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Wu C, Fu Z, Xie C, Zhao J, He F, Jiao B, Jiao B. Epidemiological Characteristics and Genotypic Features of Rotavirus and Norovirus in Jining City, 2021-2022. Viruses 2024; 16:925. [PMID: 38932216 PMCID: PMC11209223 DOI: 10.3390/v16060925] [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: 04/25/2024] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
Diarrhea, often caused by viruses like rotavirus (RV) and norovirus (NV), is a global health concern. This study focuses on RV and NV in Jining City from 2021 to 2022. Between 2021 and 2022, a total of 1052 diarrhea samples were collected. Real-Time Quantitative Fluorescent Reverse Transcriptase-PCR was used to detect RV-A, NV GI, and NV GII. For RV-A-positive samples, VP7 and VP4 genes were sequenced for genotype analysis, followed by the construction of evolutionary trees. Likewise, for NV-GII-positive samples, VP1 and RdRp genes were sequenced for genotypic analysis, and evolutionary trees were subsequently constructed. Between 2021 and 2022, Jining City showed varying detection ratios: RV-A alone (excluding co-infection of RV-A and NV GII) at 7.03%, NV GI at 0.10%, NV GII alone (excluding co-infection of RV-A and NV GII) at 5.42%, and co-infection of RV-A and NV GII at 1.14%. The highest RV-A ratios were shown in children ≤1 year and 2-5 years. Jining, Jinxiang County, and Liangshan County had notably high RV-A ratios at 24.37% (excluding co-infection of RV-A and NV GII) and 18.33% (excluding co-infection of RV-A and NV GII), respectively. Jining, Qufu, and Weishan had no RV-A positives. Weishan showed the highest NV GII ratios at 35.48% (excluding co-infection of RV-A and NV GII). Genotype analysis showed that, in 2021, G9P[8] and G2P[4] were dominant at 94.44% and 5.56%, respectively. In 2022, G8P[8], G9P[8], and G1P[8] were prominent at 75.86%, 13.79%, and 10.35%, respectively. In 2021, GII.3[P12], GII.4[P16], and GII.4[P31] constituted 71.42%, 14.29%, and 14.29%, respectively. In 2022, GII.3[P12] and GII.4[P16] accounted for 55.00% and 45.00%, respectively. RV-A and NV showed varying patterns for different time frames, age groups, and regions within Jining. Genotypic shifts were also observed in prevalent RV-A and NV GII strains in Jining City from 2021 to 2022. Ongoing monitoring of RV-A and NV is recommended for effective prevention and control.
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Affiliation(s)
- Changjing Wu
- Department of Laboratory, Jining Center for Disease Control and Prevention, Jining 272000, China; (C.W.); (C.X.); (J.Z.)
| | - Zhongyan Fu
- Department of Infectious Disease Control, Shandong Center for Disease Control and Prevention, Jinan 250001, China;
| | - Cuihua Xie
- Department of Laboratory, Jining Center for Disease Control and Prevention, Jining 272000, China; (C.W.); (C.X.); (J.Z.)
| | - Jian Zhao
- Department of Laboratory, Jining Center for Disease Control and Prevention, Jining 272000, China; (C.W.); (C.X.); (J.Z.)
| | - Feifei He
- Computer Information Technology, Northern Arizona University, Flagstaff, AZ 86011, USA;
| | - Boyan Jiao
- Department of Laboratory, Jining Center for Disease Control and Prevention, Jining 272000, China; (C.W.); (C.X.); (J.Z.)
| | - Baihai Jiao
- Department of Medicine, School of Medicine, University of Connecticut Health Center, Farmington, CT 06032, USA
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Omatola CA, Ogunsakin RE, Onoja AB, Okolo MLO, Abraham-Oyiguh J, Mofolorunsho KC, Akoh PQ, Adejo OP, Idakwo J, Okeme TO, Muhammed D, Adaji DM, Samson SO, Aminu RF, Akor ME, Edegbo E, Adamu AM. Enteropathogenic viruses associated with acute gastroenteritis among African children under 5 years of age: A systematic review and meta-analysis. J Infect 2024; 88:106169. [PMID: 38697269 DOI: 10.1016/j.jinf.2024.106169] [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: 12/01/2023] [Revised: 04/20/2024] [Accepted: 04/22/2024] [Indexed: 05/04/2024]
Abstract
Gastroenteritis viruses are the leading etiologic agents of diarrhea in children worldwide. We present data from thirty-three (33) eligible studies published between 2003 and 2023 from African countries bearing the brunt of the virus-associated diarrheal mortality. Random effects meta-analysis with proportion, subgroups, and meta-regression analyses were employed. Overall, rotavirus with estimated pooled prevalence of 31.0 % (95 % CI 24.0-39.0) predominated in all primary care visits and hospitalizations, followed by norovirus, adenovirus, sapovirus, astrovirus, and aichivirus with pooled prevalence estimated at 15.0 % (95 % CI 12.0-20.0), 10 % (95 % CI 6-15), 4.0 % (95 % CI 2.0-6.0), 4 % (95 % CI 3-6), and 2.3 % (95 % CI 1-3), respectively. Predominant rotavirus genotype was G1P[8] (39 %), followed by G3P[8] (11.7 %), G9P[8] (8.7 %), and G2P[4] (7.1 %); although, unusual genotypes were also observed, including G3P[6] (2.7 %), G8P[6] (1.7 %), G1P[6] (1.5 %), G10P[8] (0.9 %), G8P[4] (0.5 %), and G4P[8] (0.4 %). The genogroup II norovirus predominated over the genogroup I-associated infections (84.6 %, 613/725 vs 14.9 %, 108/725), with the GII.4 (79.3 %) being the most prevalent circulating genotype. In conclusion, this review showed that rotavirus remains the leading driver of viral diarrhea requiring health care visits and hospitalization among under-five years children in Africa. Thus, improved rotavirus vaccination in the region and surveillance to determine the residual burden of rotavirus and the evolving trend of other enteric viruses are needed for effective control and management of cases.
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Affiliation(s)
| | - Ropo Ebenezer Ogunsakin
- School of Health Systems and Public Health, University of Pretoria, Faculty of Health Sciences, Pretoria, South Africa
| | | | | | - Joseph Abraham-Oyiguh
- Department of Microbiology, Kogi State University, Anyigba P.M.B. 1008, Kogi State, Nigeria
| | | | - Phoebe Queen Akoh
- Department of Microbiology, Kogi State University, Anyigba P.M.B. 1008, Kogi State, Nigeria
| | - Omebije Patience Adejo
- Department of Microbiology, Kogi State University, Anyigba P.M.B. 1008, Kogi State, Nigeria
| | - Joshua Idakwo
- Department of Animal and Environmental Biology, Kogi State University, Anyigba P.M.B. 1008, Kogi State, Nigeria
| | | | - Danjuma Muhammed
- Department of Biology, Epidemiology, and Public Health Unit, Universiti Putra Malaysia, Malaysia
| | - David Moses Adaji
- Department of Biotechnology Science and Engineering, University of Alabama, Huntsville, United States
| | | | - Ruth Foluke Aminu
- Department of Microbiology, Kogi State University, Anyigba P.M.B. 1008, Kogi State, Nigeria
| | - Monday Eneojo Akor
- Department of Microbiology, Kogi State University, Anyigba P.M.B. 1008, Kogi State, Nigeria
| | - Emmanuel Edegbo
- Department of Microbiology, Kogi State University, Anyigba P.M.B. 1008, Kogi State, Nigeria
| | - Andrew Musa Adamu
- Australian Institute of Tropical Health and Medicine, James Cook University, 4811 Queensland, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, 4811 Queensland, Australia; Center for Tropical Biosecurity, James Cook University, 4811 Queensland, Australia.
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Chigor VN, Chidebelu PE, Digwo DC, Chigor CB, Nwagwu AU, Udeh OS, Oguonu CI, Dibua MEU, Farkas K. Assessment of the aetiology of acute gastroenteritis outbreaks in infants reveals rotavirus, noroviruses and adenovirus prevalence and viral coinfections in Nsukka, Nigeria. Virusdisease 2023; 34:297-306. [PMID: 37408547 PMCID: PMC10317937 DOI: 10.1007/s13337-023-00821-2] [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] [Received: 12/27/2022] [Accepted: 04/10/2023] [Indexed: 07/07/2023] Open
Abstract
A better understanding of the aetiology of acute gastroenteritis (AGE) outbreaks in Southeast Nigeria would help safeguarding public health. This study screened stool samples collected from infants (children < 5 years of age) attending selected hospitals in Nsukka for human enteric viruses and evaluated the seasonality of AGE based on three-year records available at selected hospitals. A total of 120 stool samples (109 from diarrhoeal-patients and 11 from non-diarrhoeal patients, as control) collected during the AGE outbreaks of January - March 2019 and January-February 2020. The samples were analysed using an immunochromatographic lateral flow assay for differential qualitative detection of rotavirus (RoV), adenovirus (AdV), and norovirus genogroups I and II (NoVI, NoVII). Three-year (2017-2019) retrospective data on the cases of AGE reported at the hospitals were also collected and analysed. The overall prevalence of acute gastroenteritis was high (75.83%), with 13.19%representing viral co-infections. Rotavirus detection rate (69.17%) was higher than that for other viral agents (15.83%). Both mono- and mixed infections were observed for RoV, AdV and NoVII, whereas NoVI was detected only in co-infection cases. Analysis of risk factors showed that acute gastroenteritis was detected more often in infants of age ˂1 year (73.53%) than in those 1 ≤ 2 years (22.55%) or > 2 years (3.92%) in age. Gender and age were not associated with the cases of co-infections (p˂0.05). The seasonality data indicated one peak of the infection occurring in January 2017 which has decreased consecutively in the subsequent two years. These results demonstrate the prevalence and co-occurrence of enteric viruses in cases of infantile diarrhoea in Nsukka. Further molecular characterization of enteric virus strains, especially noroviruses, in this region would contribute significantly to global epidemiological data. Supplementary Information The online version contains supplementary material available at 10.1007/s13337-023-00821-2.
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Affiliation(s)
- Vincent N. Chigor
- Water and Public Health Research Group (WPHRG), University of Nigeria, Nsukka, Enugu State Nigeria
| | - Paul E. Chidebelu
- Water and Public Health Research Group (WPHRG), University of Nigeria, Nsukka, Enugu State Nigeria
| | - Daniel C. Digwo
- Water and Public Health Research Group (WPHRG), University of Nigeria, Nsukka, Enugu State Nigeria
| | - Chinyere B. Chigor
- Water and Public Health Research Group (WPHRG), University of Nigeria, Nsukka, Enugu State Nigeria
| | - Aja U. Nwagwu
- Water and Public Health Research Group (WPHRG), University of Nigeria, Nsukka, Enugu State Nigeria
| | - Okwundu S. Udeh
- GOPD/Paediatrics, Faith Foundation Mission Hospital, Nsuk,Ka, Nsukka, Enugu State Nigeria
| | - Chukwunonso I. Oguonu
- GOPD/Paediatrics, Nsukka Medical Clinic, Ugwunkwo, Nsukka, Nsukka, Enugu State Nigeria
| | - Marie-Esther U. Dibua
- Water and Public Health Research Group (WPHRG), University of Nigeria, Nsukka, Enugu State Nigeria
| | - Kata Farkas
- School of Ocean Sciences, Bangor University, Menai Bridge, Anglesey, UK
- School of Natural Sciences, Bangor University, Bangor, Gwynedd UK
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Eugenia Afocha E, Abiodun Iwalokun B, Deji-Agboola MA, Ayorinde James B, Abayomi Banjo T, Adu F, Chukwujekwu Ezechi O, Adegbola R, Lawal Salako B. Prevalence and spatiotemporal distribution of rotavirus diarrhea among children younger than five years old in Lagos, Nigeria. J Immunoassay Immunochem 2023; 44:117-132. [PMID: 36576163 DOI: 10.1080/15321819.2022.2159430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Data on spatiotemporal distribution of rotavirus diarrhea are limited in many endemic settings. This study determined the prevalence and seasonal distribution of rotavirus among Nigerian children with diarrhea. Here, a total of 406 fecal samples were collected from patients attending six health facilities in Lagos between January - December 2019. Socio-demographic data of each enrolled child were collected. Rotavirus VP6 antigen was detected by enzyme-linked immunoassay (ELISA) and confirmation by VP7 gene detection by reverse transcription polymerase-chain reaction. The overall rotavirus diarrhea prevalence was 16.3% by ELISA with children above 2 years having 29.2% of this prevalence and higher occurrence in females (59.1%) than males (40.9%) (P < .05). Rotavirus diarrhea diagnosis using RT-PCR showed 100% concordance with ELISA. Cases of rotavirus diarrhea were detected from March to July and from September to November with the highest number of cases detected in May and June (22.7% each), followed by July (21.2%). The prevalence of rotavirus diarrhea remains high in Lagos with an emerging higher disease activity in children above 2. A different rotavirus transmission dynamics compared to previous studies from Nigeria and other African countries was found. VP6 ELISA may reliably be used for continuous rotavirus surveillance in Nigeria.
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Affiliation(s)
- Ebelechukwu Eugenia Afocha
- Medical Microbiology & Parasitology Department, Olabisi Onabanjo University, Nigeria.,Centre for Infectious Disease Research, Microbiology Department, Nigerian Institute of Medical Research, Nigeria
| | - Bamidele Abiodun Iwalokun
- Medical Microbiology & Parasitology Department, Olabisi Onabanjo University, Nigeria.,Molecular Biology & Biotechnology Department, Nigerian Institute of Medical Research, Nigeria.,Central Research Laboratory Department, Nigerian Institute of Medical Research, Nigeria
| | | | | | - Taiwo Abayomi Banjo
- Medical Microbiology & Parasitology Department, Olabisi Onabanjo University, Nigeria
| | - Festus Adu
- All Saints University Medical School, Cnr Hillborough and Great George Street, Common Wealth of Dominica, West Indies
| | | | - Richard Adegbola
- Centre for Infectious Disease Research, Microbiology Department, Nigerian Institute of Medical Research, Nigeria
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Yang L, Shi S, Na C, Li B, Zhao Z, Yang T, Yao Y. Rotavirus and Norovirus Infections in Children Under 5 Years Old with Acute Gastroenteritis in Southwestern China, 2018-2020. J Epidemiol Glob Health 2022; 12:292-303. [PMID: 35857268 PMCID: PMC9297278 DOI: 10.1007/s44197-022-00050-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/05/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Rotaviruses and noroviruses are important causes of acute gastroenteritis in children. While previous studies in China have mainly focused on rotavirus, we investigated the incidence of norovirus in addition to rotavirus in Southwestern China. METHODS From January 2018 to December 2020, cases of rotavirus or norovirus infections among children under five ages with acute gastroenteritis were evaluated retrospectively. RESULTS The detection rate of rotavirus was 24.5% (27,237/111,070) and norovirus was 26.1% (4649/17,797). Among 17,113 cases submitted for dual testing of both rotavirus and norovirus, mixed rotavirus/norovirus infections were detected in 5.0% (859/17,113) of cases. While there was no difference in norovirus incidence in outpatient compared to hospitalized cases, rotavirus was detected two times more in outpatients compared to hospitalized cases (26.6% vs.13.6%; P < 0.001). Both rotavirus and norovirus infections peaked in children aged 12-18 months seeking medical care with acute gastroenteritis (35.6% rotavirus cases; 8439/23,728 and 32.5% norovirus cases; 1660/5107). Rotavirus infections were frequent between December and March of each year while norovirus was detected earlier from October to December. Our results showed significant correlation between virus detection and environmental factors such as average monthly temperature but not relative humidity. In addition, we observed a reduction in the detection rates of rotavirus and norovirus at the beginning of the SARS-CoV-2 pandemic in 2020. CONCLUSION Our results indicate that rotavirus and norovirus are still important viral agents in pediatric acute gastroenteritis in Southwestern China.
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Affiliation(s)
- Longyu Yang
- Yunnan Key Laboratory of Vaccine Research & Development On Severe Infectious Disease, Department of Immunogenetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, 650118, Yunnan, People's Republic of China
| | - Shulan Shi
- Institute of Pediatrics, Children's Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, 650228, People's Republic of China
| | - Chen Na
- Department of Pediatrics, Yanan Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, 650000, People's Republic of China
| | - Bai Li
- Yunnan Key Laboratory of Vaccine Research & Development On Severe Infectious Disease, Department of Immunogenetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, 650118, Yunnan, People's Republic of China
| | - Zhimei Zhao
- Yunnan Key Laboratory of Vaccine Research & Development On Severe Infectious Disease, Department of Immunogenetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, 650118, Yunnan, People's Republic of China
| | - Tao Yang
- Department of Pediatrics, Yanan Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, 650000, People's Republic of China.
| | - Yufeng Yao
- Yunnan Key Laboratory of Vaccine Research & Development On Severe Infectious Disease, Department of Immunogenetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, 650118, Yunnan, People's Republic of China.
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Hasan H, Nasirudeen NA, Ruzlan MAF, Mohd Jamil MA, Ismail NAS, Wahab AA, Ali A. Acute Infectious Gastroenteritis: The Causative Agents, Omics-Based Detection of Antigens and Novel Biomarkers. CHILDREN (BASEL, SWITZERLAND) 2021; 8:1112. [PMID: 34943308 PMCID: PMC8700514 DOI: 10.3390/children8121112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/25/2022]
Abstract
Acute infectious gastroenteritis (AGE) is among the leading causes of mortality in children less than 5 years of age worldwide. There are many causative agents that lead to this infection, with rotavirus being the commonest pathogen in the past decade. However, this trend is now being progressively replaced by another agent, which is the norovirus. Apart from the viruses, bacteria such as Salmonella and Escherichia coli and parasites such as Entamoeba histolytica also contribute to AGE. These agents can be recognised by their respective biological markers, which are mainly the specific antigens or genes to determine the causative pathogen. In conjunction to that, omics technologies are currently providing crucial insights into the diagnosis of acute infectious gastroenteritis at the molecular level. Recent advancement in omics technologies could be an important tool to further elucidate the potential causative agents for AGE. This review will explore the current available biomarkers and antigens available for the diagnosis and management of the different causative agents of AGE. Despite the high-priced multi-omics approaches, the idea for utilization of these technologies is to allow more robust discovery of novel antigens and biomarkers related to management AGE, which eventually can be developed using easier and cheaper detection methods for future clinical setting. Thus, prediction of prognosis, virulence and drug susceptibility for active infections can be obtained. Case management, risk prediction for hospital-acquired infections, outbreak detection, and antimicrobial accountability are aimed for further improvement by integrating these capabilities into a new clinical workflow.
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Affiliation(s)
- Haziqah Hasan
- Department of Pediatric, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia; (H.H.); (N.A.N.); (M.A.F.R.); (M.A.M.J.)
| | - Nor Ashika Nasirudeen
- Department of Pediatric, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia; (H.H.); (N.A.N.); (M.A.F.R.); (M.A.M.J.)
| | - Muhammad Alif Farhan Ruzlan
- Department of Pediatric, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia; (H.H.); (N.A.N.); (M.A.F.R.); (M.A.M.J.)
| | - Muhammad Aiman Mohd Jamil
- Department of Pediatric, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia; (H.H.); (N.A.N.); (M.A.F.R.); (M.A.M.J.)
| | - Noor Akmal Shareela Ismail
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia;
| | - Asrul Abdul Wahab
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia;
| | - Adli Ali
- Department of Pediatric, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia; (H.H.); (N.A.N.); (M.A.F.R.); (M.A.M.J.)
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Yen CS, Huang YC, Chen CJ, Shie SS, Yang SL, Huang CG, Tsao KC, Chiu CH, Hsieh YC, Kuo CY, Arthur Huang KY, Lin TY. Detection of norovirus and rotavirus among inpatients with acute gastroenteritis in a medical center in northern Taiwan, 2013–2018. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2020; 53:955-962. [DOI: 10.1016/j.jmii.2020.06.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/10/2020] [Accepted: 06/26/2020] [Indexed: 12/14/2022]
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Amarasiri M, Utagawa E, Sano D, Katayama K. Identification of novel norovirus polymerase genotypes from pediatric fecal samples collected between the year 1997 and 2000 in Japan. INFECTION GENETICS AND EVOLUTION 2020; 82:104313. [PMID: 32259662 DOI: 10.1016/j.meegid.2020.104313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/12/2020] [Accepted: 04/01/2020] [Indexed: 11/24/2022]
Abstract
We analyzed 46 pediatric fecal samples collected between the years 1997 and 2000 to retrospectively evaluate the norovirus strains circulating during that era and to identify possible re-emergence patterns. From the tested fecal samples, we detected GII.1, GII.3, GII.4 (95/96-US) and GII.6 strains. Most importantly, two novel polymerase genotypes (GI.PNA4 and GII.PNA7) were detected during the study. Two possible recombinant strains (GII.6[P7] and GII.3[P29]) were identified and SimPlot analysis confirmed that GII.6[P7] is a recombinant strain. The study emphasizes the importance of retrospective evaluation of human fecal samples in obtaining a better understanding of norovirus circulation, re-emergence and evolution.
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Affiliation(s)
- Mohan Amarasiri
- Department of Civil and Environmental Engineering, Graduate School of Engineering, Tohoku University, Aoba 6-6-06, Aramaki, Aoba-ku, Sendai, Miyagi 980-8579, Japan.
| | - Etsuko Utagawa
- National Institute of Infectious Diseases, Gakuen 4-7-1, Musashi-murayama, Tokyo 208-0011, Japan.
| | - Daisuke Sano
- Department of Civil and Environmental Engineering, Graduate School of Engineering, Tohoku University, Aoba 6-6-06, Aramaki, Aoba-ku, Sendai, Miyagi 980-8579, Japan; Department of Frontier Science for Advanced Environment, Graduate School of Environmental Studies, Tohoku University, Aoba 6-6-06, Aramaki, Aoba-ku, Sendai, Miyagi 980-8579, Japan
| | - Kazuhiko Katayama
- Laboratory of Viral Infection I, Department of Infection Control and Immunology, Kitasato Institute for Life Sciences and Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
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