Norovirus

Neuromorphic chips for biomedical engineering

The modern medical field faces two critical challenges: the dramatic increase in data complexity and the explosive growth in data size. Especially in current research, medical diagnostic, and data processing devices relying on traditional computer architecture are increasingly showing limitations when faced with dynamic temporal and spatial processing requirements, as well as high-dimensional data processing tasks. Neuromorphic devices provide a new way for biomedical data processing due to their low energy consumption and high dynamic information processing capabilities. This paper aims to reveal the advantages of neuromorphic devices in biomedical applications. First, this review emphasizes the urgent need of biomedical engineering for diversify clinical diagnostic techniques. Secondly, the feasibility of the application in biomedical engineering is demonstrated by reviewing the historical development of neuromorphic devices from basic modeling to multimodal signal processing. In addition, this paper demonstrates the great potential of neuromorphic chips for application in the fields of biosensing technology, medical image processing and generation, rehabilitation medical engineering, and brain-computer interfaces. Finally, this review provides the pathways for constructing standardized experimental protocols using biocompatible technologies, personalized treatment strategies, and systematic clinical validation. In summary, neuromorphic devices will drive technological innovation in the biomedical field and make significant contributions to life health.

Global burden of human noroviruses contamination in drinking water sources and drinking water: A systematic review and meta-analysis identifying GII.4 and GII.17 as dominant genotypes

Human Noroviruses (HuNoVs) are the leading etiologic agents responsible for viral gastroenteritis. Drinking water (DW) serves as a significant vehicle for the transmission of HuNoVs. This study aimed to assess the occurrence of HuNoVs in drinking water sources (DWS) and DW. A systematic search spanning Web of Science, EMBASE, PubMed, and Cochrane Central Register of Controlled Trials was executed up to July 15, 2024. Following rigorous screening, 76 eligible studies underwent meta-analysis with heterogeneity assessment via Stata 14.0 using a random-effects model. The results indicated that the pooled occurrence of HuNoVs was 11 % (95 % CI: 8-14), with occurrence of 15 % (95 % CI: 10-21) in DWS and 6 % (95 % CI: 3-9) in DW. Subgroup meta-analysis demonstrated that genogroup II (GII) of HuNoVs exhibited the highest contamination occurrence of 7 % (95 % CI: 4-10), with GII.4 and GII.17 being the predominant genotypes. The two continents with the highest number of studies were Asia (n = 27) and Europe (n = 19), with HuNoVs occurrence of 14 % (95 % CI: 8-22) and 15 % (95 % CI: 7-26), respectively. Furthermore, the occurrence showed no significant differences across the four seasons: in spring, the occurrence was 11 % (95 % CI: 3-23); in summer, 15 % (95 % CI: 7-25); in autumn, 11 % (95 % CI: 2-24); and in winter, 18 % (95 % CI: 10-27). These findings provided valuable epidemiological insight into the global occurrence, seasonal variation, and genotypic distribution of HuNoVs in DWS and DW, aiding policy development and public health strategies.

Integrated in-silico design and in vivo validation of multi-epitope vaccines for norovirus

BACKGROUND

Norovirus (NoVs) is a foodborne pathogen that causes acute gastroenteritis. The diversity of its principal antigenic protein poses a significant challenge to vaccine development and the prevention of large-scale outbreaks globally. Currently, no licensed vaccines against norovirus have been approved.

METHODS

We developed a novel pipeline that integrates multiple bioinformatics tools to design broad-spectrum vaccines against NoVs. Specifically, broad-spectrum T-cell epitope vaccines were designed based on consensus sequences and optimized epitope screening, while broad-spectrum B-cell spatial epitope vaccines were constructed using high-throughput antigenicity calculations and epitope mapping.

RESULTS

This pipeline underwent rigorous validation at three levels: firstly, In silico validation: Analysis of properties and structures demonstrated the appropriateness of amino acid composition and the structural integrity of the vaccine sequences. Secondly, theoretical assessment: Evaluation of human leukocyte antigen (HLA) subtype and antigenicity coverage indicated a broad theoretical protective spectrum for the designed vaccine immunogens. Furthermore, in silico simulation confirmed their ability to elicit an immune response. Finally, animal-level validation: Experiments in mice showed that both vaccine immunogens stimulated high levels of IgG and IgA. Notably, Vac-B induced a strong IgG response against GII.2 and a robust IgA response against GII.17, comparable to the immune response elicited by the wild-type NoV non-replicating virus-like particle (VLP) protein group.

CONCLUSIONS

Both in silico and in vivo experimental findings suggest that the proposed pipeline and vaccine immunogens could serve as valuable theoretical guidance for the development of multi-epitope vaccines against NoVs.

Identification of potential 3CLpro inhibitors-modulators for human norovirus infections through an advanced virtual screening approach

The present study aimed to screen small molecular compounds such as human noroviruses (HuNoV) inhibitors/modulators that could potentially be responsible for exhibiting some magnitude of inhibitory/modulatory activity against HuNoV 3CLPro. The structural similarity-based screening against the ChEMBL database is performed against known chemical entities that are presently under pre-clinical trial. After the similarity search, remaining molecules were considered for molecular docking using SCORCH and PLANTS. On detailed analyses and comparisons with the control molecule, three hits (CHEMBL393820, CHEMBL2028556, and CHEMBL3747799) were found to have the potential for HuNoV 3CLpro inhibition/modulation. The binding interaction analysis revealed several critical amino acids responsible to hold the molecules tightly at the close proximity site of the catalytic residues of HuNoV 3CLpro. Further, MD simulation study was performed in triplicate to understand the binding stability and potentiality of the proposed molecule toward HuNov 3CLpro. The binding free energy based on MM-GBSA has revealed their strong interaction affinity with 3CLpro.

Wastewater surveillance of antibiotic-resistant bacteria for public health action: potential and challenges

Antibiotic resistance is an urgent public health threat. Actions to reduce this threat include requiring prescriptions for antibiotic use, antibiotic stewardship programs, educational programs targeting patients and healthcare providers, and limiting antibiotic use in agriculture, aquaculture, and animal husbandry. Wastewater surveillance might complement clinical surveillance by tracking time/space variation essential for detecting outbreaks and evaluating efficacy of evidence-based interventions, identifying high-risk populations for targeted monitoring, providing early warning of the emergence and spread of antibiotic-resistant bacteria (ARBs), and identifying novel antibiotic-resistant threats. Wastewater surveillance was an effective early warning system for SARS-CoV-2 spread and detection of the emergence of new viral strains. In this data-driven commentary, we explore whether monitoring wastewater for antibiotic-resistant genes (ARGs) and/or bacteria resistant to antibiotics might provide useful information for public health action. Using carbapenem resistance as an example, we highlight technical challenges associated with using wastewater to quantify temporal/spatial trends in ARBs and ARGs and compare with clinical information. While ARGs and ARBs are detectable in wastewater enabling early detection of novel ARGs, quantitation of ARBs and ARGs with current methods is too variable to reliably track space/time variation.

Epidemiological trends of diarrheal viruses in central and western Kenya before and after Rotavirus vaccine introduction

BACKGROUND

Rotavirus, norovirus, adenovirus (type 40/41) and astrovirus are the most significant viral etiological agents of acute gastroenteritis in young children globally. Kenya introduced the rotavirus vaccine into her National Immunization Program in July 2014, which has led to a significant decline in the prevalence of rotavirus. We sought to assess the impact of rotavirus vaccination on the epidemiological trends of other diarrhea-associated enteric viruses across different regions in Kenya.

METHODOLOGY

Using conventional and multiplex RT-PCR, we analyzed a total of 716 fecal samples for adenovirus, astrovirus and norovirus from children aged below 5 years presenting with acute gastroenteritis but tested negative for rotavirus at Mbita Sub-County Referral Hospital in Western Kenya and Kiambu County Referral Hospital in Central Kenya before (2011-2013) and after (2019-2020) rotavirus vaccine introduction.

RESULTS

Following the rotavirus vaccine introduction, there was no significant difference in norovirus and astrovirus prevalence post-vaccine introduction in both Central (norovirus- 5.4% vs 5.9%; astrovirus- 2% vs 2.4%) and Western Kenya (norovirus- 2% vs 3%; astrovirus 3.3% vs 5.9%). Although the prevalence of adenovirus increased substantially in Western Kenya (9% vs 12.4%), there was a significant decrease in adenovirus in Central Kenya (17%, vs 6%, p = 0.007). Before the introduction of the rotavirus vaccine, a large proportion of adenovirus cases occurred at 6-8 months in Central Kenya and 12-23 months in Western Kenya, while norovirus prevalence was highest at 12-23 months in Central and 3-5 months in Western Kenya. Astrovirus infections in Central Kenya were predominantly among children aged 12-23 months, both before and after the vaccine. Following vaccine introduction, a large proportion of adenovirus cases occurred among children aged 12-23 months in both regions. Norovirus peaked at 12-23 months in Central Kenya and showed dual peaks at 3-5 and 9-11 months in Western Kenya. Astrovirus infections in Western Kenya shifted from peaks at 6-8 and 24-59 months pre-vaccine to 9-11 months post-vaccine.

CONCLUSION

Our data demonstrate the burden and changing epidemiology of enteric viruses in Western and Central Kenya and underscores the need for continued monitoring to guide the design and implementation of appropriate public health interventions.

Peroxide Disinfection of Vesicle-Cloaked Murine Norovirus Clusters: Vesicle Membranes Protect Viruses from Inactivation

Vesicle-cloaked virus clusters, also known as viral vesicles, exhibit higher infectivity than free viruses and demonstrate persistence in the environment as well as resilience against disinfection. These emerging pathogens represent significant, yet often underestimated, health risks. Our study investigated peroxide disinfection of murine norovirus vesicles, a surrogate for human norovirus vesicles, and elucidated disinfection mechanisms. Peracetic acid, a neutral peroxide, rapidly inactivated murine norovirus vesicles. In contrast, negatively charged peroxides, i.e., peracetate and peroxymonosulfate, exhibited restricted effectiveness in inactivating murine noroviruses within vesicles. The largely intact viruses cloaked within vesicles remained infectious and retained their ability to replicate upon vesicle lysis triggered by mechanical forces, enzymatic activity, or chemical reactions following disinfection. Peroxides primarily targeted vesicle/viral proteins, particularly amino acid residues such as cysteine and methionine, without affecting the viral ORF2 gene fragment or vesicle structures. Disruption of viral internalization, rather than binding, plays a key role in infectivity loss. This work highlights the protective role of vesicle membranes and emphasizes the need for innovative disinfection approaches to effectively target viruses cloaked within vesicles.

Diaryl Diimidazopyrimidine Derivatives as Potent Inhibitors of Influenza A Virus: Synthesis, Evaluation and Docking Studies

In this report, we present a new series of diaryl diimidazopyrimidine derivatives 3a-m, that have been synthesized and assessed for their in vitro antiviral activity. The derivatives were prepared through a one-step reaction involving commercially available 2,4-diamino-6-chloropyrimidine and various phenacyl bromides 2a-m, leading to the formation of the desired diaryl diimidazo- pyrimidines 3a-m with good yields. In vitro evaluations against the Influenza A H1N1 strain identified compounds 3m (SI = 73) and 3b (SI = 23) as the most potent candidates. Additionally, antimicrobial screening indicated that compounds 3d and 3j, which contain methyl and methoxy substitutions, exhibited moderate activity against Streptococcus mutans, Salmonella typhi, and Candida albicans. Molecular Docking studies of the promising compounds 3b and 3m demonstrated significant binding interactions with the M1 matrix protein (PDB ID: 5CQE) in comparison to M2 proton channel of Influenza A (PDB: 6US9), suggesting that these derivatives may be effectively targeting the M1 protein. Additionally, molecular dynamics (MD) simulations were conducted to evaluate the stability, dynamic behaviour, and binding affinity of the most potent compounds 3b and 3m. The in vitro antiviral studies, molecular docking and MD simulations data highlight the promising pharmacological potential of these analogues, paving the way for further structural optimization and development as potential antiviral agents.

Endoscopic findings among healthy adults with asymptomatic norovirus infection in Japan: A single-center cross-sectional study

INTRODUCTION

Norovirus infection, a major cause of acute viral gastroenteritis, is commonly reported during the winter season. Norovirus invades the upper intestinal tract, causing inflammation. In severe cases, endoscopic findings and complications, including duodenal perforation, have been reported. However endoscopic findings in patients with asymptomatic infections have rarely been reported. Therefore, this study aimed to investigate the upper endoscopic findings of patients with asymptomatic norovirus infection.

METHODS

Healthy adults (aged ≥18 years) who participated in voluntary health examinations between February 2017 and January 2018 were recruited twice a week. Only the individuals who had undergone esophagogastroduodenoscopy (EGD) were included. The primary outcome measure was the presence of any gross findings of EGD.

RESULTS

The norovirus genogroup I (GI)-positive group had more duodenal scarring than the norovirus negative group (16.3 % vs 5.9 %, respectively). After adjustment for age category, sex, and alcohol consumption status, duodenal ulcer scarring exhibited a significant association with GI-positive status (adjusted odds ratio: 3.11; 95 % confidence interval: 1.42-6.82; p = 0.005, Bonferroni-corrected, p = 0.015).

CONCLUSIONS

Healthy adults with asymptomatic norovirus (GI-positive) infection showed predominantly more duodenal ulcer scarring than the norovirus-negative group on EGD.

Virucidal Activity of Lemon Juice Against Feline Calicivirus, Surrogate of Norovirus

Noroviruses are a major cause of acute gastroenteritis, often transmitted through contaminated food and water. In this study, lemon juice (LJ), rich in citric acid (CA) and flavonoids, was tested against Feline Calicivirus (FCV), used as a surrogate of human norovirus. Significant virucidal activity was observed for pure LJ (pH = 2.3), with a reduction in viral titers as high as 4.50 log10 TCID50/50 µL after 30 s and complete inactivation after 1 min. LJ also showed limited virucidal activity at a dilution of 1:2000 (pH = 6.7), with a reduction in viral titer of 0.75 log10 TCID50/50 µL. CA (at the same molarity as CA in pure LJ and adjusted to pH = 2.3) exhibited virucidal effects comparable to pure LJ, with a decrease in viral titers as high as 3.75 log10 TCID50/50 µL, whilst diluted CA (pH = 6.7) did not show significant effects. This study demonstrated the virucidal efficacy of LJ, suggesting the role of pH and, eventually, of LJ bioactive compounds against a norovirus surrogate. Due to its large use in food preparation, LJ has the potential to enhance the safety of raw food. Also, broader applications in personal hygiene and surface disinfection could be devised.

Anti-N-methyl-D-aspartate receptor encephalitis following Human norovirus infection: A case report

Human norovirus (NoV) is the most common viral cause of acute gastroenteritis worldwide. In addition to affecting the digestive system, NoV also affect the neurological systems. A 15-month-old girl presented with vomiting and diarrhea for 2 days, along with one seizure. Her stool was NoV-nucleic-acid-positive, and she had normal results for cerebrospinal fluid (CSF), cranial magnetic resonance imaging, and video-electroencephalography (VEEG). She was initially diagnosed with benign convulsions with mild gastroenteritis, but she subsequently developed walking instability, an involuntary chewing-like movement of the oropharynx, and decreased speech. On rechecking, her CSF result was positive for anti-NMDAR antibody. She was diagnosed with anti-NMDAR encephalitis, treatment consisted of intravenous immunoglobulin and glucocorticoid, following which she almost completely recovered. This case suggests the possibility that NoV infection may be one of the triggers of anti-NMDAR encephalitis. Patients with NoV infections and neurological manifestations should be considered for anti-neuronal antibody testing.

Comparative gastrointestinal organoid models across species: A Zoobiquity approach for precision medicine

Gastrointestinal (GI) health underpins systemic well-being, yet the complexity of gut physiology poses significant challenges to understanding disease mechanisms and developing effective, personalized therapies. Traditional models often fail to capture the intricate interplay between epithelial, mesenchymal, immune, and neuronal cells that govern gut homeostasis and disease. Over the past five years, advances in organoid technology have created physiologically relevant, three-dimensional GI models that replicate native tissue architecture and function. These models have revolutionized the study of autoimmune disorders, homeostatic dysfunction, and pathogen infections, such as norovirus and Salmonella, which affect millions of humans and animals globally. In this review, we explore how organoids, derived from intestinal and pluripotent stem cells, are transforming our understanding of GI development, disease etiology, and therapeutic innovation. Through the "Zoobiquity" paradigm and "One Health" framework, we highlight the integration of companion animal organoids, which provide invaluable insights into shared disease mechanisms and preclinical therapeutic development. Despite their promise, challenges remain in achieving organoid maturation, expanding immune and neuronal integration, and bridging the gap between organoid responses and in vivo outcomes. By refining these cutting-edge platforms, we can advance human and veterinary medicine alike, fostering a holistic approach to health and disease.

Utilizing Internet Search Trends and Wastewater Surveillance to Identify Infectious Disease Outbreaks in Communities

This study proposes a novel approach for viral infectious disease surveillance using Google Trends data to model wastewater virus concentrations, providing a rapid, low-cost method for indicating outbreaks. Google Trends search terms were found to correlate strongly with wastewater viral concentrations and clinical cases for influenza A and respiratory syncytial virus (R2 = 0.76 and 0.66). For norovirus and mpox, for which clinical data were limited, Google Trends showed significant correlations with wastewater concentrations. Three modeling approaches were developed: simple linear, stepwise selection, and principal component analysis. These models demonstrated strong predictive power for both norovirus (R2 of up to 0.66) and mpox (R2 of up to 0.60) wastewater concentrations. The approach was validated using a case study of a documented 2021 norovirus outbreak in Hartford, CT, where Google Trends indicators rose in tandem with wastewater concentrations, potentially providing earlier outbreak detection than clinical case data. This method offers a complementary data stream to wastewater surveillance for public health decision-making, particularly valuable in areas lacking a robust clinical testing infrastructure. Limitations include potential confounding factors, such as media coverage and the need to consider local idioms in international applications.

Progress and challenges in thermal inactivation of norovirus in oysters

Norovirus is the leading cause of viral foodborne illnesses worldwide, primarily due to its high infectivity, transmissibility, and environmental persistence. Oysters bioaccumulate norovirus particles through filter-feeding in sewage-contaminated waters and retain them for extended periods. Raw oysters are considered a significant high-risk food commody, as they can serve as vectors to transfer the pathogen to humans. Outbreaks associated with the consumption of cooked oysters indicate survival of virus particles in response to various cooking techniques. Undercooked oysters pose a substantial risk of norovirus infection, a risk that is suggested to be similar to raw oysters. Detecting human norovirus in food remains challenging due to the lack of a quantitative culture-based system that has hindered our understanding of norovirus response to heat. This article provides a critical review of the literature on mechanisms of heat inactivation and potential factors involved in the survival of norovirus in oysters during cooking. It also highlights challenges associated with norovirus detection, the necessity of risk-based research on norovirus in cooked oysters and understanding the impact of the virus-associated matrix on virus inactivation. Addressing these knowledge gaps is crucial for conducting a risk-based approach to determining cooking conditions sufficient to inactivate norovirus oysters to safe levels.

Exploring non-alcohol-based disinfectant: virucidal efficacy of arginine and Zinc chloride against feline calicivirus

Introduction

Norovirus, a leading cause of acute gastroenteritis worldwide, is notably stable in the environment due to its non-enveloped nature. In the absence of effective vaccines or treatments, disinfection remains the primary prevention strategy, highlighting the importance of virucidal efficacy in household care products. Conventional effective disinfectants are predominantly alcohol-based, but alcohol is known to pose health risks, such as skin irritation. This study investigates a non-alcohol-based alternative, specifically a combination of Arginine and Zinc chloride (ZnCl2).

Methods

Utilizing MS2 bacteriophage as a surrogate, we identified a robust combination of arginine and ZnCl2 that is effective against Feline Calicivirus (FCV), a mammalian virus surrogate model for Norovirus.

Results

Our results determined a 5 min contact time at pH 11 as optimal, achieving significant virucidal activity against FCV without pH-induced reversibility. Dynamic Light Scattering (DLS) and transmission electron microscopy (TEM) analyses suggested that the mechanism of action for the Arg-Zn2+-Arg complex does not involve capsid disruption. Further insights from molecular modeling studies revealed that the complex potentially inhibits FCV by occupying a key capsid binding pocket essential for Junctional Adhesion Molecule (JAM) receptor engagement, thereby preventing viral entry.

Conclusion

These findings allow us to propose a novel and non-alcohol-based virucidal approach against viruses from the Caliciviridae family, highlighting the potential of Arg-Zn2+-Arg complexes in public health protection.

Kinetics and Mechanisms of Solar UVB Disinfection of Vesicle-Cloaked Murine Norovirus Clusters and Free Noroviruses

Human norovirus, a major global cause of gastroenteritis, forms vesicle-cloaked virus clusters (known as viral vesicles), showing increased infectivity and persistence in aquatic environments. We investigated UVB disinfection, a key mechanism of solar disinfection commonly employed in developing countries, targeting murine norovirus vesicles and free murine noroviruses as surrogates for human noroviruses. At low viral concentrations of 109 gene copies per liter, viral infectivity loss as quantified by the integrated cell culture-reverse transcription-quantitative polymerase chain reaction (ICC-RT-qPCR) indicated that vesicles were 1.51 to 1.73 times more resistant to disinfection compared to free viruses. Virus inactivation was primarily due to protein damage as quantified by bicinchoninic acid and Western blot assays, and the damage of virus binding to host cells as quantified by RT-qPCR. Molecular simulations predicted that the oxidation of a tyrosine residue in the viral protein 1 prohibited binding. UVB irradiation of viral/vesicle proteins resulted in 1O2 formation as quantified by time-resolved phosphorescence, and for the first time, endogenous 1O2 was confirmed to contribute to virus inactivation by UVB. Our study recognizes the limitation of UVB disinfection of viral vesicles particularly in solar wastewater treatment and advocates for enhanced disinfection strategies to protect public health.

TREM-1 as a Potential Coreceptor in Norovirus Pathogenesis: Insights from Transcriptomic Analysis and Molecular Docking

Norovirus (NoV) is a major cause of acute diarrheal disease in humans. However, due to complications in cultivating this virus, bioinformatics aids in elucidating the virus-host relationship. One of the molecules that has been associated with the burden of viral diseases is TREM-1, mainly due to its role in amplifying the inflammatory response. Thus, we hypothesized that TREM-1 may be involved in NoV infection. Analysis of public transcriptomic data sets showed an increased expression of Trem1 and Trem3 during murine NoV (MNoV) infection. Then, molecular docking was performed between murine TREM-1 and the P domain of the MNoV VP1 protein. The viral antigenic segment C'-D' was recognized by the murine TREM-1 CDR1 region. Subsequently, based on phylogenetic criteria, NoV VP1 proteins from the GII.4 genotype sequenced in different years (1987, 2010, 2012, 2014, 2016, and 2019) were modeled. Using docking and molecular dynamics simulations, a stable interaction was observed between the human TREM-1 Ig-like domain and the conserved S and P segments of the NoV VP1 protein. Notably, this interaction was conserved over the years and was mainly dictated by the TREM-1 CDR3 region. Also, coexpression between Trem1 with genes involved in apoptosis and pyroptosis pathways was surveyed during viral infection by MNoV. It was found that Trem1 is primarily expressed with genes from the pyroptosis pathway. These simulations strongly suggest the involvement of TREM-1 in NoV pathogenesis and its potential contribution as a coreceptor.

Norovirus Surveillance and Outbreak Investigations in Peru: 25 Years of Experience at NAMRU SOUTH

Norovirus is the worldwide leading cause of gastroenteric diseases. It affects mainly infants and older adults, but the findings are mainly derived from outbreak investigations rather than population-based cohorts. The U. S. Naval Medical Research Unit SOUTH (NAMRU SOUTH) developed and conducted research studies in the last 20 years focusing on the military and general populations afflicted by this pathogen. For the latter, studies included all age groups in 2 main communities in Peru, representing people from the highlands and tropical areas. The results helped elucidate the incidence of norovirus infection among different age groups as well as identifying risk factors, seasonality, and economic burden on the patient. The collected data demonstrate an increase of norovirus cases, not only in the previously reported age groups but also in adults. Consequently, this increase of norovirus cases in adults may impair the occupational productivity in civilian populations and operational readiness among service members.

An Epidemiologic Investigation for an Outbreak of Norovirus Infection in a Daycare Center in Gyeonggi-Do, Republic of Korea, 2023

Background/Objectives: Norovirus is one of the primary causes of foodborne illness in South Korea. This study aimed to identify the cause of a norovirus outbreak in a daycare center in a city in February 2023 and to prevent further spread through an epidemiologic investigation. Methods: A total of 93 individuals, including daycare staff, children, and kitchen staff, were included. A field epidemiologic investigation was conducted, consisting of case definition, collection of environmental and preserved food samples, and human specimens, along with interviews. A matched case-control study (1:3 ratio) was designed to analyze risk factors, and a statistical analysis, including odds ratios with 95% confidence intervals and chi-square tests, was performed to identify associations between food consumption and infection. Person-to-person transmission was also assessed through epidemiological data analysis. Results: Among the 93 individuals, 16 (17.2%) were identified as cases, of which nine (9.7%) were confirmed cases. The same genotype of norovirus (GII) was detected in eight human samples. No significant association was found between specific food items and infection. The epidemic curve and transmission network analysis suggested that the primary mode of transmission was person-to-person contact within the daycare center. Conclusions: This study highlights the critical role of hygiene practices in daycare settings to prevent person-to-person transmission of norovirus. Regular public health education, environmental disinfection, and early symptom recognition are essential preventive measures.

Research advancements on theaflavins: Isolation, purification, synthesis, gut microbiota interactions, and applications potentials

Theaflavins (TFs), specific polyphenolic compounds found in tea, including TF, TF-3-G, TF-3'-G, and TFDG, are renowned for their health-promoting effects. The growing interest in TFs among researchers necessitates a comprehensive review of their properties and impacts. This review systematically examines the chemical and physical properties of TFs, covering their isolation, purification, synthesis, safety, and bioavailability, as well as their implications for health. Special attention is paid to the dynamic interactions between TFs and gut microbiota (GM), exploring how GM metabolizes TFs and the consequent effects on the microbial community. An in-depth understanding of these interactions is crucial for realizing the full health benefits of TFs. Additionally, this review summarizes the well-documented health benefits of TFs, including their roles in ameliorating metabolic diseases, exhibiting anti-inflammatory properties, reducing viral infections, and potential applications in treating cancer and neurological diseases. It also explores the potential industrial applications of TFs, underscoring the need for further research to enhance their benefits for human health and well-being. The primary goal of this review is to support and inspire further detailed investigations into TFs.

Development of RNA reference materials for norovirus GI and GII using digital PCR

Norovirus is a highly virulent pathogen that causes enteritis in all age groups worldwide. Owing to the diversity of noroviruses, the development of vaccines and treatments is challenging, and an early and accurate diagnosis is crucial. Reference materials (RMs) developed previously for norovirus genotypes I (GI) and II (GII) were quantified using reverse transcription quantitative PCR. In this study, we developed norovirus GI and GII RMs as in vitro transcribed RNA forms. These RMs were then assigned reference values for the RNA copy number concentration. The concentrations of GI and GII RMs determined using in-house reverse transcription digital PCR assays were (1.92±0.37)×107 and (1.20±0.27)×107 copy/mL, respectively. The homogeneity and stability of the RMs were evaluated, and their compatibility with commercial diagnostic kits was validated. These RMs can be used for the development of detection assays, as calibrants for various molecular measurement techniques, and as test materials for internal and external quality assurance.

Replication-deficient Sendai virus expressing human norovirus capsid protein elicits robust NoV-specific antibody and T-cell responses in mice

Human norovirus (HuNoV) is a major global cause of acute gastroenteritis, with vaccine development facing several challenges. Despite years of research, there are currently no licensed vaccines available for controlling HuNoVs. Here, we describe the construction and testing of a replication-deficient Sendai virus (SeV) vector as a potential vaccine candidate against the HuNoV GII.4 genotype. SeV was chosen as the vaccine backbone due to its non-pathogenic nature in humans, its capability for long-term antigen expression in mammalian cells, and its suitability for mucosal administration. By inserting the HuNoV GII.4 capsid gene, VP1, into the SeV genome, we generated a replication-deficient SeV (SeV/dP.VP1) vector. The resultant SeV/dP.VP1 virus were observed to successfully express the inserted NoV VP1 gene upon infection. Inoculating the vaccine into wild-type mice elicited NoV-specific IgG antibodies, along with INF-γ and IL-2-producing T cells, through both intranasal (i.n.) and intramuscular (i.m.) immunization. Furthermore, a significant level of NoV-specific IgA was detected in lung homogenates after i.n. immunization, particularly using a high dose of the viral vector. Additionally, a synergistic effect was observed with heterologous prime-boost regimens using SeV/dP.VP1 and MVA.VP1 vectors, indicating the potential for more robust immune responses when the vaccine design is optimized. Our study demonstrates the potential of a SeV vaccine candidate in eliciting a broad immune response and lays the foundation for further exploration of the SeV vector platform's potential as a HuNoV vaccine. Additionally, the results emphasize the importance of vaccine dosage and administration route, highlighting the need for tailored immunization strategies.

Detection of human noroviruses in sewage by next generation sequencing in Shandong Province, 2019-2021

BACKGROUND

Human noroviruses are the major cause of acute gastroenteritis and exhibit considerable genetic diversity. Next generation sequencing (NGS) analysis based on environmental surveillance has been proved to be an effective method in norovirus surveillance.

METHODS

Between January 2019 and December 2021, 36 sewage samples were collected and analyzed using real-time quantitative PCR to detect noroviruses. Partial VP1 region was amplified and subjected to NGS analysis to assess the abundance and genetic characterization of various norovirus genotypes across different samples.

RESULTS

A total of 23 norovirus genotypes were identified, including 9 genotypes of GI, 13 genotypes of GII and 1 genotype of GIX. The most frequently detected genotypes were GI.5 (86.11%), GII.2 (86.11%), GII.4 (63.89%), GII.17 (58.33%), and GII.13 (55.56%). Additionally, some rare genotypes, such as GI.7, GII.5, GII.9, and GII.16, which had not been previously reported in Shandong, were identified. No significant differences were observed in genotypic diversity or viral copy numbers in sewage samples when comparing pre- and post-COVID-19 periods. A total of 379 partial VP1 sequences were obtained, with the means sequence identity within a genotype of Shandong sequences ranging from 92.69 to 98.37% and a coefficient of variation ranging from 1.46 to 6.73%. Phylogenetic analysis indicated that local noroviruses within each genotype comprised multiple co-circulating lineages.

CONCLUSIONS

Our data demonstrate that sewage contains noroviruses with considerable high diversities. NGS based environmental surveillance greatly improves the understanding of norovirus circulation and should be encouraged.

Detection of Porcine Norovirus GII.18 Strains in Pigs Using Broadly Reactive RT-qPCR Assay for Genogroup II Noroviruses

Noroviruses, belonging to the family Caliciviridae, are classified into at least ten genogroups (G) based on their major capsid protein (VP1). The common genogroup to be identified in both humans and pigs is GII, although porcine noroviruses (PoNoVs) belong to genotypes of their own (GII.11, GII.18, and GII.19). So far, PoNoVs have not been studied much in Finland, possibly due to their rather symptomless nature in pigs. In the present study, we enrolled a total of 189 fecal samples collected from pigs from Finnish farms. Samples were taken from 12 farms in 2010, 2019 and 2020. We analyzed feces from growing pigs ranging from 2.1 to 6 months of age. RNA was extracted from fecal suspensions using a commercial viral RNA extraction kit, followed by RT (reverse transcription)-qPCR. The genotypes were determined by Sanger sequencing of the PCR fragments amplified by conventional PCR. Of the 12 farms, 6 (50%) had at least one PoNoV-infected pig. Altogether 18 (9.5%) of the 189 pigs tested positive for PoNoVs. Pigs mostly aged over 4 months were infected with PoNoVs. Eventually, 12 positive samples were determined as genotype GII.18. We could demonstrate the presence of PoNoVs in Finnish pigs. In future, more studies in which longer sequences from PoNoV genome can be obtained, are required.

Municipal secondary-treated effluent data seem to be a suitable source of information for human viral trends

Employing a long-time series of municipal wastewater samples collected in 2020, the present study aims to confirm whether the appearance of SARS-CoV-2 influences the environmental load and behaviour of both JC Virus and Norovirus, determine the ability of the selected wastewater treatment plant (WWTP) to remove viral genomes, and assess if secondary-treated effluent data is somehow related to the incidence of the viral diseases reported by the local hospital. From the 11 raw influent and 52 secondary-treated effluent samples tested, JC Virus data present an occurrence frequency of 100 %, showing two different abundance patterns along the year, before and after the appearance of SARS-CoV-2. The constant detection of JC nucleic acids in wastewater reinforces the idea that urine is responsible for transmitting this virus. The Norovirus genogroup (G) II was detected more frequently than GI, both in influents and effluents, and their characteristic incidence peaks were not observed in late 2020. Regarding SARS-CoV-2 RNA, it appeared only in 5.8 % of the effluents, possibly due to the iron dosing used by the WWTP to reduce both phosphorus and organic matter concentrations in order to meet the requirements of European legislation, and/or the pre-filtration laboratory step which neglected the possibility of viral association with the solid fraction. The results suggest a poor performance of the WWTP, since Log removal values below 1.8 were determined. We were able to trace the development of local Norovirus outbreaks in the effluent samples to some extent, suggesting that secondary-treated effluents may be used to monitor human viruses by following viral nucleic acid levels.

Protective role of antibodies in enteric virus infections: Lessons from primary and secondary immune deficiencies

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.

Recent Progress in Nanomaterial-Based Surface-Enhanced Raman Spectroscopy for Food Safety Detection

Food safety has recently become a widespread concern among consumers. Surface-enhanced Raman scattering (SERS) is a rapidly developing novel spectroscopic analysis technique with high sensitivity, an ability to provide molecular fingerprint spectra, and resistance to photobleaching, offering broad application prospects in rapid trace detection. With the interdisciplinary development of nanomaterials and biotechnology, the detection performance of SERS biosensors has improved significantly. This review describes the advantages of nanomaterial-based SERS detection technology and SERS's latest applications in the detection of biological and chemical contaminants, the identification of foodborne pathogens, the authentication and quality control of food, and the safety assessment of food packaging materials. Finally, the challenges and prospects of constructing and applying nanomaterial-based SERS sensing platforms in the field of food safety detection are discussed with the aim of early detection and ultimate control of foodborne diseases.

In Vitro Culture of Human Norovirus in the Last 20 Years

Human noroviruses (HuNoVs) are the main pathogens that cause acute gastroenteritis and lead to huge economic losses annually. Due to the lack of suitable culture systems, the pathogenesis of HuNoVs and the development of vaccines and drugs have progressed slowly. Although researchers have employed various methods to culture HuNoVs in vitro in the last century, problems relating to the irreducibility, low viral titer, and non-infectiousness of the progeny virus should not be ignored. In 2016, researchers achieved the cultivation and successive passaging of some HuNoV genotypes using human intestinal enteroids, initially demonstrating the potential use of organoids in overcoming this challenge. This paper reviews the efforts made in the last 20 years to culture HuNoVs in vitro and discusses the superiority and limitations of employing human intestinal enteroids/organoids as an in vitro culture model for HuNoVs.

Establishment and characterization of noro-VLP measurement by digital ELISA

Highly sensitive viral analytical techniques are essential tools for preventing the spread of infections. In this study, we established a digital enzyme-linked immunosorbent assay (ELISA) system to quantify norovirus proteins with high sensitivity. We used norovirus-like particles (noro-VLPs) as a surrogate for norovirus and constructed two digital ELISA systems using two different antibody pairs. The quantitative performance of the noro-VLP measurement using each digital ELISA system was evaluated. Both assay systems exhibited high sensitivity, good linearity, and high stability. The first system exhibited a limit of detection (LOD) of 87 pg mL-1 and correlation coefficient (R2) of 0.9984. Analysis of samples containing 5 ng per mL noro-VLP confirmed inter-assay variation of 5.5%, and intra-assay variation of 5.2%. The second system exhibited an LOD of 19 pg mL-1 and R2 of 0.9984. Analysis of samples containing 5 ng per mL noro-VLP confirmed inter-assay variation of 4.5%, and intra-assay variation of 2.5%. Comparison of the two systems using the same calibrant for unpurified and fractionated noro-VLPs revealed that the quantitative values for unpurified noro-VLPs were the same, whereas those for fractionated noro-VLPs were dramatically different. Our findings indicate that the reactivity to various components in the noro-VLP solution was altered depending on the different antibodies. Furthermore, our study highlights the importance of using appropriate calibrants, which contain the same ratio of components as the noro-VLP analyte, to afford accurate measurements.

VirID: Beyond Virus Discovery-An Integrated Platform for Comprehensive RNA Virus Characterization

RNA viruses exhibit vast phylogenetic diversity and can significantly impact public health and agriculture. However, current bioinformatics tools for viral discovery from metagenomic data frequently generate false positive virus results, overestimate viral diversity, and misclassify virus sequences. Additionally, current tools often fail to determine virus-host associations, which hampers investigation of the potential threat posed by a newly detected virus. To address these issues we developed VirID, a software tool specifically designed for the discovery and characterization of RNA viruses from metagenomic data. The basis of VirID is a comprehensive RNA-dependent RNA polymerase database to enhance a workflow that includes RNA virus discovery, phylogenetic analysis, and phylogeny-based virus characterization. Benchmark tests on a simulated data set demonstrated that VirID had high accuracy in profiling viruses and estimating viral richness. In evaluations with real-world samples, VirID was able to identify RNA viruses of all types, but also provided accurate estimations of viral genetic diversity and virus classification, as well as comprehensive insights into virus associations with humans, animals, and plants. VirID therefore offers a robust tool for virus discovery and serves as a valuable resource in basic virological studies, pathogen surveillance, and early warning systems for infectious disease outbreaks.

Norovirus outbreaks in a nursery school in Buenos Aires, Argentina

Norovirus (NoV) is the leading cause of outbreaks of acute gastroenteritis worldwide. These are non-enveloped viruses that are classified into 10 genogroups, of which genogroup I (GI), II (GII), IV (GIV), VIII (GVIII), and IX (GIX) are the ones that infect humans. Two outbreaks (A and B) of acute gastroenteritis that occurred in a nursery school are described. The first outbreak (A) occurred in November 2018, and the second (B) in February 2020. The detection of viral and bacterial pathogens was performed to study both outbreaks. Additionally, an epidemiological investigation of the outbreaks was conducted. In the analyzed fecal and vomit samples from both children and adults in the nursery school, NoV GII.4 [P16] Sydney 2012 and NoV GI.3 [P13] were detected in outbreaks A and B, respectively. Since the study of acute gastroenteritis outbreaks is underestimated in Argentina, it is necessary to design prevention, study, and control protocols, as well as to improve the outbreak notification system in our country.

VP1 of human and murine noroviruses recognizes glycolipid sulfatide via the P domain

Noroviruses are a prevalent cause of human viral gastroenteritis, yet the precise mechanisms underlying their infection cycle, particularly their interactions with and entry into cells, remain poorly understood. Human norovirus (HuNoV) primarily targets human small intestinal epithelial cells, within which 3-O-sulfogalactosylceramide (sulfatide) ranks among the most abundant glycosphingolipids (GSLs). While sulfatide involvement in the binding and infection mechanism of several viruses has been documented, its interaction with noroviruses remains underexplored. This study investigated whether noroviruses interact with sulfatide. We found that the recombinant viral capsid protein VP1 of HuNoV (genogroups I and II) and murine norovirus (genogroup V) exhibited robust binding to sulfatide compared with other tested GSLs using enzyme-linked immunosorbent assay, thin-layer chromatography binding assay and real-time quantitative reverse transcription polymerase chain reaction binding assay. VP1 also bound 3-O-sulfated lactosylceramide, which shares the 3-O-sulfated galactose moiety with sulfatide. However, both VP1 and its P domain, identified as the sulfatide-binding domain, exhibited limited binding to structural analogues of sulfatide and other sulfated compounds. These findings suggest a specific recognition of the 3-O-sulfated galactose moiety. Notably, we found that sulfatide is a novel binding target for norovirus particles. Overall, our findings reveal a previously unknown norovirus-sulfatide interaction, proposing sulfatide as a potential candidate for norovirus infection receptors.

Complete Genomic Characterization of Global Pathogens, Respiratory Syncytial Virus (RSV), and Human Norovirus (HuNoV) Using Probe-based Capture Enrichment

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections in children worldwide, while human noroviruses (HuNoV) are a leading cause of epidemic and sporadic acute gastroenteritis. Generating full-length genome sequences for these viruses is crucial for understanding viral diversity and tracking emerging variants. However, obtaining high-quality sequencing data is often challenging due to viral strain variability, quality, and low titers. Here, we present a set of comprehensive oligonucleotide probe sets designed from 1,570 RSV and 1,376 HuNoV isolate sequences in GenBank. Using these probe sets and a capture enrichment sequencing workflow, 85 RSV positive nasal swab samples and 55 (49 stool and six human intestinal enteroids) HuNoV positive samples encompassing major subtypes and genotypes were characterized. The Ct values of these samples ranged from 17.0-29.9 for RSV, and from 20.2-34.8 for HuNoV, with some HuNoV having below the detection limit. The mean percentage of post-processing reads mapped to viral genomes was 85.1% for RSV and 40.8% for HuNoV post-capture, compared to 0.08% and 1.15% in pre-capture libraries, respectively. Full-length genomes were>99% complete in all RSV positive samples and >96% complete in 47/55 HuNoV positive samples-a significant improvement over genome recovery from pre-capture libraries. RSV transcriptome (subgenomic mRNAs) sequences were also characterized from this data. Probe-based capture enrichment offers a comprehensive approach for RSV and HuNoV genome sequencing and monitoring emerging variants.

Virus Shedding and Diarrhea: A Review of Human Norovirus Genogroup II Infection in Gnotobiotic Pigs

For nearly twenty years, gnotobiotic (Gn) pigs have been used as a model of human norovirus (HuNoV) infection and disease. Unique in their ability to develop diarrhea and shed virus post oral challenge, Gn pigs have since been used to evaluate the infectivity of several genogroup II HuNoV strains. Nearly all major pandemic GII.4 variants have been tested in Gn pigs, with varying rates of infectivity. Some induce an asymptomatic state despite being shed in large quantities in stool, and others induce high incidence of both diarrhea and virus shedding. Non-GII.4 strains, including GII.12 and GII.6, have also been evaluated in Gn pigs. Again, rates of diarrhea and virus shedding tend to vary between studies. Several factors may influence these findings, including age, dosage, biological host factors, or bacterial presence. The impact of these factors is nuanced and requires further evaluation to elucidate the exact mechanisms behind increases or decreases in infection rates. Regardless, the value of Gn pig models in HuNoV research cannot be understated, and the model will surely continue to contribute to the field in years to come.

Validation of one-step reverse transcription digital PCR assays for Norovirus GI

Regular monitoring of Norovirus presence in environmental and food samples is crucial due to its high transmission rates and outbreak potential. For detecting Norovirus GI, reverse transcription qPCR method is commonly used, but its sensitivity can be affected by assay performance. This study shows significantly reduced assay performance in digital PCR or qPCR when using primers targeting Norovirus GI genome 5291-5319 (NC_001959), located on the hairpin of the predicted RNA structure. It is highly recommended to avoid this region in commercial kit development or diagnosis to minimizing potential risk of false negatives.

Viral aptamer screening and aptamer-based biosensors for virus detection: A review

Virus-induced infectious diseases have a detrimental effect on public health and exert significant influence on the global economy. Therefore, the rapid and accurate detection of viruses is crucial for effectively preventing and diagnosing infections. Aptamer-based detection technologies have attracted researchers' attention as promising solutions. Aptamers, small single-stranded DNA or RNA screened via systematic evolution of ligands by exponential enrichment (SELEX), possess a high affinity towards their target molecules. Numerous aptamers targeting viral marker proteins or virions have been developed and widely employed in aptamer-based biosensors (aptasensor) for virus detection. This review introduces SELEX schemes for screening aptamers and discusses distinctive SELEX strategies designed explicitly for viral targets. Furthermore, recent advances in aptamer-based biosensing methods for detecting common viruses using different virus-specific aptamers are summarized. Finally, limitations and prospects associated with developing of aptamer-based biosensors are discussed.

A Pilot Study of Aerosolization of Infectious Murine Norovirus in an Experimental Setup

Human norovirus is transmitted mainly via the faecal-oral route, but norovirus disease outbreaks have been reported in which airborne transmission has been suggested as the only explanation. We used murine norovirus (MNV) as a surrogate for human norovirus to determine the aerosolization of infectious norovirus in an experimental setup. A 3-l air chamber system was used for aerosolization of MNV. Virus in solution (6 log10 TCID50/ml) was introduced into the nebulizer for generating aerosols and a RAW 264.7 cell dish without a lid was placed in the air chamber. Cell culture medium samples were taken from the dishes after the aerosol exposure time of 30 or 90 min, and the dishes were placed in a 37 °C, 5% CO2 incubator and inspected with a light microscope for viral cytopathic effects (CPEs). We determined both the infectious MNV TCID50 titre and used an RT-qPCR assay. During the experiments, virus infectivity remained stable for 30 and 90 min in the MNV solution in the nebulizer. Infectious MNV TCID50 values/ml of 2.89 ± 0.29 and 3.20 ± 0.49 log10 were measured in the chamber in RAW 264.7 cell dish media after the 30-min and 90-min exposure, respectively. The MNV RNA loads were 6.20 ± 0.24 and 6.93 ± 1.02 log10 genome copies/ml, respectively. Later, a typical MNV CPE appeared in the aerosol-exposed RAW cell dishes. We demonstrated that MNV was aerosolized and that it remained infectious in the experimental setup used. Further studies required for understanding the behaviour of MNV in aerosols can thus be performed.

Miniaturized MXene-based electrochemical biosensors for virus detection

The timely control of infectious diseases can prevent the spread of infections and mitigate the significant socio-economic damage witnessed during recent pandemics. Diagnostic methods play a significant role in detecting highly contagious agents, such as viruses, to prevent further transmission. The emergence of advanced point-of-care techniques offers several advantages over conventional approaches for detecting infectious agents. These techniques are highly sensitive, rapid, can be miniaturized, and are cost-effective. Recently, MXene-based 2D nanocomposites have proven beneficial for fabricating electrochemical biosensors due to their suitable electrical, optical, and mechanical properties. This article covers electrochemical biosensors based on MXene nanocomposite for the detection of viruses, along with the associated challenges and future possibilities. Additionally, we highlight various conventional techniques for the detection of infectious agents, discussing their pros and cons. We delve into the challenges faced during the fabrication of MXene-based biosensors and explore future endeavors. It is anticipated that the information presented in this work will pave the way for the development of Point-of-Care (POC) devices capable of sensitive and selective virus detection, enhancing preparedness for ongoing and future pandemics.

Investigation of caliciviruses and astroviruses in Gabonese rodents: A possible influence of national and international trade on the spread of enteric viruses

Caliciviruses (Caliciviridae) and astroviruses (Astroviridae) are among the leading cause of non-bacterial foodborne disease and gastroenteritis in human. These non-enveloped RNA viruses infect a wide range of vertebrate species including rodents. Rodents are among the most important hosts of infectious diseases globally and are responsible for over 80 zoonotic pathogens that affect humans. Therefore, screening pathogens in rodents will be is necessary to prevent cross-species transmission to prevent zoonotic outbreaks. In the present study, we screened caliciviruses and astroviruses in order to describe their diversity and whether they harbor strains that can infect humans. RNA was then extracted from intestine samples of 245 rodents and retrotranscribed in cDNA to screen caliciviruses and astroviruses by PCRs. All the samples tested negative for caliciviruses and while astroviruses were detected in 18 (7.3%) samples of Rattus rattus species. Phylogenetic analyses based on the RdRp gene showed that all the sequences belonged to Mamastrovirus genus in which they were genetically related to R. rattus related AstVs previously detected in Gabon or in Rattus spp. AstV from Kenya and Asia. These findings suggested that transportation such as land and railway, as well national and international trade, are likely to facilitate spread of AstVs by the dissemination of rodents.

Melting curve analysis reveals false-positive norovirus detection in a molecular syndromic panel

BACKGROUND

Molecular syndromic panels can improve rapidity of results and ease clinical laboratory workflow, although caution has been raised for potential false-positive results. Upon implementation of a new panel for infectious diarrhea (BioFire® FilmArray® Gastrointestinal [GI] Panel, bioMérieux) in our clinical laboratory, a higher than expected number of stool samples with norovirus were detected.

OBJECTIVES

The goal of this study was to investigate positive percent agreement and the false-positive rate of norovirus detected by the multiplex BioFire GI panel compared to a singleplex commercial assay.

STUDY DESIGN

From October 2023 to January 2024, all prospective stool samples with a positive norovirus result by BioFire had melting curves reviewed manually using the BioFire FilmArray Torch System. Stool samples further underwent testing by a supplementary real-time RT-PCR assay (Xpert® Norovirus, Cepheid) for comparative analysis.

RESULTS

Of the 50 stool samples with norovirus detected by BioFire, 18 (36 %) tested negative by Xpert (deemed "false-positives"). Furthermore, melting curve analysis revealed nearly all of these samples had atypical melting curve morphologies for the "Noro-1" target on BioFire (16/18, 89 %), which was statistically significant (Odds Ratio 173.2, 95 % CI [22.2, 5326.9], p < 0.0001). Stool samples with multiple pathogens detected by BioFire including norovirus were not more likely to produce false-positive norovirus results (Odds Ratio 1, 95 % CI [0.3, 3.3], p = 1).

CONCLUSIONS

Although not described in the manufacturer's Instructions for Use, we propose routine manual review of melting curves for the BioFire GI panel prior to reporting, to mitigate potential false-positive norovirus results.

Wastewater surveillance together with metaviromic data revealed the unusual resurgence of infectious diseases after the first wave of the COVID-19 outbreak

How to address public health priorities after COVID-19 is becoming a critical task. To this end, we conducted wastewater surveillance for six leading pathogens, namely, SARS-CoV-2, norovirus, rotavirus, influenza A virus (IAV), enteroviruses and respiratory syncytial virus (RSV), in Nanchang city from January to April 2023. Metaviromic sequencing was conducted at the 1st, 4th, 7th, 9th, 12th and 14th weeks to reveal the dynamics of viral pathogens that were not covered by qPCR. Amplicon sequencing of the conserved region of norovirus GI and GII and the rotavirus and region encoding nonstructural protein of RSV was also conducted weekly. The results showed that after a rapid decrease in SARS-CoV-2 sewage concentrations occurred in January 2023, surges of norovirus, rotavirus, IAV and RSV started at the 6th, 7th, 8th and 11th weeks, respectively. The dynamics of the sewage concentrations of norovirus, rotavirus, IAV and RSV were consistent with the off-season resurgence of the above infectious diseases. Notably, peak sewage concentrations of norovirus GI, GII, rotavirus, IAV and RSV were found at the 6th, 3rd, 7th, 7th and 8th weeks, respectively. Astroviruses also resurge after the 7th week, as revealed by metaviromic data, suggesting that wastewater surveillance together with metaviromic data provides an essential early warning tool for revealing patterns of infectious disease resurgence.

Wastewater surveillance for viral pathogens: A tool for public health

A focus on water quality has intensified globally, considering its critical role in sustaining life and ecosystems. Wastewater, reflecting societal development, profoundly impacts public health. Wastewater-based epidemiology (WBE) has emerged as a surveillance tool for detecting outbreaks early, monitoring infectious disease trends, and providing real-time insights, particularly in vulnerable communities. WBE aids in tracking pathogens, including viruses, in sewage, offering a comprehensive understanding of community health and lifestyle habits. With the rise in global COVID-19 cases, WBE has gained prominence, aiding in monitoring SARS-CoV-2 levels worldwide. Despite advancements in water treatment, poorly treated wastewater discharge remains a threat, amplifying the spread of water-, sanitation-, and hygiene (WaSH)-related diseases. WBE, serving as complementary surveillance, is pivotal for monitoring community-level viral infections. However, there is untapped potential for WBE to expand its role in public health surveillance. This review emphasizes the importance of WBE in understanding the link between viral surveillance in wastewater and public health, highlighting the need for its further integration into public health management.

CX-6258 hydrochloride hydrate: A potential non-nucleoside inhibitor targeting the RNA-dependent RNA polymerase of norovirus

Human norovirus (HuNoV), a primary cause of non-bacterial gastroenteritis, currently lacks approved treatment. RdRp is vital for virus replication, making it an attractive target for therapeutic intervention. By application of structure-based virtual screening procedure, we present CX-6258 hydrochloride hydrate as a potent RdRp non-nucleoside inhibitor, effectively inhibiting HuNoV RdRp activity with an IC50 of 3.61 μM. Importantly, this compound inhibits viral replication in cell culture, with an EC50 of 0.88 μM. In vitro binding assay validate that CX-6258 hydrochloride hydrate binds to RdRp through interaction with the "B-site" binding pocket. Interestingly, CX-6258-contacting residues such as R392, Q439, and Q414 are highly conserved among major norovirus GI and GII variants, suggesting that it may be a general inhibitor of norovirus RdRp. Given that CX-6258 hydrochloride hydrate is already utilized as an orally efficacious pan-Pim kinase inhibitor, it may serve as a potential lead compound in the effort to control HuNoV infections.

Epidemiology of norovirus infection in Nigeria: a systematic review and meta-analysis

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.

Epidemiological and genetic characteristics of norovirus in Hangzhou, China, in the postepidemic era

OBJECTIVE

Norovirus (NoV) is an important human pathogen that can cause severe gastroenteritis in vulnerable populations. This study aimed to analyze the epidemiological and genetic characteristics of 2021-2023 NoV in Hangzhou, China.

METHODS

This study enrolled patients aged 0-18 years who underwent NoV RNA detection in the hospital between January 2021 and October 2023 and analyzed the epidemiological characteristics of NoV. Polymerase chain reaction (PCR) was used to detect NoV RNA. Subtype classification and whole-genome sequencing were performed.

RESULTS

There was a high prevalence of NoV infection in 2023, with NoV-positive samples accounting for 63.10 % of the total number of positive samples collected during the three-year period. The prevalence was abnormally high in summer, and the number of positive samples accounted for 48.20 % of the total positive samples for the whole year, which was much greater than the level in the same period in previous years (2023, 48.20% vs 2021, 13.66% vs 2022, 15.21 %). The GⅡ.4 subtype played a leading role, followed by increased mixed infection with GⅠ.5 and GⅡ.4. Whole-genome sequencing results suggested that GII.P16-GⅡ.4 had R297H and D372N key locus mutations. The evolutionary rate was 4.29 × 10-3 for the RdRp gene and 4.84 × 10-3 for the VP1 gene. The RdRp gene and VP1 gene of NoV GII.P16-GⅡ.4 have undergone rapid population evolution during the COVID-19 epidemic.

CONCLUSION

In the summer of 2023, an abnormally high incidence of NoV appeared in Hangzhou, China. The major epidemic strain GII.P16-GⅡ.4 showed a certain range of gene mutations and a fast evolutionary rate.

Acute Gastroenteritis Outbreak Among Colorado River Rafters and Backpackers in the Grand Canyon, 2022

INTRODUCTION

From April 1 to May 31, 2022, Grand Canyon National Park received increased acute gastroenteritis reports. Pooled portable toilet specimens identified norovirus genogroups I and II. We sought to determine outbreak transmission contributors and individual risk factors while rafting or backpacking in the park.

METHODS

Grand Canyon rafters and backpackers were surveyed online from June 13-July 8, 2022, and a Cox proportional hazards model was used to identify predictors associated with illness and adjusted for potential confounding factors.

RESULTS

Among 762 surveys, 119 cases and 505 well persons submitted complete survey data. Illness among rafters was associated with interaction with ill persons during the trip (adjusted hazard ratio [adjHR] = 3.4 [95%CI 2.3-5.0]) and lack of any hand hygiene (1.2 [0.7-1.9]) or use of only sanitizer or water (1.6 [1.04-2.6]) before snacks. Younger rafters had higher illness rates compared to those ≥60 y (1.5 [1.2-1.8] for ages 40-59 and 2.2 [1.4-3.5] for ages <40 y).

CONCLUSIONS

Person-to-person transmission likely accounted for the widespread outbreak. Future outbreak mitigation efforts on river trips could focus on symptom screening before the trip starts, prompt separation of ill and well passengers, strict adherence to hand hygiene with soap and water, minimizing social interactions among rafting groups, and widespread outbreak notices and education to all park users.

Rotavirus vaccines in Africa and Norovirus genetic diversity in children aged 0 to 5 years old: a systematic review and meta-analysis : Rotavirus vaccines in Africa and Norovirus genetic diversity

Noroviruses are the second leading cause of death in children under the age of 5 years old. They are responsible for 200 million cases of diarrhoea and 50,000 deaths in children through the word, mainly in low-income countries. The objective of this review was to assess how the prevalence and genetic diversity of noroviruses have been affected by the introduction of rotavirus vaccines in Africa. PubMed, Web of Science and Science Direct databases were searched for articles. All included studies were conducted in Africa in children aged 0 to 5 years old with gastroenteritis. STATA version 16.0 software was used to perform the meta-analysis. The method of Dersimonian and Laird, based on the random effects model, was used for the statistical analyses in order to estimate the pooled prevalence's at a 95% confidence interval (CI). Heterogeneity was assessed by Cochran's Q test using the I2 index. The funnel plot was used to assess study publication bias. A total of 521 studies were retrieved from the databases, and 19 were included in the meta-analysis. The pooled norovirus prevalence's for pre- and post-vaccination rotavirus studies were 15% (95 CI, 15-18) and 13% (95 CI, 09-17) respectively. GII was the predominant genogroup, with prevalence of 87.64% and 91.20% respectively for the pre- and post-vaccination studies. GII.4 was the most frequently detected genotype, with rates of 66.84% and 51.24% respectively for the pre- and post-vaccination studies. This meta-analysis indicates that rotavirus vaccination has not resulted in a decrease in norovirus infections in Africa.

A narrative review of norovirus epidemiology, biology, and challenges to vaccine development

Norovirus is a leading cause of acute gastroenteritis (AGE) globally. AGE resulting from norovirus causes significant morbidity and mortality in countries of all income levels, particularly among young children and older adults. Prevention of norovirus AGE represents a unique challenge as the virus is genetically diverse with multiple genogroups and genotypes cocirculating globally and causing disease in humans. Variants of the GII.4 genotype are typically the most common genotype, and other genotypes cause varying amounts of disease year-to-year, with GII.2, GII.3, and GII.6 most prevalent in recent years. Noroviruses are primarily transmitted via the fecal-oral route and only a very small number of virions are required for infection, which makes outbreaks of norovirus extremely difficult to control when they occur. Settings like long-term care facilities, daycares, and hospitals are at high risk of outbreaks and can have very high attack rates resulting in substantial costs and disease burden. Severe cases of norovirus AGE are most common in vulnerable patient populations, such as infants, the elderly, and immunocompromised individuals, with available treatments limited to rehydration therapies and supportive care. To date, there are no FDA-approved norovirus vaccines; however, several candidates are currently in development. Given the substantial human and economic burden associated with norovirus AGE, a vaccine to prevent morbidity and mortality and protect vulnerable populations could have a significant impact on global public health.

Noroviruses: Evolutionary Dynamics, Epidemiology, Pathogenesis, and Vaccine Advances-A Comprehensive Review

Noroviruses constitute a significant aetiology of sporadic and epidemic gastroenteritis in human hosts worldwide, especially among young children, the elderly, and immunocompromised patients. The low infectious dose of the virus, protracted shedding in faeces, and the ability to persist in the environment promote viral transmission in different socioeconomic settings. Considering the substantial disease burden across healthcare and community settings and the difficulty in controlling the disease, we review aspects related to current knowledge about norovirus biology, mechanisms driving the evolutionary trends, epidemiology and molecular diversity, pathogenic mechanism, and immunity to viral infection. Additionally, we discuss the reservoir hosts, intra-inter host dynamics, and potential eco-evolutionary significance. Finally, we review norovirus vaccines in the development pipeline and further discuss the various host and pathogen factors that may complicate vaccine development.

Self-Powered Immunoassay of Norovirus in Human Stools by π-Electron-Rich Homojunction for Enhanced Charge Transfer

Norovirus (NoV) stands as a significant causative agent of nonbacterial acute gastroenteritis on a global scale, presenting a substantial threat to public health. Hence, the development of simple and rapid analytical techniques for NoV detection holds great importance in preventing and controlling the outbreak of the epidemic. In this work, a self-powered photoelectrochemical (PEC) immunosensor of NoV capsid protein (VP1) was proposed by the π-electron-rich carbon nitride homojunction (ER-CNH) as the photoanode. C4N2 ring derived from π-rich locust bean gum was introduced into the tri-s-triazine structure, creating a large π-delocalized conjugated carbon nitride homojunction. This strategy enhances the C/N atomic ratio, which widens light utilization, narrows the bandgap, and optimizes the electronic band structure of carbon nitride. By introduction of a π-rich conjugated structure, p-type domains were induced within n-type domains to build the internal electric field at the interface, thus forming a p-n homojunction to boost carrier separation and transfer. The ER-CNH photoanode exhibited excellent photoelectric performance and water oxidation capacity. Since VP1 inhibits the water oxidation of the ER-CNH photoanode, the open-circuit potential of the as-prepared PEC immunosensor system was reduced for detecting NoV VP1. The self-powered PEC immunosensor achieved a remarkably low detection limit (∼5 fg mL-1) and displayed high stability and applicability for actual stool samples. This research serves as a foundation concept for constructing immunosensors to detect other viruses and promotes the application of self-powered systems for life safety.