Norovirus GII.3[P12] Outbreak Associated with the Drinking Water Supply in a Rural Area in Galicia, Spain, 2021

Inactivation kinetics of selected pathogenic and non-pathogenic bacteria by aqueous ozone to validate minimum usage in purified water

Ozone is often used as an antimicrobial agent at the final step in purified water processing. When used in purified bottled water manufacturing, residual ozone should not exceed 0.4 mg/L, per US-FDA regulations. These regulations require the control of Escherichia coli and other coliform bacteria; however, non-coliform pathogens can contaminate bottled water. Hence, it is prudent to test the efficacy of ozone against such pathogens to determine if the regulated ozone level adequately ensures the safety of the product. Inactivation of selected pathogenic and non-pathogenic bacteria in purified water was investigated as a function of ozone dose, expressed in Ct units (mg O3*min/L). Bacterial species tested were Enterococcus faecium, E. coli (two serotypes), Listeria monocytogenes (three strains), Pseudomonas aeruginosa, and Salmonella enterica (three serovars). Resulting dose (Ct)-response (reduction in populations' log10 CFU/mL) relationships were mostly linear with obvious heteroscedasticity. This heteroscedastic relationship required developing a novel statistical approach to analyze these data so that the lower bound of the dose-response relationships can be determined and appropriate predictive models for such a bound can be formulated. An example of this analysis was determining the 95%-confidence lower bound equation for the pooled dose-responses of all tested species; the model can be presented as follows: Logpopulationreduction = 3.80Ct + 1.84. Based on this relationship, application ozone at a Ct of 0.832 and 21°C achieves ≥ 5-log reduction in the population of any of the tested pathogenic and non-pathogenic bacteria. This dose can be implemented by applying ozone at 0.832 mg/L for 1 min, 0.416 mg/L for 2 min, or other combinations. The study also proved the suitability of E. faecium ATCC 8459 as a surrogate strain for the pathogens tested in the current study for validating water decontamination processes by ozone. In conclusion, the study findings can be usefully implemented in processing validation of purified water and possibly other water types.

Acute gastroenteritis outbreak associated with multiple and rare norovirus genotypes after storm events in Santa Catarina, Brazil

Norovirus is a major cause of acute diarrheal disease (ADD) outbreaks worldwide. In the present study, we investigated an ADD outbreak caused by norovirus in several municipalities of Santa Catarina state during the summer season, southern Brazil in 2023. As of the 10th epidemiological week of 2023, approximately 87 000 ADD cases were reported, with the capital, Florianópolis, recording the highest number of cases throughout the weeks. By using RT-qPCR and sequencing, we detected 10 different genotypes, from both genogroups (G) I and II. Some rare genotypes were also identified. Additionally, rotavirus and human adenovirus were sporadically detected among the ADD cases. Several features of the outbreak suggest that sewage-contaminated water could played a role in the surge of ADD cases. Storm events in Santa Catarina state that preceded the outbreak likely increased the discharge of contaminated wastewater and stormwater into water bodies, such as rivers and beaches during a high touristic season in the state. Climate change-induced extreme weather events, including intensified rainfall and frequent floods, can disturb healthcare and sanitation systems. Implementing public policies for effective sanitation, particularly during peak times, is crucial to maintain environmental equilibrium and counter marine pollution.

Rare Recombinant GI.5[P4] Norovirus That Caused a Large Foodborne Outbreak of Gastroenteritis in a Hotel in Spain in 2021

Noroviruses are among the most important causes of acute gastroenteritis (AGE). In summer 2021, a large outbreak of norovirus infections affecting 163 patients, including 15 norovirus-confirmed food handlers, occurred in a hotel in Murcia in southeast Spain. A rare GI.5[P4] norovirus strain was identified as the cause of the outbreak. The epidemiological investigation determined that norovirus transmission might have been initiated through an infected food handler. The food safety inspection found that some symptomatic food handlers continued working during illness. Molecular investigation with whole-genome and ORF1 sequencing provided enhanced genetic discrimination over ORF2 sequencing alone and enabled differentiation of the GI.5[P4] strains into separate subclusters, suggesting different chains of transmission. These recombinant viruses have been identified circulating globally over the last 5 years, warranting further global surveillance. IMPORTANCE Due to the large genetic diversity of noroviruses, it is important to enhance the discriminatory power of typing techniques to differentiate strains when investigating outbreaks and elucidating transmission chains. This study highlights the importance of (i) using whole-genome sequencing to ensure genetic differentiation of GI noroviruses to track chains of transmission during outbreak investigations and (ii) the adherence of symptomatic food handlers to work exclusion rules and strict hand hygiene practices. To our knowledge, this study provides the first full-length genome sequences of GI.5[P4] strains apart from the prototype strain.