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Ross AG, Khanam F, Islam MT, Chowdhury F, Sleigh AC. Diagnosis and Management of Acute Enteropathogens in Returning Travelers. Int J Infect Dis 2022; 123:34-40. [DOI: 10.1016/j.ijid.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 10/16/2022] Open
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Tsai H, Yune P, Rao M. Norovirus disease among older adults. Ther Adv Infect Dis 2022; 9:20499361221136760. [DOI: 10.1177/20499361221136760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Norovirus, a leading cause of gastroenteritis outbreaks worldwide, results in substantial direct and indirect healthcare costs. Adults older than 65 years of age bear a significant proportion of the disease burden, and the disease course in this population is often more severe and protracted. In this narrative review, we discuss the epidemiology of norovirus infection, mechanisms of pathogenesis, and transmission pertinent to outbreaks along with infection prevention and control efforts. We also describe the clinical manifestations of norovirus disease with a focus on individuals older than 65 years of age, diagnosis and available treatment options, and the challenges and progress within vaccine development.
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Affiliation(s)
- Helen Tsai
- Montefiore Medical Center, Bronx, NY, USA
| | | | - Mana Rao
- Essen Medical Associates, Bronx, NY 10461, USA
- ArchCare, New York, NY, USA
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Haddadin Z, Batarseh E, Hamdan L, Stewart LS, Piya B, Rahman H, Spieker AJ, Chappell J, Wikswo ME, Dunn JR, Payne DC, Vinjé J, Hall AJ, Halasa N. Characteristics of GII.4 Norovirus Versus Other Genotypes in Sporadic Pediatric Infections in Davidson County, Tennessee, USA. Clin Infect Dis 2021; 73:e1525-e1531. [PMID: 32667045 PMCID: PMC8492161 DOI: 10.1093/cid/ciaa1001] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/10/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Norovirus is a leading cause of epidemic acute gastroenteritis (AGE), with most outbreaks occurring during winter. The majority of outbreaks are caused by GII.4 noroviruses; however, data to support whether this is true for sporadic medically attended AGE are limited. Therefore, we sought to compare the clinical characteristics and seasonality of GII.4 vs non-GII.4 viruses. METHODS Children aged 15 days -17 years with AGE symptoms were recruited from the outpatient, emergency department, and inpatient settings at Vanderbilt Children's Hospital, Davidson County, Nashville, Tennessee, from December 2012 -November 2015. Stool specimens were tested using qRT-PCR for GI and GII noroviruses and subsequently genotyped by sequencing a partial region of the capsid gene. RESULTS A total of 3705 patients were enrolled, and stool specimens were collected and tested from 2885 (78%) enrollees. Overall, 636 (22%) samples were norovirus-positive, of which 567 (89%) were GII. Of the 460 (81%) genotyped GII-positive samples, 233 (51%) were typed as GII.4 and 227 (49%) as non-GII.4. Compared with children with non-GII.4 infections, children with GII.4 infections were younger, more likely to have diarrhea, and more likely to receive oral rehydration fluids. Norovirus was detected year-round and peaked during winter. CONCLUSIONS Approximately 40% of sporadic pediatric norovirus AGE cases were caused by GII.4 norovirus. Children infected with GII.4 had more severe symptoms that required more medical care. Seasonal variations were noticed among different genotypes. These data highlight the importance of continuous norovirus surveillance and provide important information on which strains pediatric norovirus vaccines should protect against.
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Affiliation(s)
- Zaid Haddadin
- Department of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Einas Batarseh
- Department of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lubna Hamdan
- Department of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Laura S Stewart
- Department of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Bhinnata Piya
- Department of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Herdi Rahman
- Department of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Andrew J Spieker
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - James Chappell
- Department of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mary E Wikswo
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - John R Dunn
- Tennessee Department of Health, Nashville, Tennessee, USA
| | - Daniel C Payne
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jan Vinjé
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Aron J Hall
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Natasha Halasa
- Department of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Kocher J, Castellucci TB, Wen K, Li G, Yang X, Lei S, Jiang X, Yuan L. Simvastatin Reduces Protection and Intestinal T Cell Responses Induced by a Norovirus P Particle Vaccine in Gnotobiotic Pigs. Pathogens 2021; 10:pathogens10070829. [PMID: 34357979 PMCID: PMC8308729 DOI: 10.3390/pathogens10070829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/20/2021] [Accepted: 06/28/2021] [Indexed: 11/24/2022] Open
Abstract
Noroviruses (NoVs) are a leading cause of acute gastroenteritis worldwide. P particles are a potential vaccine candidate against NoV. Simvastatin is a cholesterol-reducing drug that is known to increase NoV infectivity. In this study, we examined simvastatin’s effects on P particle-induced protective efficacy and T-cell immunogenicity using the gnotobiotic pig model of human NoV infection and diarrhea. Pigs were intranasally inoculated with three doses (100 µg/dose) of GII.4/VA387-derived P particles together with monophosphoryl lipid A and chitosan adjuvants. Simvastatin-fed pigs received 8 mg/day orally for 11 days prior to challenge. A subset of pigs was orally challenged with 10 ID50 of a NoV GII.4/2006b variant at post-inoculation day (PID) 28 and monitored for 7 days post-challenge. Intestinal and systemic T cell responses were determined pre- and postchallenge. Simvastatin abolished the P particle’s protection and significantly increased diarrhea severity after NoV infection. Simvastatin decreased proliferation of virus-specific and non-specific CD8 T cells in duodenum and virus-specific CD4 and CD8 T cells in spleen and significantly reduced numbers of intestinal mononuclear cells in vaccinated pigs. Furthermore, simvastatin significantly decreased numbers of duodenal CD4+IFN-γ+, CD8+IFN-γ+ and regulatory T cells and total duodenal activated CD4+ and CD8+ T cells in vaccinated pigs pre-challenge at PID 28. Following challenge, simvastatin prevented the IFN-γ+ T cell response in spleen of vaccinated pigs. These results indicate that simvastatin abolished P particle vaccine-induced partial protection through, at least in part, impairing T cell immunity. The findings have specific implications for the development of preventive and therapeutic strategies against NoV gastroenteritis, especially for the elderly population who takes statin-type drugs.
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Affiliation(s)
- Jacob Kocher
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (J.K.); (T.B.C.); (K.W.); (G.L.); (X.Y.); (S.L.)
| | - Tammy Bui Castellucci
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (J.K.); (T.B.C.); (K.W.); (G.L.); (X.Y.); (S.L.)
| | - Ke Wen
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (J.K.); (T.B.C.); (K.W.); (G.L.); (X.Y.); (S.L.)
| | - Guohua Li
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (J.K.); (T.B.C.); (K.W.); (G.L.); (X.Y.); (S.L.)
| | - Xingdong Yang
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (J.K.); (T.B.C.); (K.W.); (G.L.); (X.Y.); (S.L.)
| | - Shaohua Lei
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (J.K.); (T.B.C.); (K.W.); (G.L.); (X.Y.); (S.L.)
| | - Xi Jiang
- Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| | - Lijuan Yuan
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (J.K.); (T.B.C.); (K.W.); (G.L.); (X.Y.); (S.L.)
- Correspondence:
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Janczuk-Richter M, Gromadzka B, Richter Ł, Panasiuk M, Zimmer K, Mikulic P, Bock WJ, Maćkowski S, Śmietana M, Niedziółka Jönsson J. Immunosensor Based on Long-Period Fiber Gratings for Detection of Viruses Causing Gastroenteritis. SENSORS 2020; 20:s20030813. [PMID: 32028629 PMCID: PMC7038722 DOI: 10.3390/s20030813] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/22/2020] [Accepted: 01/30/2020] [Indexed: 02/06/2023]
Abstract
Since the norovirus is the main cause of acute gastroenteritis all over the world, its fast detection is crucial in medical diagnostics. In this work, a rapid, sensitive, and selective optical fiber biosensor for the detection of norovirus virus-like particles (VLPs) is reported. The sensor is based on highly sensitive long-period fiber gratings (LPFGs) coated with antibodies against the main coat protein of the norovirus. Several modification methods were verified to obtain reliable immobilization of protein receptors on the LPFG surface. We were able to detect 1 ng/mL norovirus VLPs in a 40-min assay in a label-free manner. Thanks to the application of an optical fiber as the sensor, there is a possibility to increase the user’s safety by separating the measurement point from the signal processing setup. Moreover, our sensor is small and light, and the proposed assay is straightforward. The designed LPFG-based biosensor could be applied in both fast norovirus detection and in vaccine testing.
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Affiliation(s)
- Marta Janczuk-Richter
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warsaw, Poland; (M.J.-R.)
| | - Beata Gromadzka
- Intercollegiate Faculty of Biotechnology, University of Gdańsk and Medical University of Gdańsk, A. Abrahama 58, 80-307 Gdańsk, Poland; (B.G.); (M.P.); (K.Z.)
| | - Łukasz Richter
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warsaw, Poland; (M.J.-R.)
| | - Mirosława Panasiuk
- Intercollegiate Faculty of Biotechnology, University of Gdańsk and Medical University of Gdańsk, A. Abrahama 58, 80-307 Gdańsk, Poland; (B.G.); (M.P.); (K.Z.)
| | - Karolina Zimmer
- Intercollegiate Faculty of Biotechnology, University of Gdańsk and Medical University of Gdańsk, A. Abrahama 58, 80-307 Gdańsk, Poland; (B.G.); (M.P.); (K.Z.)
| | - Predrag Mikulic
- Centre de recherche en photonique, Université du Québec en Outaouais, 101 rue Saint-Jean-Bosco, Gatineau, QC J8X 3X7, Canada; (P.M.); (W.J.B.)
| | - Wojtek J. Bock
- Centre de recherche en photonique, Université du Québec en Outaouais, 101 rue Saint-Jean-Bosco, Gatineau, QC J8X 3X7, Canada; (P.M.); (W.J.B.)
| | - Sebastian Maćkowski
- Baltic Institute of Technology, Al. Zwycięstwa 96/98, 81-451 Gdynia, Poland;
| | - Mateusz Śmietana
- Warsaw University of Technology, Institute of Microelectronics and Optoelectronics, 00-662 Koszykowa 75, Warsaw, Poland;
| | - Joanna Niedziółka Jönsson
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warsaw, Poland; (M.J.-R.)
- Correspondence: ; Tel.: +48-22-343-3130
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Burke RM, Shah MP, Wikswo ME, Barclay L, Kambhampati A, Marsh Z, Cannon JL, Parashar UD, Vinjé J, Hall AJ. The Norovirus Epidemiologic Triad: Predictors of Severe Outcomes in US Norovirus Outbreaks, 2009-2016. J Infect Dis 2020; 219:1364-1372. [PMID: 30445538 DOI: 10.1093/infdis/jiy569] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 09/19/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Noroviruses are the leading cause of acute gastroenteritis outbreaks worldwide. Clarifying the viral, host, and environmental factors (epidemiologic triad) associated with severe outcomes can help target public health interventions. METHODS Acute norovirus outbreaks reported to the National Outbreak Reporting System (NORS) in 2009-2016 were linked to laboratory-confirmed norovirus outbreaks reported to CaliciNet. Outbreaks were analyzed for differences in genotype (GII.4 vs non-GII.4), hospitalization, and mortality rates by timing, setting, transmission mode, demographics, clinical symptoms, and health outcomes. RESULTS A total of 3747 norovirus outbreaks were matched from NORS and CaliciNet. Multivariable models showed that GII.4 outbreaks (n = 2353) were associated with healthcare settings (odds ratio [OR], 3.94 [95% confidence interval {CI}, 2.99-5.23]), winter months (November-April; 1.55 [95% CI, 1.24-1.93]), and older age of cases (≥50% aged ≥75 years; 1.37 [95% CI, 1.04-1.79]). Severe outcomes were more likely among GII.4 outbreaks (hospitalization rate ratio [RR], 1.54 [95% CI, 1.23-1.96]; mortality RR, 2.77 [95% CI, 1.04-5.78]). Outbreaks in healthcare settings were also associated with higher hospitalization (RR, 3.22 [95% CI, 2.34-4.44]) and mortality rates (RR, 5.65 [95% CI, 1.92-18.70]). CONCLUSIONS Severe outcomes more frequently occurred in norovirus outbreaks caused by GII.4 and those in healthcare settings. These results should help guide preventive interventions for targeted populations, including vaccine development.
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Affiliation(s)
- Rachel M Burke
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Minesh P Shah
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary E Wikswo
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Leslie Barclay
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Anita Kambhampati
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia.,IHRC, Inc, Atlanta, Georgia
| | - Zachary Marsh
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia.,Oak Ridge Institute for Science and Education, Tennessee, Atlanta, Georgia
| | | | - Umesh D Parashar
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Jan Vinjé
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
| | - Aron J Hall
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia
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7
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HBGA binding modes and selectivity in noroviruses upon mutation: a docking and molecular dynamics study. J Mol Model 2019; 25:369. [DOI: 10.1007/s00894-019-4261-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 11/13/2019] [Indexed: 01/01/2023]
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8
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Bierhoff M, Arvelo W, Estevez A, Bryan J, McCracken JP, López MR, López B, Parashar UD, Lindblade KA, Hall AJ. Incidence and Clinical Profile of Norovirus Disease in Guatemala, 2008-2013. Clin Infect Dis 2019; 67:430-436. [PMID: 29420688 DOI: 10.1093/cid/ciy091] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 02/03/2018] [Indexed: 12/15/2022] Open
Abstract
Background Acute gastroenteritis (AGE) is a leading infectious cause of morbidity worldwide, particularly among children in developing countries. With the decline of rotavirus disease rates following introduction of rotavirus vaccines, the relative importance of norovirus will likely increase. Our objectives in this study were to determine the incidence and clinical profile of norovirus disease in Guatemala. Methods We analyzed data from a population-based surveillance study conducted in Guatemala from 2008 through 2013. Demographic information, clinical data, and stool samples were collected from patients who presented with AGE (≥3 liquid stools within 24 hours that initiated 7 days before presentation). Estimated incidence of hospitalized, outpatient, and total community norovirus disease was calculated using surveillance data and household surveys of healthcare use. Results We included 999 AGE hospitalizations and 3189 AGE outpatient visits at facilities, of which 164 (16%) and 370 (12%), respectively, were positive for norovirus. Severity of norovirus was milder than of rotavirus. Community incidence of norovirus ranged from 2068 to 4954 per 100000 person-years (py) in children aged<5 years. Children aged <5 years also had higher incidence of norovirus-associated hospitalization (51-105 per 100000 py) compared with patients aged ≥5 years (0-1.6 per 100000 py and 49-80 per 100000 py, respectively). Conclusions This study highlights the burden of norovirus disease in Guatemala, especially among young children. These data can help prioritize development of control strategies, including the potential use of vaccines, and provide a baseline to evaluate the impact of such interventions.
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Affiliation(s)
- Marieke Bierhoff
- Centers for Disease Control and Prevention, Atlanta, Georgia.,VU Medical Center, Amsterdam, The Netherlands
| | - Wences Arvelo
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Joe Bryan
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | | | - Kim A Lindblade
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Aron J Hall
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Abstract
BACKGROUND Based on the impact public health of norovirus and the current progress in norovirus vaccine development, it is necessary to continuously monitor the epidemiology of norovirus infection, especially in children who are more susceptible to norovirus. OBJECTIVES To monitor the activity and genotypes of norovirus infection in sporadic diarrhea in Shanghainese children during 2014-2018. STUDY DESIGN Acute diarrheal cases were prospectively enrolled in the outpatient setting. Real-time reverse transcription-polymerase chain reaction was used for screening norovirus GI and GII genogroups. Dual norovirus genotypes were identified based on the partial capsid and polymerase gene sequences. RESULTS Of the 3422 children with diarrhea, 510 (14.9%) were positive for noroviruses with 13 (2.5%) strains being GI genogroup and 497 (97.5%) strains being GII genogroup. Five distinct capsid GII genotypes were identified, including GII.4-Sydney/2012 (71.8%), GII.3 (13.8%), GII.17 (7.8%), GII.2 (6.0%), GII.6 (0.3%) and GII.8 (0.3%). Seven polymerase GII genotypes were identified, including GII.Pe (77.0%), GII.P12 (11.0%), GII.P17 (9.0%), GII.P16 (2.1%), and GII.P7, GII.P8 and GII.P2 in each (0.3%). Eleven distinct polymerase/capsid genotypes were identified with GII.Pe/GII.4-Sydney/2012 (74.2%), GII.P12/GII.3 (11.7%) and GII.P17/GII.17 (7.7%) being common. GII.P17/GII.17 strains were detected since September 2014. Recombinant GII.P16/GII.2 strains were detected since December 2016. CONCLUSIONS Norovirus is a major pathogen causing diarrhea in Shanghainese children. GII.Pe/GII.4-Sydney/2012 strains remained the predominant genotype. The emergence of GII.P17/GII.17 and GII.P16/GII.2 strains in sporadic diarrhea was consistent with norovirus-associated outbreaks attributable to these 2 novel variants in China. Continuous monitoring norovirus genotypes circulating in pediatric population is needed for current vaccine development.
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Tan M, Jiang X. Norovirus Capsid Protein-Derived Nanoparticles and Polymers as Versatile Platforms for Antigen Presentation and Vaccine Development. Pharmaceutics 2019; 11:pharmaceutics11090472. [PMID: 31547456 PMCID: PMC6781506 DOI: 10.3390/pharmaceutics11090472] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 08/27/2019] [Accepted: 09/09/2019] [Indexed: 12/11/2022] Open
Abstract
Major viral structural proteins interact homotypically and/or heterotypically, self-assembling into polyvalent viral capsids that usually elicit strong host immune responses. By taking advantage of such intrinsic features of norovirus capsids, two subviral nanoparticles, 60-valent S60 and 24-valent P24 nanoparticles, as well as various polymers, have been generated through bioengineering norovirus capsid shell (S) and protruding (P) domains, respectively. These nanoparticles and polymers are easily produced, highly stable, and extremely immunogenic, making them ideal vaccine candidates against noroviruses. In addition, they serve as multifunctional platforms to display foreign antigens, self-assembling into chimeric nanoparticles or polymers as vaccines against different pathogens and illnesses. Several chimeric S60 and P24 nanoparticles, as well as P domain-derived polymers, carrying different foreign antigens, have been created and demonstrated to be promising vaccine candidates against corresponding pathogens in preclinical animal studies, warranting their further development into useful vaccines.
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Affiliation(s)
- Ming Tan
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
| | - Xi Jiang
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
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Azim KF, Hasan M, Hossain MN, Somana SR, Hoque SF, Bappy MNI, Chowdhury AT, Lasker T. Immunoinformatics approaches for designing a novel multi epitope peptide vaccine against human norovirus (Norwalk virus). INFECTION GENETICS AND EVOLUTION 2019; 74:103936. [PMID: 31233780 DOI: 10.1016/j.meegid.2019.103936] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 12/19/2022]
Abstract
Norovirus is known as a major cause of several acute gastroenteritis (AGE) outbreaks each year. A study was conducted to develop a unique multi epitope subunit vaccine against human norovirus by adopting reverse vaccinology approach. The entire viral proteome of Norwalk virus was retrieved and allowed for further in silico study to predict highly antigenic epitopes through antigenicity, transmembrane topology screening, allergenicity assessment, toxicity analysis, population coverage analysis and molecular docking approach. Capsid protein VP1 and protein VP2 were identified as most antigenic viral proteins which generated a plethora of antigenic epitopes. Physicochemical properties and secondary structure of the designed vaccine were assessed to ensure its thermostability, hydrophilicity, theoretical PI and structural behavior. Molecular docking analysis of the refined vaccine with different MHCs and human immune TLR8 receptor demonstrated higher binding interaction as well. Complexed structure of the modeled vaccine and TLR8 showed minimal deformability at molecular level. The designed construct was reverse transcribed and adapted for E. coli strain K12 prior to insertion within pET28a(+) vector for its heterologous cloning and expression, and sequence of vaccine constructs showed no similarity with human proteins. However, the study could initiate in vitro and in vivo studies regarding effective vaccine development against human norovirus.
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Affiliation(s)
- Kazi Faizul Azim
- Faculty of Biotechnology and Genetic Engineering, Sylhet Agricultural University, Sylhet 3100, Bangladesh; Department of Microbial Biotechnology, Sylhet Agricultural University, Sylhet 3100, Bangladesh
| | - Mahmudul Hasan
- Faculty of Biotechnology and Genetic Engineering, Sylhet Agricultural University, Sylhet 3100, Bangladesh; Department of Pharmaceuticals and Industrial Biotechnology, Sylhet Agricultural University, Sylhet 3100, Bangladesh
| | - Md Nazmul Hossain
- Faculty of Biotechnology and Genetic Engineering, Sylhet Agricultural University, Sylhet 3100, Bangladesh; Department of Microbial Biotechnology, Sylhet Agricultural University, Sylhet 3100, Bangladesh.
| | - Saneya Risa Somana
- Faculty of Biotechnology and Genetic Engineering, Sylhet Agricultural University, Sylhet 3100, Bangladesh
| | - Syeda Farjana Hoque
- Faculty of Biotechnology and Genetic Engineering, Sylhet Agricultural University, Sylhet 3100, Bangladesh
| | - Md Nazmul Islam Bappy
- Faculty of Biotechnology and Genetic Engineering, Sylhet Agricultural University, Sylhet 3100, Bangladesh
| | - Anjum Taiebah Chowdhury
- Faculty of Biotechnology and Genetic Engineering, Sylhet Agricultural University, Sylhet 3100, Bangladesh
| | - Tahera Lasker
- Faculty of Biotechnology and Genetic Engineering, Sylhet Agricultural University, Sylhet 3100, Bangladesh
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12
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Yang W, Steele M, Lopman B, Leon JS, Hall AJ. The Population-Level Impacts of Excluding Norovirus-Infected Food Workers From the Workplace: A Mathematical Modeling Study. Am J Epidemiol 2019; 188:177-187. [PMID: 30202923 DOI: 10.1093/aje/kwy198] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 08/24/2018] [Indexed: 02/04/2023] Open
Abstract
Norovirus is the leading cause of acute gastroenteritis and foodborne disease in the United States. The Food and Drug Administration recommends that food workers infected with norovirus be excluded from the workplace while symptomatic and for 48 hours after their symptoms subside. Compliance with this recommendation is not ideal, and the population-level impacts of changes in food-worker compliance have yet to be quantified. We aimed to assess the population impacts of varying degrees of compliance with the current recommendation through the use of a compartmental model. We modeled the number and proportion of symptomatic norovirus cases averted annually in the US population (using data from 1983-2014) in specific age groups (children aged <5 years, children aged 5-17 years, adults aged 18-64 years, and adults aged ≥65 years) under various scenarios of food-worker exclusion (i.e., proportion compliant and days of postsymptomatic exclusion) in comparison with a referent scenario which assumed that 66.6¯% of norovirus-symptomatic food workers and 0% of postsymptomatic food workers were excluded from work. Overall, we estimated that 6.0 million cases of norovirus have already been avoided annually under the referent scenario and that 6.7 million (28%) more cases might be avoided through 100% compliance with the current recommendations. Substantial population-level benefits were predicted from improved compliance in exclusion of norovirus-infected food workers from the workplace-benefits that may be realized through policies or programs incentivizing self-exclusion.
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Affiliation(s)
- Wen Yang
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Molly Steele
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ben Lopman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Juan S Leon
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Aron J Hall
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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13
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Yildiz M, Kocak A. Molecular Dynamics Studies of Histo-Blood Group Antigen Blocking Human Immunoglobulin A Antibody and Escape Mechanism in Noroviruses Upon Mutation. J Comput Biol 2018; 26:962-974. [PMID: 30570348 DOI: 10.1089/cmb.2018.0163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Norovirus is the causing agent of acute gastroenteritis disease globally. Efforts in developing therapeutics against virus infection mostly fail due to emergence of drug resistance that is a consequence of presence of high mutation rates in virus genome during virus' life cycle. In this study, we computationally analyzed the affinity of a drug target, wild type VP1 envelope protein and its three variants to a therapeutic antibody FAB5I2. We have found that mutations break important hydrogen bonds and cause high fluctuations in residues that form VP1-FAB5I2 complex interface. In addition to changes in dynamics, we also revealed that the affinity of FAB5I2 to VP1 protein drops significantly upon mutations in terms of relative binding free energy.
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Affiliation(s)
- Muslum Yildiz
- Department of Molecular Biology and Genetics, Gebze Technical University, Kocaeli, Turkey
| | - Abdulkadir Kocak
- Department of Chemistry, Gebze Technical University, Kocaeli, Turkey
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14
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Hallowell BD, Parashar UD, Hall AJ. Epidemiologic challenges in norovirus vaccine development. Hum Vaccin Immunother 2018; 15:1279-1283. [PMID: 30481104 PMCID: PMC6663132 DOI: 10.1080/21645515.2018.1553594] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 11/24/2018] [Indexed: 10/27/2022] Open
Abstract
Norovirus is the leading cause of acute gastroenteritis (AGE) worldwide. In the United States norovirus is estimated to cause 19-21 million illnesses, 1.7-1.9 million outpatient visits, 56,000-71,000 hospitalizations, and 570-800 deaths annually. Through direct costs and loss of productivity, norovirus disease cost the US economy more than $5.5 billion annually. Due to the lack of available therapies to treat norovirus infections and their highly infectious nature, preventing norovirus illness through vaccination is an appealing strategy. Currently, several norovirus vaccines are in development, including five vaccines in preclinical trials, an oral monovalent vaccine (Vaxart, Inc.) that recently completed a phase IB clinical trial, and a bivalent intramuscular vaccine (Takeda Pharmaceutical Company Limited) in a phase IIB clinical trial. However, no norovirus vaccines are currently available on the market. In this commentary we aim to describe some of the barriers faced in norovirus vaccine development, particularly focusing on vaccine effectiveness and defining the target population.
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Affiliation(s)
- Benjamin D. Hallowell
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, GA, USA
| | - Umesh D. Parashar
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Aron J. Hall
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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15
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Mattison CP, Cardemil CV, Hall AJ. Progress on norovirus vaccine research: public health considerations and future directions. Expert Rev Vaccines 2018; 17:773-784. [PMID: 30092671 DOI: 10.1080/14760584.2018.1510327] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Noroviruses are the leading cause of foodborne illness worldwide, account for approximately one-fifth of acute gastroenteritis (AGE) cases globally, and cause a substantial economic burden. Candidate norovirus vaccines are in development, but there is currently no licensed vaccine. AREAS COVERED Noroviruses cause approximately 684 million cases and 212,000 deaths per year across all age groups, though burden estimates vary by study and region. Challenges to vaccine research include substantial and rapidly evolving genetic diversity, short-term and homotypic immunity to infection, and the absence of a single, well-established correlate of protection. Nonetheless, several norovirus vaccine candidates are currently in development, utilizing virus-like particles (VLPs), P particles, and recombinant adenoviruses. Of these, a bivalent GI.1/GII.4 VLP-based intramuscular vaccine (Phase IIb) and GI.1 oral vaccine (Phase I) are in clinical trials. EXPERT COMMENTARY A norovirus vaccine should target high-risk populations, including the young and the elderly, and protect them against the most common circulating norovirus strains. A norovirus vaccine would be a powerful tool in the prevention and control of norovirus while lessening the burden of AGE worldwide. However, more robust burden and cost estimates are needed to justify investments in and guide norovirus vaccine development.
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Affiliation(s)
- Claire P Mattison
- a Oak Ridge Institute for Science and Education , Oak Ridge , TN , USA.,b Division of Viral Diseases, Viral Gastroenteritis Branch , Centers for Disease Control and Prevention , Atlanta , USA
| | - Cristina V Cardemil
- b Division of Viral Diseases, Viral Gastroenteritis Branch , Centers for Disease Control and Prevention , Atlanta , USA
| | - Aron J Hall
- b Division of Viral Diseases, Viral Gastroenteritis Branch , Centers for Disease Control and Prevention , Atlanta , USA
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16
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Li J, Gao X, Ye YL, Wan T, Zang H, Mo PH, Song CL. An acute gastroenteritis outbreak associated with person-to-person transmission in a primary school in Shanghai: first report of a GI.5 norovirus outbreak in China. BMC Infect Dis 2018; 18:316. [PMID: 29986649 PMCID: PMC6038313 DOI: 10.1186/s12879-018-3224-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 06/29/2018] [Indexed: 01/15/2023] Open
Abstract
Background GII noroviruses are a common cause of acute gastroenteritis (AGE) outbreaks in institutional settings globally. However, AGE outbreaks caused by GI norovirus, especially the GI.5 genotype, are relatively uncommon. Methods In February 2017, an AGE outbreak occurred in a primary school in Shanghai, China. An outbreak investigation was undertaken, and fecal specimens, rectal swabs, and environmental swabs were collected. Pathogen detection was performed and the positive specimens were characterized by gene sequencing. Results The descriptive epidemiological analysis suggested that this outbreak, involving 19 cases in two classes (designated classes A and B), was a small-scale propagated epidemic and person-to-person transmission was the most plausible transmission mode. The outbreak comprised two peaks, with 15 cases occurring in class A during the main peak and four cases occurring in class B in the subsequent minor peak. The primary attack rate was 38% and the secondary attack rate was 10%. Univariable logistic regression indicated that contacting a suspect case was a risk factor for norovirus infection, with an unadjusted OR of 5.6 (95% CI: 1.6–20.1). Six fecal specimens were positive for GI norovirus, with a single genotype, GI.5 norovirus, being involved, as characterized by genotyping. This outbreak was the first reported outbreak of GI.5 norovirus in China. Conclusions This study implies that GI.5 norovirus is a potential agent of outbreaks spread by person-to-person transmission in institutional settings. The investigation highlights the importance of sensitive surveillance, timely isolation of individuals who are ill, adequate hand hygiene, and proper environmental disinfection for prevention and control of AGE outbreaks caused by norovirus.
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Affiliation(s)
- Jian Li
- Clinical Research Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
| | - Xia Gao
- Department of Acute Infectious Diseases Control, Jinshan District Center for Diseases Control and Prevention, 94 Weisheng Rd, Jinshan District, Shanghai, 201599, China
| | - Yu-Long Ye
- Department of Microbiology, Jinshan District Center for Diseases Control and Prevention, Shanghai, China
| | - Tang Wan
- Department of Acute Infectious Diseases Control, Jinshan District Center for Diseases Control and Prevention, 94 Weisheng Rd, Jinshan District, Shanghai, 201599, China
| | - Hao Zang
- Department of Acute Infectious Diseases Control, Jinshan District Center for Diseases Control and Prevention, 94 Weisheng Rd, Jinshan District, Shanghai, 201599, China
| | - Ping-Hua Mo
- Department of Acute Infectious Diseases Control, Jinshan District Center for Diseases Control and Prevention, 94 Weisheng Rd, Jinshan District, Shanghai, 201599, China
| | - Can-Lei Song
- Department of Acute Infectious Diseases Control, Jinshan District Center for Diseases Control and Prevention, 94 Weisheng Rd, Jinshan District, Shanghai, 201599, China.
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Gagneux-Brunon A, Lucht F, Launay O, Berthelot P, Botelho-Nevers E. Vaccines for healthcare-associated infections: present, future, and expectations. Expert Rev Vaccines 2018; 17:421-433. [DOI: 10.1080/14760584.2018.1470507] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Amandine Gagneux-Brunon
- Inserm, CIC 1408, I-REIVAC, University Hospital of Saint-Etienne, Saint-Etienne, France
- GIMAP EA 3064, University of Lyon, Saint-Etienne, France
| | - Frédéric Lucht
- Inserm, CIC 1408, I-REIVAC, University Hospital of Saint-Etienne, Saint-Etienne, France
- GIMAP EA 3064, University of Lyon, Saint-Etienne, France
| | - Odile Launay
- Inserm CIC 1417, I-REIVAC, University of Paris-Descartes, University Hospital of Cochin-Broca-Hôtel-Dieu, Paris, France
| | - Philippe Berthelot
- GIMAP EA 3064, University of Lyon, Saint-Etienne, France
- Infection control unit, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Elisabeth Botelho-Nevers
- Inserm, CIC 1408, I-REIVAC, University Hospital of Saint-Etienne, Saint-Etienne, France
- GIMAP EA 3064, University of Lyon, Saint-Etienne, France
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18
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Bruggink L, Witlox K, Huang B, Warrilow D, Marshall J. GII.4 norovirus recombinant causes gastroenteritis epidemic in Eastern Australia, winter 2017. J Med Virol 2018; 90:1168-1171. [PMID: 29476635 DOI: 10.1002/jmv.25063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 02/14/2018] [Indexed: 12/23/2022]
Abstract
In Victoria, Australia, 160 gastroenteritis outbreaks were norovirus positive for the period January-September 2017. A distinctive peak in norovirus outbreaks was seen May-August, with 118 positive outbreaks occurring in the peak period. The peak was primarily due to the emergence of a GII.P4_NewOrleans_2009/GII.4_Sydney_2012 recombinant that had genetically changed sufficiently to escape herd immunity. This recombinant was also identified elsewhere in Australia, with highly similar sequences identified in Queensland during the same time period. The recombinant GII.P4_NewOrleans_2009/GII.4_Sydney_2012 has not been reported to cause norovirus epidemics outside Australia, suggesting regional factors play a role in determining norovirus genotype incidence.
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Affiliation(s)
- Leesa Bruggink
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Kristie Witlox
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Bixing Huang
- Public Health Virology Laboratory, Public and Environmental Health, Forensic and Scientific Services, Health Support Queensland, Department of Health, Queensland, Australia
| | - David Warrilow
- Public Health Virology Laboratory, Public and Environmental Health, Forensic and Scientific Services, Health Support Queensland, Department of Health, Queensland, Australia
| | - John Marshall
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Peter Doherty Institute for Infection and Immunity, Victoria, Australia
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19
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Abstract
Norovirus is a leading cause of childhood vomiting and diarrhea in the United States and globally. Although most illnesses caused by norovirus are self-resolving, severe outcomes may occur from dehydration, including hospitalization and death. A vast majority of deaths from norovirus occur in developing countries. Immunocompromised children are at risk for more severe outcomes. Treatment of norovirus illness is focused on early correction of dehydration and maintenance of fluid status and nutrition. Hand hygiene, exclusion of ill individuals, and environmental cleaning are important for norovirus outbreak prevention and control, and vaccines to prevent norovirus illness are currently under development.
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Affiliation(s)
- Minesh P Shah
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA.
| | - Aron J Hall
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA
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20
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Abstract
Norovirus is the leading cause of acute gastroenteritis in the USA. Although secondary household transmission of norovirus is frequently reported in outbreaks, little is known about specific risk factors for susceptibility and infectiousness in the household. Three norovirus outbreaks were investigated and data were collected on individuals exposed in the primary outbreak setting and their household members. Potential individual- and household-level risk factors for susceptibility and infectiousness were assessed using univariate and multivariate generalised linear mixed models. In the univariate models, the secondary attack rate (SAR) was significantly higher when living in a household with two or more primary cases (incidence rate ratio (IRR) = 2·1; 95% confidence interval (CI) 1·37-3·29), more than one primary case with vomiting (IRR = 1·9; CI 1·11-3·37), and at least one primary case with diarrhoea (IRR = 3·0; CI 1·46-6·01). After controlling for other risk factors in the multivariate models, the SAR was significantly higher among those living in a household with two or more primary cases (adjusted IRR = 2·0; CI 1·17-3·47) and at least one primary case with diarrhoea (adjusted IRR = 2·8; CI 1·35-5·93). These findings underscore the importance of maintaining proper hygiene and isolating ill household members to prevent norovirus transmission in the household.
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21
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Bruggink LD, Moselen JM, Roberts JA, Marshall JA. Evolutionary changes in the capsid P2 region of Australian strains of the norovirus GII.Pe_GII.4. J Med Microbiol 2017; 66:1014-1022. [PMID: 28742004 DOI: 10.1099/jmm.0.000531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The protruding (P) 2 region of the norovirus capsid is thought to include hypervariable sites involved in receptor binding. This study examines the changes that occurred in the P2 region of GII.Pe_GII.4 norovirus in the course of its evolution from a precursor phase (2008-2009), to an intermediate phase (2010) and finally to an epidemic phase (2012-2015). METHODOLOGY Twenty-two P2 region amino acid (aa) sequences (166 aa long) from all phases of the evolution of the virus were compared and the changes analysed.Results/key findings. Twenty sites in the P2 region underwent aa change and of these, 10 corresponded to previously proposed hypervariable sites and 10 to novel hypervariable sites. It was notable that aa changes at two sites, X and Y, only emerged as the epidemic phase progressed. 3D computer modelling of the P2 region indicated that neither X nor Y were in the uppermost 'crown', but further down in the 'neck' portion. The location of X and Y and the nature of aa change at Y suggest these sites were important in enhancing the structural integrity of the capsid, which in turn may have facilitated the longer term viability of the virus. CONCLUSION The current study helps establish the validity of previously proposed hypervariable sites in the P2 region as well as indicating new ones. It also provides quantitative and qualitative data on how these sites changed over the evolutionary history of a particular norovirus strain.
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Affiliation(s)
- Leesa D Bruggink
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Victoria, Australia
| | - Jean M Moselen
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Victoria, Australia
| | - Jason A Roberts
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Victoria, Australia
| | - John A Marshall
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Victoria, Australia
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Genotype analysis of noroviruses associated with gastroenteritis outbreaks in childcare centres, Victoria, Australia, 2012-2015. Epidemiol Infect 2017; 145:1933-1941. [PMID: 28397614 DOI: 10.1017/s0950268817000681] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The characteristics of norovirus outbreaks in children (0-5 years) in childcare centres in Victoria, Australia (2012-2015) were examined. The three most common open reading frame (ORF) 2 genotypes in childcare centre outbreaks were GII.4 (42%), GII.6 (21%) and GII.3 (14%); the remaining genotypes (GI.2, GI.3, GI.4, GI.8, GI.13, GII.1, GII.2, GII.7 and GII.13) each made up <10%. The GII.4 genotype was the only norovirus genotype seen in all 4 years of the study and was the most common genotype in 2012-2014 but in 2015 the most common genotype was GII.2. The GII.4 genotype was more common in children 0-2 years, whereas GII.2 and GII.7 were more common in children 4-5 years. ORF 1/ORF 2 recombinant forms identified were GII.P4_NewOrleans_2009/GII.4_Sydney_2012, GII.P12/GII.3, GII.Pb (GII.21)/GII.3, GII.Pe/GII.2, GII.Pe/GII.4_Sydney_2012 and GII.Pg/GII.1. The findings indicate that norovirus genotype prevalence patterns in children were influenced by the age of the children and the year in which the analysis was carried out. The majority of norovirus infections (84%) occurred after the first year of life so that vaccination before the age of one would appear to be the most efficacious.
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Norovirus Disease in Older Adults Living in Long-Term Care Facilities: Strategies for Management. CURRENT GERIATRICS REPORTS 2017; 6:26-33. [PMID: 29204334 DOI: 10.1007/s13670-017-0195-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose of Review Noroviruses are the most common cause of gastroenteritis outbreaks in long-term care facility (LTCFs). This review summarizes the most up-to-date knowledge on norovirus infection in LTCFs with the aim of identifying potential strategies for management. Recent Findings LTCF residents are at greater risk of norovirus infection. Early identification of norovirus infection and prompt initiation of appropriate supportive therapy are required to reduce morbidity and mortality. Measures to prevent outbreaks and reduce the risk of norovirus infection in LTCFs include timely diagnosis and implementation of infection control interventions to limit virus transmission. Summary Current guidelines for prevention and control are based on generic principles of infection control. Real-time reverse transcription-quantitative polymerase chain reaction assays have been the gold standard for the rapid and sensitive detection of noroviruses. With the recent breakthroughs of human norovirus in vitro culture, doors are now opened to evaluate the efficacy of environmental disinfectants and hand hygiene options. Additionally, development of licensed vaccines against noroviruses may provide another important tool for infection prevention among high-risk individuals.
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Bok K, Prevots DR, Binder AM, Parra GI, Strollo S, Fahle GA, Behrle-Yardley A, Johnson JA, Levenson EA, Sosnovtsev SV, Holland SM, Palmore TN, Green KY. Epidemiology of Norovirus Infection Among Immunocompromised Patients at a Tertiary Care Research Hospital, 2010-2013. Open Forum Infect Dis 2016; 3:ofw169. [PMID: 27800529 PMCID: PMC5084716 DOI: 10.1093/ofid/ofw169] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 08/05/2016] [Indexed: 11/13/2022] Open
Abstract
Background. Noroviruses are a major cause of infectious gastroenteritis worldwide, and viruses can establish persistent infection in immunocompromised individuals. Risk factors and transmission in this population are not fully understood. Methods. From 2010 through 2013, we conducted a retrospective review among immunocompromised patients (n = 268) enrolled in research studies at the National Institutes of Health Clinical Center and identified a subset of norovirus-positive patients (n = 18) who provided stool specimens for norovirus genotyping analysis. Results. Norovirus genome was identified by reverse-transcription quantitative polymerase chain reaction in stools of 35 (13%) of the 268 immunocompromised patients tested, and infection prevalence was 21% (11 of 53) in persons with primary immune deficiencies and 12% (20 of 166) among persons with solid tumors or hematologic malignancies. Among 18 patients with norovirus genotyping information, norovirus GII.4 was the most prevalent genotype (14 of 18, 78%). Persistent norovirus infection (≥6 months) was documented in 8 of 18 (44%) individuals. Phylogenetic analysis of the GII.4 capsid protein sequences identified at least 5 now-displaced GII.4 variant lineages, with no evidence of their nosocomial transmission in the Clinical Center. Conclusions. Norovirus was a leading enteric pathogen identified in this immunocompromised population. Both acute and chronic norovirus infections were observed, and these were likely community-acquired. Continued investigation will further define the role of noroviruses in these patients and inform efforts toward prevention and treatment.
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Affiliation(s)
- Karin Bok
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases (NIAID)
| | | | | | - Gabriel I Parra
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases (NIAID)
| | - Sara Strollo
- Laboratory of Clinical Infectious Disease, NIAID
| | - Gary A Fahle
- Microbiology Service, Clinical Center , National Institutes of Health , Bethesda, Maryland
| | - Allison Behrle-Yardley
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases (NIAID)
| | - Jordan A Johnson
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases (NIAID)
| | - Eric A Levenson
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases (NIAID)
| | - Stanislav V Sosnovtsev
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases (NIAID)
| | | | - Tara N Palmore
- Laboratory of Clinical Infectious Disease, NIAID; Hospital Epidemiology Service, National Institutes of Health Clinical Center
| | - Kim Y Green
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases (NIAID)
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25
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Hall AJ, Glass RI, Parashar UD. New insights into the global burden of noroviruses and opportunities for prevention. Expert Rev Vaccines 2016; 15:949-51. [PMID: 27142965 DOI: 10.1080/14760584.2016.1178069] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Aron J Hall
- a Division of Viral Diseases , National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Roger I Glass
- b Fogarty International Center , National Institutes of Health , Bethesda , MD , USA
| | - Umesh D Parashar
- a Division of Viral Diseases , National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA
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26
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Agnihothram SS, Basco MDS, Mullis L, Foley SL, Hart ME, Sung K, Azevedo MP. Infection of Murine Macrophages by Salmonella enterica Serovar Heidelberg Blocks Murine Norovirus Infectivity and Virus-induced Apoptosis. PLoS One 2015; 10:e0144911. [PMID: 26658916 PMCID: PMC4679214 DOI: 10.1371/journal.pone.0144911] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 11/25/2015] [Indexed: 12/02/2022] Open
Abstract
Gastroenteritis caused by bacterial and viral pathogens constitutes a major public health threat in the United States accounting for 35% of hospitalizations. In particular, Salmonella enterica and noroviruses cause the majority of gastroenteritis infections, with emergence of sporadic outbreaks and incidence of increased infections. Although mechanisms underlying infections by these pathogens have been individually studied, little is known about the mechanisms regulating co-infection by these pathogens. In this study, we utilized RAW 264.7 murine macrophage cells to investigate the mechanisms governing co-infection with S. enterica serovar Heidelberg and murine norovirus (MNV). We demonstrate that infection of RAW 264.7 cells with S. enterica reduces the replication of MNV, in part by blocking virus entry early in the virus life cycle, and inducing antiviral cytokines later in the infection cycle. In particular, bacterial infection prior to, or during MNV infection affected virus entry, whereas MNV entry remained unaltered when the virus infection preceded bacterial invasion. This block in virus entry resulted in reduced virus replication, with the highest impact on replication observed during conditions of co-infection. In contrast, bacterial replication showed a threefold increase in MNV-infected cells, despite the presence of antibiotic in the medium. Most importantly, we present evidence that the infection of MNV-infected macrophages by S. enterica blocked MNV-induced apoptosis, despite allowing efficient virus replication. This apoptosis blockade was evidenced by reduction in DNA fragmentation and absence of poly-ADP ribose polymerase (PARP), caspase 3 and caspase 9 cleavage events. Our study suggests a novel mechanism of pathogenesis whereby initial co-infection with these pathogens could result in prolonged infection by either of these pathogens or both together.
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Affiliation(s)
- Sudhakar S Agnihothram
- Division of Microbiology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, Arkansas, United States of America
| | - Maria D S Basco
- Division of Microbiology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, Arkansas, United States of America
| | - Lisa Mullis
- Division of Microbiology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, Arkansas, United States of America
| | - Steven L Foley
- Division of Microbiology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, Arkansas, United States of America
| | - Mark E Hart
- Division of Microbiology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, Arkansas, United States of America
| | - Kidon Sung
- Division of Microbiology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, Arkansas, United States of America
| | - Marli P Azevedo
- Division of Microbiology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, Arkansas, United States of America
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López-Sagaseta J, Malito E, Rappuoli R, Bottomley MJ. Self-assembling protein nanoparticles in the design of vaccines. Comput Struct Biotechnol J 2015; 14:58-68. [PMID: 26862374 PMCID: PMC4706605 DOI: 10.1016/j.csbj.2015.11.001] [Citation(s) in RCA: 245] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 11/10/2015] [Indexed: 01/09/2023] Open
Abstract
For over 100 years, vaccines have been one of the most effective medical interventions for reducing infectious disease, and are estimated to save millions of lives globally each year. Nevertheless, many diseases are not yet preventable by vaccination. This large unmet medical need demands further research and the development of novel vaccines with high efficacy and safety. Compared to the 19th and early 20th century vaccines that were made of killed, inactivated, or live-attenuated pathogens, modern vaccines containing isolated, highly purified antigenic protein subunits are safer but tend to induce lower levels of protective immunity. One strategy to overcome the latter is to design antigen nanoparticles: assemblies of polypeptides that present multiple copies of subunit antigens in well-ordered arrays with defined orientations that can potentially mimic the repetitiveness, geometry, size, and shape of the natural host-pathogen surface interactions. Such nanoparticles offer a collective strength of multiple binding sites (avidity) and can provide improved antigen stability and immunogenicity. Several exciting advances have emerged lately, including preclinical evidence that this strategy may be applicable for the development of innovative new vaccines, for example, protecting against influenza, human immunodeficiency virus, and respiratory syncytial virus. Here, we provide a concise review of a critical selection of data that demonstrate the potential of this field. In addition, we highlight how the use of self-assembling protein nanoparticles can be effectively combined with the emerging discipline of structural vaccinology for maximum impact in the rational design of vaccine antigens.
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Affiliation(s)
| | - Enrico Malito
- GlaxoSmithKline Vaccines S.r.l., Via Fiorentina 1, 53100 Siena, Italy
| | - Rino Rappuoli
- GlaxoSmithKline Vaccines S.r.l., Via Fiorentina 1, 53100 Siena, Italy
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