: 10.1016/j.mbs.2018.04.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/06/2018] [Accepted: 04/09/2018] [Indexed: 11/26/2022]
Abstract
What role do asymptomatically infected individuals play in the transmission dynamics? There are many diseases, such as norovirus and influenza, where some infected hosts show symptoms of the disease while others are asymptomatically infected, i.e. do not show any symptoms. The current paper considers a class of epidemic models following an SEIR (Susceptible → Exposed → Infectious → Recovered) structure that allows for both symptomatic and asymptomatic cases. The following question is addressed: what fraction ρ of those individuals getting infected are infected by symptomatic (asymptomatic) cases? This is a more complicated question than the related question for the beginning of the epidemic: what fraction of the expected number of secondary cases of a typical newly infected individual, i.e. what fraction of the basic reproduction number R0, is caused by symptomatic individuals? The latter fraction only depends on the type-specific reproduction numbers, while the former fraction ρ also depends on timing and hence on the probabilistic distributions of latent and infectious periods of the two types (not only their means). Bounds on ρ are derived for the situation where these distributions (and even their means) are unknown. Special attention is given to the class of Markov models and the class of continuous-time Reed-Frost models as two classes of distribution functions for latent and infectious periods. We show how these two classes of models can exhibit very different behaviour.
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Affiliation(s)
- Ka Yin Leung
- Department of mathematics, Stockholm University, Stockholm 106 91, Sweden.
| | - Pieter Trapman
- Department of mathematics, Stockholm University, Stockholm 106 91, Sweden.
| | - Tom Britton
- Department of mathematics, Stockholm University, Stockholm 106 91, Sweden.
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Genotypic and Epidemiological Trends of Acute Gastroenteritis Associated with Noroviruses in China from 2006 to 2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111341. [PMID: 29099784 PMCID: PMC5707980 DOI: 10.3390/ijerph14111341] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 10/23/2017] [Accepted: 10/31/2017] [Indexed: 12/14/2022]
Abstract
There are periodical norovirus-associated acute gastroenteritis outbreaks around the world. This study aimed to analyze the molecular and epidemiological features of norovirus infections in China during 2006–2016. We extracted epidemiological data from 132 norovirus outbreaks and the norovirus genotyping for 1291 sequences in China over the past ten years. A total of 132 norovirus outbreaks (8133 cases) were reported in China, where the east and south regions were most affected [47.7% (63/132)]. The highest number of outbreaks occurred in 2015. A seasonal pattern has been observed, with a peak from November to the following March. Most of the outbreaks occurred in middle and primary schools, accounting for 28.8% (38/132), and 28.0% (37/132) of outbreaks, respectively. The dominant age group was 10 to 19 years old, responsible for 75.7% (933/1232) of cases. Generally, the dominant genotypes was GII, for 81.9% (1058/1291) of sequences. G II.4 was the predominant genotype in China from 2004 to 2014. However, the GII.17 became more prevalent starting in 2014. Norovirus-associated acute gastroenteritis increased sharply in recent years caused by the emergence of GII.17, but epidemiological features have not changed during 2006–2016. Vigilant surveillance should be strengthened to promptly detect any variation.
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He T, McMillen TA, Qiu Y, Chen LH, Lu X, Pang XL, Kamboj M, Tang YW. Norovirus Loads in Stool Specimens of Cancer Patients with Norovirus Gastroenteritis. J Mol Diagn 2017; 19:836-842. [PMID: 28807813 DOI: 10.1016/j.jmoldx.2017.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 05/25/2017] [Accepted: 06/22/2017] [Indexed: 11/15/2022] Open
Abstract
In immunocompromised patients with norovirus (NoV) gastroenteritis, the relationship between fecal NoV load and clinical complications has not been examined. In this study, a validated real-time quantitative PCR assay was used to determine viral loads for NoV genogroup I and II (GI and GII) in NoV-positive stool specimens of cancer patients. A total of 234 specimens from 152 patients were positive for NoV, including 201 of GII and 33 of GI. Geometric mean of logarithmic copies per gram of stool (w/w) of NoV-GII were 9.03 ± 1.71 (means ± SD), which was significantly higher than that of NoV-GI [7.87 ± 1.49; odd ratio (OR), 3.22; 95% CI, 1.33-7.76; P = 0.009]. Among 152 patients with gastroenteritis, the fecal NoV geometric mean of logarithmic copy was correlated with mild (n = 85; 7.97 ± 1.55), moderate (n = 23; 9.09 ± 1.38), and severe (n = 44; 10.39 ± 0.91) episodes of severity by modified Vesikari scoring system, respectively. Multivariate analysis revealed that high level of NoV load was correlated with GII infections (OR, 4.13; 95% CI, 1.62-10.55; P = 0.003) and associated with development of severe clinical symptom (OR, 5.53; 95% CI, 2.00-7.24; P = 0.001) at the time of diagnosis. Infection with GII strains was more common than GI infection in cancer patients with viral gastroenteritis.
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Affiliation(s)
- Taojun He
- Department of Laboratory Medicine, Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China; Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Tracy A McMillen
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yuanyuan Qiu
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Liang Hua Chen
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Xuedong Lu
- Department of Laboratory Medicine, Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
| | - Xiao-Li Pang
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Alberta Provincial Laboratory for Public Health, Edmonton, Alberta, Canada
| | - Mini Kamboj
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, New York
| | - Yi-Wei Tang
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, New York.
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Brown LAK, Clark I, Brown JR, Breuer J, Lowe DM. Norovirus infection in primary immune deficiency. Rev Med Virol 2017; 27:e1926. [DOI: 10.1002/rmv.1926] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 01/19/2017] [Accepted: 01/31/2017] [Indexed: 02/06/2023]
Affiliation(s)
| | - Ian Clark
- Department of Cellular Pathology; Royal Free London NHS Foundation Trust; London UK
| | - Julianne R. Brown
- Microbiology, Virology and Infection Control; Great Ormond Street Hospital for Children NHS Foundation Trust; London UK
- NIHR Biomedical Research Centre; Great Ormond Street Hospital for Children NHS Foundation Trust and University College; London UK
| | - Judith Breuer
- Division of Infection and Immunity; University College London; London UK
| | - David M. Lowe
- Institute of Immunity and Transplantation; University College London, Royal Free Campus; London UK
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Abstract
Noroviruses are the leading cause of acute gastroenteritis around the world. An individual living in the United States is estimated to develop norovirus infection five times in his or her lifetime. Despite this, there is currently no antiviral or vaccine to combat the infection, in large part because of the historical lack of cell culture and small animal models. However, the last few years of norovirus research were marked by a number of ground-breaking advances that have overcome technical barriers and uncovered novel aspects of norovirus biology. Foremost among them was the development of two different
in vitro culture systems for human noroviruses. Underappreciated was the notion that noroviruses infect cells of the immune system as well as epithelial cells within the gastrointestinal tract and that human norovirus infection of enterocytes requires or is promoted by the presence of bile acids. Furthermore, two proteinaceous receptors are now recognized for murine norovirus, marking the first discovery of a functional receptor for any norovirus. Recent work further points to a role for certain bacteria, including those found in the gut microbiome, as potential modulators of norovirus infection in the host, emphasizing the importance of interactions with organisms from other kingdoms of life for viral pathogenesis. Lastly, we will highlight the adaptation of drop-based microfluidics to norovirus research, as this technology has the potential to reveal novel insights into virus evolution. This review aims to summarize these new findings while also including possible future directions.
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Affiliation(s)
- Eric Bartnicki
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Juliana Bragazzi Cunha
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Abimbola O Kolawole
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Christiane E Wobus
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, USA
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Baldridge MT, Turula H, Wobus CE. Norovirus Regulation by Host and Microbe. Trends Mol Med 2016; 22:1047-1059. [PMID: 27887808 DOI: 10.1016/j.molmed.2016.10.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 10/05/2016] [Accepted: 10/05/2016] [Indexed: 12/16/2022]
Abstract
Norovirus (NoV) infection is the leading cause of epidemic gastroenteritis globally, and can lead to detrimental chronic infection in immunocompromised hosts. Despite its prevalence as a cause of diarrheal illness, the study of human NoVs (HNoVs) has historically been limited by a paucity of models. The use of murine NoV (MNoV) to interrogate mechanisms of host control of viral infection has facilitated the exploration of different genetic mouse models, revealing roles for both innate and adaptive immunity in viral regulation. MNoV studies have also recently identified important interactions between the commensal microbiota and NoV with clear extensions to HNoVs. In this review, we discuss the most current understanding of how the host, the microbiome, and their interactions regulate NoV infections.
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Affiliation(s)
- Megan T Baldridge
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA.
| | - Holly Turula
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Christiane E Wobus
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, USA
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