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Arnaboldi S, Righi F, Mangeri L, Galuppini E, Bertasi B, Finazzi G, Varisco G, Ongaro S, Gandolfi C, Lamera R, Amboni P, Rota E, Balbino D, Colombo C, Gelmi M, Boffelli A, Gasparri S, Filipello V, Losio MN. Contamination source identification for the prompt management of a gastroenteritis outbreak caused by norovirus in drinking water in Northern Italy. Heliyon 2024; 10:e32767. [PMID: 38975098 PMCID: PMC11225738 DOI: 10.1016/j.heliyon.2024.e32767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 06/07/2024] [Accepted: 06/08/2024] [Indexed: 07/09/2024] Open
Abstract
In June 2022, a gastroenteritis outbreak occurred in a town in Northern Italy, possibly associated with the ingestion of norovirus from public drinking water. Noroviruses are highly infectious RNA viruses, with high stability in the environment. They are the primary cause of non-bacterial gastroenteritis worldwide, and despite the fact that the disease is mainly self-limiting, norovirus infection can lead to severe illness in the immunocompromised, the elderly and children. Immediately after the notification of the suspected norovirus outbreak, faecal specimens were collected from hospitalised patients, and water samples were collected from public drinking fountains in the affected area, to confirm the presence of norovirus. Norovirus was detected in 80 % (95 % CI 0.58-0.91) of the faecal specimens, and in 50 % (95 % CI 0.28-0.72) of the water samples using RT (reverse transcription) Real-time PCR. The identification of GII genotype in all samples confirmed public drinking water as the source of norovirus contamination. In addition, in one faeces and one water sample, the co-presence of genotypes GI and GII was detected. The strains were typed by sequencing, with most of them belonging to the genotype GII.3. Immediately after the confirmation of norovirus contamination in public drinking water, the local competent authorities applied safety measures, resulting in a decline in number of cases. Moreover, after the application of disinfection protocols in the water plant, the sampling was repeated with negative results for norovirus in the affected area. However, positive samples were found in the neighbouring area (prevalence 10.00 %, 95 % CI 0.02-0.40) and in the water spring (prevalence 50.00 %, 95 % CI 0.21-0.78), suggesting norovirus persistence and spread from the water source. The prompt identification of the source of contamination, and collaboration with the local authorities guided the implementation of proper procedures to control viral spread, resulting in the successful control of the outbreak.
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Affiliation(s)
- Sara Arnaboldi
- Food Safety Department, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna (IZSLER), Via A. Bianchi 9, 25124, Brescia, Italy
| | - Francesco Righi
- Food Safety Department, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna (IZSLER), Via A. Bianchi 9, 25124, Brescia, Italy
| | - Lucia Mangeri
- Food Safety Department, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna (IZSLER), Via A. Bianchi 9, 25124, Brescia, Italy
| | - Elisa Galuppini
- Food Safety Department, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna (IZSLER), Via A. Bianchi 9, 25124, Brescia, Italy
| | - Barbara Bertasi
- Food Safety Department, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna (IZSLER), Via A. Bianchi 9, 25124, Brescia, Italy
| | - Guido Finazzi
- Food Safety Department, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna (IZSLER), Via A. Bianchi 9, 25124, Brescia, Italy
- National Reference Centre for Emerging Risks in Food Safety (CRESA), Via A. Bianchi 9, 25124, Brescia, Italy
| | - Giorgio Varisco
- Food Safety Department, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna (IZSLER), Via A. Bianchi 9, 25124, Brescia, Italy
| | - Stefania Ongaro
- Department of Hygiene and Health, Agenzia di Tutela della Salute (ATS), Via Borgo Palazzo 130, 24100, Bergamo, Italy
| | - Camillo Gandolfi
- Department of Hygiene and Health, Agenzia di Tutela della Salute (ATS), Via Borgo Palazzo 130, 24100, Bergamo, Italy
| | - Rossella Lamera
- Department of Hygiene and Health, Agenzia di Tutela della Salute (ATS), Via Borgo Palazzo 130, 24100, Bergamo, Italy
| | - Paolo Amboni
- Department of Hygiene and Health, Agenzia di Tutela della Salute (ATS), Via Borgo Palazzo 130, 24100, Bergamo, Italy
| | - Elena Rota
- Department of Hygiene and Health, Agenzia di Tutela della Salute (ATS), Via Borgo Palazzo 130, 24100, Bergamo, Italy
| | - Deborah Balbino
- Department of Hygiene and Health, Agenzia di Tutela della Salute (ATS), Via Borgo Palazzo 130, 24100, Bergamo, Italy
| | - Constanza Colombo
- Department of Hygiene and Health, Agenzia di Tutela della Salute (ATS), Via Borgo Palazzo 130, 24100, Bergamo, Italy
| | - Martina Gelmi
- Department of Hygiene and Health, Agenzia di Tutela della Salute (ATS), Via Borgo Palazzo 130, 24100, Bergamo, Italy
| | - Alessandra Boffelli
- Department of Hygiene and Health, Agenzia di Tutela della Salute (ATS), Via Borgo Palazzo 130, 24100, Bergamo, Italy
| | - Serena Gasparri
- Department of Hygiene and Health, Agenzia di Tutela della Salute (ATS), Via Borgo Palazzo 130, 24100, Bergamo, Italy
| | - Virginia Filipello
- Food Safety Department, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna (IZSLER), Via A. Bianchi 9, 25124, Brescia, Italy
| | - Marina-Nadia Losio
- Food Safety Department, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna (IZSLER), Via A. Bianchi 9, 25124, Brescia, Italy
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Gao J, Xue L, Li Y, Zhang J, Dai J, Ye Q, Wu S, Gu Q, Zhang Y, Wei X, Wu Q. A systematic review and meta-analysis indicates a high risk of human noroviruses contamination in vegetable worldwide, with GI being the predominant genogroup. Int J Food Microbiol 2024; 413:110603. [PMID: 38306773 DOI: 10.1016/j.ijfoodmicro.2024.110603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/30/2023] [Accepted: 01/21/2024] [Indexed: 02/04/2024]
Abstract
Human noroviruses (HuNoVs) are the most predominant viral agents of acute gastroenteritis. Vegetables are important vehicles of HuNoVs transmission. This study aimed to assess the HuNoVs prevalence in vegetables. We searched the Web of Science, Excerpta Medica Database, PubMed, and Cochrane databases until June 1, 2023. A total of 27 studies were included for the meta-analysis. Statistical analysis was conducted using Stata 14.0 software. This analysis showed that the pooled HuNoVs prevalence in vegetables was 7 % (95 % confidence interval (CI): 3-13) worldwide. The continent with largest number of studies was Europe, and the highest number of samples was lettuce. As revealed by the results of the subgroup meta-analysis, the prevalence of GI genogroup was the highest (3 %, 95 % CI: 1-7). A higher prevalence was seen in vegetables from farms (18 %, 95 % CI: 5-37), while only 4 % (95 % CI: 1-8) in retail. The HuNoVs prevalence of ready-to-eat vegetables and non-ready-to-eat vegetables was 2 % (95 % CI: 0-8) and 9 % (95 % CI: 3-16), respectively. The prevalence by quantitative real time RT-PCR was 8 % (95 % CI: 3-15) compared to 3 % (95 % CI: 0-13) by conventional RT-PCR. Furthermore, the HuNoVs prevalence in vegetables was 6 % (95 % CI: 1-14) in ISO pretreatment method and 8 % (95 % CI: 1-19) in non-ISO method, respectively. This study is helpful in comprehensively understanding the prevalence of HuNoVs contamination in vegetables worldwide.
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Affiliation(s)
- Junshan Gao
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, National Health Commission Science and Technology Innovation Platform for Nutrition and Safety of Microbial Food, Guangzhou, Guangdong 510070, China
| | - Liang Xue
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, National Health Commission Science and Technology Innovation Platform for Nutrition and Safety of Microbial Food, Guangzhou, Guangdong 510070, China.
| | - Yijing Li
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, National Health Commission Science and Technology Innovation Platform for Nutrition and Safety of Microbial Food, Guangzhou, Guangdong 510070, China
| | - Jumei Zhang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, National Health Commission Science and Technology Innovation Platform for Nutrition and Safety of Microbial Food, Guangzhou, Guangdong 510070, China
| | - Jingsha Dai
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, National Health Commission Science and Technology Innovation Platform for Nutrition and Safety of Microbial Food, Guangzhou, Guangdong 510070, China
| | - Qinghua Ye
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, National Health Commission Science and Technology Innovation Platform for Nutrition and Safety of Microbial Food, Guangzhou, Guangdong 510070, China
| | - Shi Wu
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, National Health Commission Science and Technology Innovation Platform for Nutrition and Safety of Microbial Food, Guangzhou, Guangdong 510070, China
| | - Qihui Gu
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, National Health Commission Science and Technology Innovation Platform for Nutrition and Safety of Microbial Food, Guangzhou, Guangdong 510070, China
| | - Youxiong Zhang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, National Health Commission Science and Technology Innovation Platform for Nutrition and Safety of Microbial Food, Guangzhou, Guangdong 510070, China
| | - Xianhu Wei
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, National Health Commission Science and Technology Innovation Platform for Nutrition and Safety of Microbial Food, Guangzhou, Guangdong 510070, China
| | - Qingping Wu
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, National Health Commission Science and Technology Innovation Platform for Nutrition and Safety of Microbial Food, Guangzhou, Guangdong 510070, China.
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Fumian TM, Malta FC, Sarmento SK, Fernandes SB, Negri CM, Belettini SADA, Machado MH, Guimarães MAAM, de Assis RMS, Baduy GA, Fialho AM, Burlandy FM. Acute gastroenteritis outbreak associated with multiple and rare norovirus genotypes after storm events in Santa Catarina, Brazil. J Med Virol 2023; 95:e29205. [PMID: 37933896 DOI: 10.1002/jmv.29205] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 11/08/2023]
Abstract
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.
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Affiliation(s)
- Tulio Machado Fumian
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Fábio Correia Malta
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- Department of Infectious and Parasitic Diseases, School of Medicine, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sylvia Kahwage Sarmento
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Cynthia Maria Negri
- Central Laboratory of Public Health-LACEN, Florianópolis, Santa Catarina, Brazil
| | | | | | - Maria Angelica Arpon Marandino Guimarães
- Department of Infectious and Parasitic Diseases, School of Medicine, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosane Maria Santos de Assis
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Gabriel Assad Baduy
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Alexandre Madi Fialho
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Fernanda Marcicano Burlandy
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Zhou J, Hung YC, Xie X. Application of electric field treatment (EFT) for microbial control in water and liquid food. JOURNAL OF HAZARDOUS MATERIALS 2023; 445:130561. [PMID: 37055970 DOI: 10.1016/j.jhazmat.2022.130561] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/23/2022] [Accepted: 12/04/2022] [Indexed: 06/19/2023]
Abstract
Water disinfection and food pasteurization are critical to reducing waterborne and foodborne diseases, which have been a pressing public health issue globally. Electrified treatment processes are emerging and have become promising alternatives due to the low cost of electricity, independence of chemicals, and low potential to form by-products. Electric field treatment (EFT) is a physical pathogen inactivation approach, which damages cell membrane by irreversible electroporation. EFT has been studied for both water disinfection and food pasteurization. However, no study has systematically connected the two fields with an up-to-date review. In this article, we first provide a comprehensive background of microbial control in water and food, followed by the introduction of EFT. Subsequently, we summarize the recent EFT studies for pathogen inactivation from three aspects, the processing parameters, its efficacy against different pathogens, and the impact of liquid properties on the inactivation performance. We also review the development of novel configurations and materials for EFT devices to address the current challenges of EFT. This review introduces EFT from an engineering perspective and may serve as a bridge to connect the field of environmental engineering and food science.
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Affiliation(s)
- Jianfeng Zhou
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Yen-Con Hung
- Department of Food Science and Technology, College of Agriculture and Environmental Sciences, University of Georgia, Griffin, GA, USA
| | - Xing Xie
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
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Norovirus GII.3[P12] Outbreak Associated with the Drinking Water Supply in a Rural Area in Galicia, Spain, 2021. Microbiol Spectr 2022; 10:e0104822. [PMID: 35867474 PMCID: PMC9431064 DOI: 10.1128/spectrum.01048-22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Noroviruses are likely to be underrecognized in most suspected waterborne outbreaks. Therefore, effective norovirus detection and the early recognition of water as a possible source of infection are important to reduce morbidity as appropriate steps are taken to control the source.
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Özgüler ZÖ, Priyakanta N, Coban SC, Sezerol MA, Shaikh IA, Temel F. An acute gastroenteritis outbreak associated with a contaminated water supply system, Turkey, 2018. JOURNAL OF WATER AND HEALTH 2022; 20:1064-1070. [PMID: 35902988 DOI: 10.2166/wh.2022.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Disruption of routine monitorization and chlorination of the water supply system during a week-long holiday led to a multi-organism gastroenteritis outbreak in a district with limited laboratory support. More than a 10-fold increase in patients with gastroenteritis was reported. Enteropathogenic Escherichia coli, Enteroaggregative E. coli, and norovirus were detected in human specimen samples. The main water tank and pipes were rusted; 13 out of the 19 water samples tested positive for total Coliform (1-920 colony-forming units (CFU)/100 ml) and E. coli (1-720 CFU/100 ml). Chlorine levels were below 0.2 ppm in seven of the nine samples. Information of 1,815 cases was obtained from the hospital records with a crude attack rate of 2.9%. Cases widespread in the district increased throughout the holiday, epidemic curve revealed a point-source outbreak. The case-control study revealed that consumption of drinking tap water and using it to clean vegetables/fruits were significantly associated with the illness. While drinking only bottled water had a protective effect against the illness. The culture technique showed that the water supply samples were positive for pathogenic bacteria. Upon decision in a multi-stakeholder meeting, the water tank was cleaned, and the Municipality initiated the renovation of the water supply system.
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Affiliation(s)
- Zeynep Özge Özgüler
- General Directorate of Public Health, Ministry of Health of Turkey, Adnan Saygun St, Çankaya, Ankara, Turkey E-mail:
| | - Nayak Priyakanta
- WHO Country Office Turkey, World Health Organization, WHO Country Office Turkey, Yukarı Dikmen, Çankaya, Ankara, Turkey
| | - Serap Cetin Coban
- General Directorate of Public Health, Ministry of Health of Turkey, Adnan Saygun St, Çankaya, Ankara, Turkey E-mail:
| | - Mehmet Akif Sezerol
- General Directorate of Public Health, Ministry of Health of Turkey, Adnan Saygun St, Çankaya, Ankara, Turkey E-mail:
| | - Irshad Ali Shaikh
- WHO Country Office Turkey, World Health Organization, WHO Country Office Turkey, Yukarı Dikmen, Çankaya, Ankara, Turkey
| | - Fehminaz Temel
- General Directorate of Public Health, Ministry of Health of Turkey, Adnan Saygun St, Çankaya, Ankara, Turkey E-mail:
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High Prevalence and Diversity of Caliciviruses in a Community Setting Determined by a Metagenomic Approach. Microbiol Spectr 2022; 10:e0185321. [PMID: 35196791 PMCID: PMC8865552 DOI: 10.1128/spectrum.01853-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We recently carried out a metagenomic study to determine the fecal virome of infants during their first year of life in a semirural community in Mexico. A total of 97 stool samples from nine children were collected starting 2 weeks after birth and monthly thereafter until 12 months of age. In this work, we describe the prevalence and incidence of caliciviruses in this birth cohort. We found that 54 (56%) and 24 (25%) of the samples were positive for norovirus and sapovirus sequence reads detected by next-generation sequencing, respectively. Potential infections were arbitrarily considered when at least 20% of the complete virus genome was determined. Considering only these samples, there were 3 cases per child/year for norovirus and 0.33 cases per child/year for sapovirus. All nine children had sequence reads related to norovirus in at least 2 and up to 10 samples, and 8 children excreted sapovirus sequence reads in 1 and up to 5 samples during the study. The virus in 35 samples could be genotyped. The results showed a high diversity of both norovirus (GI.3[P13], GI.5, GII.4, GII.4[P16], GII.7[P7], and GII.17[P17]) and sapovirus (GI.1, GI.7, and GII.4) in the community. Of interest, despite the frequent detection of caliciviruses in the stools, all children remained asymptomatic during the study. Our results clearly show that metagenomic studies in stools may reveal a detailed picture of the prevalence and diversity of gastrointestinal viruses in the human gut during the first year of life. IMPORTANCE Human caliciviruses are important etiological agents of acute gastroenteritis in children under 5 years of age. Several studies have characterized their association with childhood diarrhea and their presence in nondiarrheal stool samples. In this work, we used a next-generation sequencing approach to determine, in a longitudinal study, the fecal virome of infants during their first year of life. Using this method, we found that caliciviruses can be detected significantly more frequently than previously reported, providing a more detailed picture of the prevalence and genetic diversity of these viruses in the human gut during early life.
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Mariita RM, Davis JH, Randive RV. Illuminating Human Norovirus: A Perspective on Disinfection of Water and Surfaces Using UVC, Norovirus Model Organisms, and Radiation Safety Considerations. Pathogens 2022; 11:pathogens11020226. [PMID: 35215169 PMCID: PMC8879714 DOI: 10.3390/pathogens11020226] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/22/2022] [Accepted: 02/03/2022] [Indexed: 02/04/2023] Open
Abstract
Human noroviruses (HuNoVs) are a major cause of gastroenteritis and are associated with high morbidity because of their ability to survive in the environment and small inoculum size required for infection. Norovirus is transmitted through water, food, high touch-surfaces, and human-to-human contact. Ultraviolet Subtype C (UVC) light-emitting diodes (LEDs) can disrupt the norovirus transmission chain for water, food, and surfaces. Here, we illuminate considerations to be adhered to when picking norovirus surrogates for disinfection studies and shine light on effective use of UVC for norovirus infection control in water and air and validation for such systems and explore the blind spot of radiation safety considerations when using UVC disinfection strategies. This perspective also discusses the promise of UVC for norovirus mitigation to save and ease life.
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Boles C, Brown G, Nonnenmann M. Determination of murine norovirus aerosol concentration during toilet flushing. Sci Rep 2021; 11:23558. [PMID: 34876637 PMCID: PMC8651634 DOI: 10.1038/s41598-021-02938-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 11/24/2021] [Indexed: 11/14/2022] Open
Abstract
Murine norovirus (MNV) was used as a surrogate for human viral pathogens (e.g., norovirus) to determine if toilet flushing resulted in the aerosolization of virus. A flushometer type toilet was seeded with a viral solution of 105 and 106 PFU mL-1 of MNV and then flushed. Upon flushing, two bioaerosol samplers were activated to collect aerosolized MNV. Prior to the experiment, two optical particle counters monitored particle size and number distribution of aerosol produced from flushing a toilet across height, position, and side. The location with the highest mean particle concentration, was behind the toilet and 0.15 m above the toilet bowl rim, which is where bioaerosol sampling occurred. Bioaerosol and toilet water samples were collected, extracted and then quantified using RT-ddPCR. The concentration of MNV collected after seeding the toilet water ranged from 2.18 × 105 to 9.65 × 106 total copies of MNV. Positive samples of airborne MNV were detected with collected concentrations ranging from 383 to 684 RNA copies/m3 of air. This study provides evidence that viral pathogens may be aerosolized when a toilet is flushed. Furthermore, the MNV used in this study is a model organism for human norovirus and may be generalizable to other viral pathogens (e.g., coronavirus). This study suggests that virus is aerosolized from toilet flushing and may contribute to human exposure to viral pathogens.
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Affiliation(s)
| | - Grant Brown
- College of Public Health, University of Iowa, Iowa City, IA, USA
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Saadoun I, Ababneh Q, Jaradat Z. Genomic detection of waterborne enteric viruses as water quality indicators in Al-Zarqa River, Jordan. JOURNAL OF WATER AND HEALTH 2021; 19:604-615. [PMID: 34371497 DOI: 10.2166/wh.2021.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Al-Zarqa River is the second main tributary to River Jordan after the Yarmouk River. The river flow has been modified by discharge of industrial wastewater and treated domestic water. Concerns about the occurrence of waterborne pathogenic viruses in the surface waters of Al-Zarqa River prompted the analysis of the surface water quality with respect to the presence of enteric viruses. Viruses were concentrated from a total of 33 different water environmental samples including raw sewage, effluent samples and river water collected from and around the river over a period of 11 months. Calculated recovery yields for these concentration methods ranged between 2 and 8%. Polymerase chain reaction (PCR), reverse transcriptase-PCR (RT-PCR), nested RT-PCR and southern blotting hybridization analysis were used for the detection of hepatitis A virus, norovirus, astrovirus and human adenovirus 40/41, with the later one being detected in 21 (64%) of the samples that also showed previous positive presence for enteroviruses. To our knowledge, this is the first molecular biology report in Jordan describing the circulation of adenoviruses, which were detected more frequently than enteroviruses in sewage and water samples, and therefore, they can be used as an index for the presence of human pathogenic viruses in water environment.
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Affiliation(s)
- Ismail Saadoun
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, UAE E-mail:
| | - Qutaiba Ababneh
- Department of Biotechnology and Genetic Engineering, Faculty of Science and Arts, Jordan University of Science and Technology, Irbid, Jordan
| | - Ziad Jaradat
- Department of Biotechnology and Genetic Engineering, Faculty of Science and Arts, Jordan University of Science and Technology, Irbid, Jordan
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Torén K, Schiöler L, Nenonen NP, Hannoun C, Roth A, Andersson LM, Westin J, Bergström T. Risk factors for norovirus infection in healthcare workers during nosocomial outbreaks: a cross-sectional study. Antimicrob Resist Infect Control 2021; 10:107. [PMID: 34294149 PMCID: PMC8299649 DOI: 10.1186/s13756-021-00979-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/08/2021] [Indexed: 12/03/2022] Open
Abstract
Background Norovirus outbreaks cause severe medico-socio-economic problems affecting healthcare workers and patients. The aim of the study was to investigate prevalence of norovirus infection and risk factors for infection in healthcare workers during nosocomial outbreaks. Methods A cross-sectional study of norovirus infections in healthcare workers was performed in seven outbreak wards in a large university hospital. Packs (swab for rectal sampling, and questionnaire) were posted to healthcare workers on notification of a ward outbreak. Rectal samples were examined with norovirus-specific real-time PCR. Replies from questionnaires were analysed using logistic regression models with norovirus genogroup (G)II positive findings as dependent variable. The results are expressed as odds ratios (OR) with 95% confidence intervals (CI). Sequencing and phylogenetic analyses (1040 nucleotides) were used to characterize norovirus strains from healthcare workers. Cluster analyses included norovirus GII.4 strains detected in ward patients during the ongoing outbreaks. Results Of 308 packs issued to healthcare workers, 129 (42%) were returned. norovirus GII was detected in 26 healthcare workers (20.2%). Work in cohort care (OR 4.8, 95% CI 1.4–16.3), work in wards for patients with dementia (OR 13.2, 95% CI 1.01–170.7), and having diarrhoea, loose stools or other gastrointestinal symptoms the last week (OR 7.7, 95% CI 2.5–27.2) were associated with increased norovirus prevalence in healthcare workers. Sequencing revealed norovirus GII.4 in healthcare workers samples, and strains detected in healthcare workers and ward patients during a given ward outbreak showed ≥ 99% similarity. Conclusion Norovirus positive findings in healthcare workers were strongly associated with symptomatic infection, close contact with sick patients, and dementia nursing. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-021-00979-8.
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Affiliation(s)
- Kjell Torén
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Box 414, 405 30, Gothenburg, Sweden. .,Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Linus Schiöler
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Box 414, 405 30, Gothenburg, Sweden
| | - Nancy P Nenonen
- Department of Infectious Diseases/Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Charles Hannoun
- Department of Infectious Diseases/Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Anette Roth
- Department of Infectious Diseases/Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Lars-Magnus Andersson
- Department of Infectious Diseases/Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Johan Westin
- Department of Infectious Diseases/Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Tomas Bergström
- Department of Infectious Diseases/Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
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12
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Kim JG, Kim JS, Kim JG. Characteristics of Norovirus Food Poisoning Outbreaks in Korea in the 2000s. J Food Prot 2021; 84:472-480. [PMID: 33108448 DOI: 10.4315/jfp-20-093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 10/18/2020] [Indexed: 11/11/2022]
Abstract
ABSTRACT Norovirus food poisoning outbreaks in Korea (South) appeared in the 2000s and have been increasing since then. We aimed to investigate the epidemiological features of norovirus food poisoning outbreaks in Korea from 2002 to 2017, on the basis of official food poisoning statistics and publically reliable reports, and to find any associations with climate factors. Norovirus was the most common cause of food poisoning among known causative substances in Korea during the study period. More than one-third of the outbreaks occurred in group meal service facilities, including school lunch programs. A few of these facilities used groundwater contaminated with noroviruses to wash or cook food, which contributed to outbreaks. Norovirus occurrences showed strong seasonality: cold and relatively dry winter air may help norovirus to flourish. Both norovirus genotypes GI and GII that are infectious to humans were detected, with GII becoming more prevalent than GI. According to our correlation analysis in connection with climate factors, average temperatures, the highest and lowest temperatures, precipitation, the number of rain days, and humidity showed a significant negative correlation with a monthly norovirus occurrence (P < 0.05). The lowest temperature and average temperature had higher coefficients of correlation, -0.377 and -0.376, respectively. The norovirus outbreaks in Korea showed complex etiological characteristics, although more prevailed in wintertime, and are now a major public health problem. The use of groundwater in group meal service settings is a public health issue, as well as a norovirus concern; therefore, groundwater used in food service facilities and businesses should be treated for safety. HIGHLIGHTS
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Affiliation(s)
- Jong-Gyu Kim
- Faculty of Food and Health Sciences, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Republic of Korea (ORCID: https://orcid.org/0000-0001-7310-1492 [Jong-Gyu Kim])
| | - Joong-Soon Kim
- Department of Industrial and Management Engineering, Keimyung University, Daegu 42601, Republic of Korea
| | - Jeong-Gyoo Kim
- School of Games (Software), Hongik University, Sejong 30016, Republic of Korea
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13
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Okumus B. Norovirus and Coronavirus Risks in Food Service Settings: A Systematic Review for Future Research. JOURNAL OF CULINARY SCIENCE & TECHNOLOGY 2021. [DOI: 10.1080/15428052.2021.1888835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Bendegul Okumus
- Food Service and Lodging Management Department, Rosen College of Hospitality Management, University of Central Florida, Orlando, FL USA
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14
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Zheng L, Zhang H, Ma J, Liu J, Ma S, Wang M, Huo Y. Phylogenetic and biological characterizations of a GI.3 norovirus. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2020; 85:104554. [PMID: 32927119 DOI: 10.1016/j.meegid.2020.104554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/25/2020] [Accepted: 09/09/2020] [Indexed: 01/05/2023]
Abstract
Noroviruses (NoVs) are a major cause of acute non-bacterial gastroenteritis worldwide. In this study, we report the isolation, near-complete genome sequencing, and expression and biological characterization of the major capsid protein (VP1) of a GI.3 NoV isolated from a child presenting acute gastroenteritis. The genome of the GI.3 NoV is 7746 bp in length, not including the poly-adenylation tail. Phylogenetic analysis based on the complete VP1 nucleotide sequences indicates that GI.3 NoVs could be divided into four clusters, with 4.6%, 5.3%, 6.6%, 1.9% intracluster variations in nucleotide and 4.8%, 3.8%, 6.1%, 1.7% intracluster variations in amino acid sequences, respectively. A Bayesian evolutionary analysis showed that GI.3 NoVs evolved at 2.44 × 10-3, 2.78 × 10-3, and 3.04 × 10-3 nucleotide substitutions/site/year using a strict clock model, an uncorrelated log-normal model (UCLN), and an uncorrelated exponential derivation model (UCED), respectively. VP1 protein expression using a recombinant baculovirus expression system leads to the successful assembly of virus-like particles (VLPs). In vitro VLP-Histo-blood group antigen (HBGA) binding assay indicates that GI.3 NoV VLPs strongly bind to blood type A salivary HBGAs, moderately bind to blood type O salivary HBGAs, and weakly bind or do not bind to blood type B and AB salivary HBGAs. In vitro VLP-HBGA binding blockade assay indicated that the binding of GI.3 NoV VLPs to blood type A salivary HBGAs could only be blocked by anti-GI.3 NoV VLPs serum but not non-GI.3 NoV genotype-specific hyperimmune sera (GI.2, GI.7, GII.4, GII.6, GII.7, and GII.17). The detailed characterization of GI.3 NoV in this study provides evidence that GI.3 NoV undergoes rapid evolution and exhibits no cross-blocking effects, suggesting that GI.3 NoV may potentially be utilized in the development of multivalent NoV vaccines.
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Affiliation(s)
- Lijun Zheng
- The Sixth People's Hospital of Zhengzhou, Zhengzhou, China
| | | | - Jie Ma
- The Sixth People's Hospital of Zhengzhou, Zhengzhou, China
| | - Jinjin Liu
- The Sixth People's Hospital of Zhengzhou, Zhengzhou, China
| | - Shuhuan Ma
- The Sixth People's Hospital of Zhengzhou, Zhengzhou, China
| | | | - Yuqi Huo
- The Sixth People's Hospital of Zhengzhou, Zhengzhou, China.
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15
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Waldman P, Lucas FS, Varrault G, Moulin L, Wurtzer S. Hydrophobic Organic Matter Promotes Coxsackievirus B5 Stabilization and Protection from Heat. FOOD AND ENVIRONMENTAL VIROLOGY 2020; 12:118-129. [PMID: 31912415 DOI: 10.1007/s12560-019-09418-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 12/30/2019] [Indexed: 05/28/2023]
Abstract
In urban rivers, many of which are used for drinking water production, viruses encounter a range of particulate, colloidal, and dissolved organic and inorganic compounds. To date, the impact of environmental organic matter on virus persistence in the environment has received little attention. In the present study, fresh water was fractioned to separate particulate natural organic matter from dissolved forms. Each fraction was tested for its ability to promote coxsackievirus B5 resistance to heat inactivation. Our results demonstrate that, at natural concentrations, environmental waters contain particulate or dissolved compounds that are able to protect viruses from heat. We also show that hydrophobic compounds promote an efficient protection against heat inactivation. This study suggests that local conditions encountered by viruses in the environment could greatly impact their persistence.
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Affiliation(s)
- P Waldman
- Laboratoire Eau Environnement Et Systèmes Urbains (LEESU, UMR MA 102), Faculté des Sciences Et Technologie, Université Paris-Est, 61 Avenue du Général de Gaulle, 94000, Créteil, France
| | - F S Lucas
- Laboratoire Eau Environnement Et Systèmes Urbains (LEESU, UMR MA 102), Faculté des Sciences Et Technologie, Université Paris-Est, 61 Avenue du Général de Gaulle, 94000, Créteil, France
| | - G Varrault
- Laboratoire Eau Environnement Et Systèmes Urbains (LEESU, UMR MA 102), Faculté des Sciences Et Technologie, Université Paris-Est, 61 Avenue du Général de Gaulle, 94000, Créteil, France
| | - L Moulin
- Eau de Paris, DRDQE, 33 Avenue Jean Jaurès, 94200, Ivry sur Seine, France.
| | - S Wurtzer
- Eau de Paris, DRDQE, 33 Avenue Jean Jaurès, 94200, Ivry sur Seine, France
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16
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Environmental and Adaptive Changes Necessitate a Paradigm Shift for Indicators of Fecal Contamination. Microbiol Spectr 2020. [DOI: 10.1128/microbiolspec.erv-0001-2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
ABSTRACT
Changes in the occurrence, distribution, and seasonal variation of waterborne pathogens due to global climate change may increase the risk of human exposure to these microorganisms, thus heightening the need for more reliable surveillance systems. Routine monitoring of drinking water supplies and recreational waters is performed using fecal indicator microorganisms, such as
Escherichia coli
,
Enterococcus
spp., and coliphages. However, the presence and numbers of these indicators, especially
E. coli
and
Enterococcus
spp., do not correlate well with those of other pathogens, especially enteric viruses, which are a major cause of waterborne outbreaks associated with contaminated water and food, and recreational use of lakes, ponds, rivers, and estuarine waters. For that reason, there is a growing need for a surveillance system that can detect and quantify viral pathogens directly in water sources to reduce transmission of pathogens associated with fecal transmission. In this review, we present an updated overview of relevant waterborne enteric viruses that we believe should be more commonly screened to better evaluate water quality and to determine the safety of water use and reuse and of epidemiological data on viral outbreaks. We also discuss current methodologies that are available to detect and quantify these viruses in water resources. Finally, we highlight challenges associated with virus monitoring. The information presented in this review is intended to aid in the assessment of human health risks due to contact with water sources, especially since current environmental and adaptive changes may be creating the need for a paradigm shift for indicators of fecal contamination.
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17
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Quantitative PCR Detection of Enteric Viruses in Wastewater and Environmental Water Sources by the Lisbon Municipality: A Case Study. WATER 2020. [DOI: 10.3390/w12020544] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Current regulations and legislation require critical revision to determine safety for alternative water sources and water reuse as part of the solution to global water crisis. In order to fulfill those demands, Lisbon municipality decided to start water reuse as part of a sustainable hydric resources management, and there was a need to confirm safety and safeguard for public health for its use in this context. For this purpose, a study was designed that included a total of 88 samples collected from drinking, superficial, underground water, and wastewater at three different treatment stages. Quantitative Polimerase Chain Reaction (PCR) detection (qPCR) of enteric viruses Norovirus (NoV) genogroups I (GI) and II (GII) and Hepatitis A (HepA) was performed, and also FIB (E. coli, enterococci and fecal coliforms) concentrations were assessed. HepA virus was only detected in one untreated influent sample, whereas NoV GI/ NoV GI were detected in untreated wastewater (100/100%), secondary treated effluent (47/73%), and tertiary treated effluent (33/20%). Our study proposes that NoV GI and GII should be further studied to provide the support that they may be suitable indicators for water quality monitoring targeting wastewater treatment efficiency, regardless of the level of treatment.
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18
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Hofmann FM, Michaelis M, Stößel U, Hofmann F. [On Statistical Underreporting of Norovirus-Infections: Insights from Register Data of Two Local Public Health Authorities]. DAS GESUNDHEITSWESEN 2020; 83:357-362. [PMID: 31962363 DOI: 10.1055/a-1076-8128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Only laboratory-confirmed norovirus (NoV) cases have to be notified to the Robert Koch Institute (RKI) since 2011, but not other, e. g. clinical-epidemiological cases. It can be assumed that the extent of underreporting of NoV cases in Germany has significantly increased since then. OBJECTIVES To discuss the extent of underreporting, we wanted to find out how many laboratory tests were carried out during gastroenteritis outbreaks. Furthermore, the significance of NoV outbreaks in occupational health is discussed. MATERIALS AND METHODS Of all pseudonymized gastroenteritis outbreak data reported to 2 local health authorities between 2011 and 2015, the proportion of NoV outbreaks and reported cases of infection among employees in hospitals and community facilities (nursing homes for the elderly, day-care centers, schools) confirmed by laboratory tests was calculated retrospectively. RESULTS Only a few gastroenteritis outbreaks in day-care centers were etiologically diagnosed, so that only 6% and less could be classified as NoV outbreaks. In nursing homes for the elderly, about half of the outbreaks were classified as NoV, in hospitals almost all of them. Employees accounted for up to 23% of those affected in NoV outbreaks. CONCLUSIONS The low level of laboratory diagnostics carried out during gastroenteritis outbreaks in day-care centers suggests a considerable number of hidden NoV cases. The significant proportion of staff relative to the total number of infected persons during the outbreaks highlights the importance of the burden of NoV outbreaks as a topic in occupational health. Further, large-scale prospective studies are needed to empirically substantiate these initial findings.
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Affiliation(s)
- Felix Martin Hofmann
- FFAS, Freiburger Forschungsstelle Arbeits- und Sozialmedizin, Freiburg im Breisgau
| | - Martina Michaelis
- FFAS, Freiburger Forschungsstelle Arbeits- und Sozialmedizin, Freiburg im Breisgau
| | - Ulrich Stößel
- FFAS, Freiburger Forschungsstelle Arbeits- und Sozialmedizin, Freiburg im Breisgau
| | - Friedrich Hofmann
- FFAS, Freiburger Forschungsstelle Arbeits- und Sozialmedizin, Freiburg im Breisgau
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19
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Abstract
Water is one of the most important substances on earth and without it life cannot exist. However, poor water quality in many parts of the world has increased the number of water-related diseases, making it the leading cause of disease and death globally for both young and old. Waterborne pathogens cause diseases in humans through two major exposure pathways: drinking water and recreational waters. This chapter on waterborne pathogens will be starting with an introduction, followed by descriptions on classical waterborne pathogens; bacteria, viruses, protozoans, and helminths placing emphasis on the World Health Organization guidelines. Further to conventional waterborne pathogens, fresh organisms and new strains from already known pathogens are being identified and that present important additional challenges to both the water and public health sectors. Hence later part of the chapter focuses on the potential waterborne pathogens and will conclude with a summary of the content.
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Affiliation(s)
- D.N. Magana-Arachchi
- Molecular Microbiology & Human Diseases Unit, National Institute of Fundamental Studies, Kandy, Sri Lanka
| | - R.P. Wanigatunge
- Department of Plant and Molecular Biology, University of Kelaniya, Kelaniya, Sri Lanka
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20
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Two Drinking Water Outbreaks Caused by Wastewater Intrusion Including Sapovirus in Finland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224376. [PMID: 31717479 PMCID: PMC6888097 DOI: 10.3390/ijerph16224376] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/06/2019] [Accepted: 11/06/2019] [Indexed: 12/27/2022]
Abstract
Drinking water outbreaks occur worldwide and may be caused by several factors, including raw water contamination, treatment deficiencies, and distribution network failure. This study describes two drinking water outbreaks in Finland in 2016 (outbreak I) and 2018 (outbreak II). Both outbreaks caused approximately 450 illness cases and were due to drinking water pipe breakage and subsequent wastewater intrusion into the distribution system. In both outbreaks, the sapovirus was found in patient samples as the main causative agent. In addition, adenoviruses and Dientamoeba fragilis (outbreak I), and noroviruses, astroviruses, enterotoxigenic and enterohemorragic Escherichia coli (ETEC and EHEC, respectively) and Plesiomonas shigelloides (outbreak II) were detected in patient samples. Water samples were analyzed for the selected pathogens largely based on the results of patient samples. In addition, traditional fecal indicator bacteria and host-specific microbial source tracking (MST) markers (GenBac3 and HF183) were analyzed from water. In drinking water, sapovirus and enteropathogenic E. coli (EPEC) were found in outbreak II. The MST markers proved useful in the detection of contamination and to ensure the success of contaminant removal from the water distribution system. As mitigation actions, boil water advisory, alternative drinking water sources and chlorination were organized to restrict the outbreaks and to clean the contaminated distribution network. This study highlights the emerging role of sapoviruses as a waterborne pathogen and warrants the need for testing of multiple viruses during outbreak investigation.
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21
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Poma HR, Kundu A, Wuertz S, Rajal VB. Data fitting approach more critical than exposure scenarios and treatment of censored data for quantitative microbial risk assessment. WATER RESEARCH 2019; 154:45-53. [PMID: 30771706 DOI: 10.1016/j.watres.2019.01.041] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/29/2018] [Accepted: 01/28/2019] [Indexed: 05/24/2023]
Abstract
Recreational waters are a source of many diseases caused by human viral pathogens, including norovirus genogroup II (NoV GII) and enterovirus (EV). Water samples from the Arenales river in Salta, Argentina, were concentrated by ultrafiltration and analyzed for the concentrations of NoV GII and EV by quantitative PCR. Out of 65 samples, 61 and 59 were non-detects (below the Sample Limit of Detection limit, SLOD) for EV and NoV GII, respectively. We hypothesized that a finite number of environmental samples would lead to different conclusions regarding human health risks based on how data were treated and fitted to existing distribution functions. A quantitative microbial risk assessment (QMRA) was performed and the risk of infection was calculated using: (a) two methodological approaches to find the distributions that best fit the data sets (methods H and R), (b) four different exposure scenarios (primary contact for children and adults and secondary contact by spray inhalation/ingestion and hand-to-mouth contact), and (c) five alternatives for treating censored data. The risk of infection for NoV GII was much higher (and exceeded in most cases the acceptable value established by the USEPA) than for EV (in almost all the scenarios within the recommended limit), mainly due to the low infectious dose of NoV. The type of methodology used to fit the monitoring data was critical for these datasets with numerous non-detects, leading to very different estimates of risk. Method R resulted in higher projected risks than Method H. Regarding the alternatives for treating censored data, replacing non-detects by a unique value like the average or median SLOD to simplify the calculations led to the loss of information about the particular characteristics of each sample. In addition, the average SLOD was highly impacted by extreme values (due to events such as precipitations or point source contamination). Instead, using the SLOD or half- SLOD captured the uniqueness of each sample since they account for the history of the sample including the concentration procedure and the detection method used. Finally, substitution of non-detects by Zero is not realistic since a negative result would be associated with a SLOD that can change by developing more efficient and sensitive methodology; hence this approach would lead to an underestimation of the health risk. Our findings suggest that in most cases the use of the half-SLOD approach is appropriate for QMRA modeling.
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Affiliation(s)
- Hugo Ramiro Poma
- Instituto de Investigaciones para la Industria Química (INIQUI), CONICET, Universidad Nacional de Salta (UNSa), Av. Bolivia 5150, Salta, 4400, Argentina
| | - Arti Kundu
- Department of Civil and Environmental Engineering, University of California, Davis, 95616, USA
| | - Stefan Wuertz
- Department of Civil and Environmental Engineering, University of California, Davis, 95616, USA; Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, 637551, Singapore; School of Civil and Environmental Engineering, Nanyang Technological University, 639798, Singapore
| | - Verónica Beatriz Rajal
- Instituto de Investigaciones para la Industria Química (INIQUI), CONICET, Universidad Nacional de Salta (UNSa), Av. Bolivia 5150, Salta, 4400, Argentina; Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, 637551, Singapore; Facultad de Ingeniería, UNSa, Salta, Argentina.
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22
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The prevalence of non-GII.4 norovirus genotypes in acute gastroenteritis outbreaks in Jinan, China. PLoS One 2018; 13:e0209245. [PMID: 30592717 PMCID: PMC6310239 DOI: 10.1371/journal.pone.0209245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 12/03/2018] [Indexed: 01/01/2023] Open
Abstract
Noroviruses (NoVs) are the leading cause of acute viral gastroenteritis outbreaks. From June 2015 to March 2017, fifteen outbreaks of acute gastroenteritis (AGE) were reported to the Jinan Center for Disease Control and Prevention in China. To identify the circulating NoV genotypes associated with outbreaks in Jinan, China, 414 specimens from the 15 outbreaks were collected and analyzed for the causative viruses, and phylogenetic analysis was performed on the NoV-positive strains. The NoV detection rate was 57.5% (238/414), and a total of 14 outbreaks were caused by NoVs (eight by infection with genogroup II (GII), five by mixed infection with GI and GII, and one by mixed infection with GII and rotavirus (RoV)-A). A total of 75 NoV sequences were obtained from 13 NoV-positive outbreaks and classified into seven genotypes (38 GII.17, 13 GII.2, 4 GII.3, 4 GII.1, 10 GI.6, 5 GI.5 and 1 GI.3), while GII.4 was not identified. The most prevalent genotype changed yearly during the 2015–2017 period. Phylogenetic analysis demonstrated that these NoV genotypes had high homology with the strains circulating worldwide, especially strains from Asian countries and cities. Our study illustrated that multiple non-GII.4 NoV genotypes were prevalent in outbreaks of AGE in Jinan, China. Year-round surveillance of multiple NoV genotypes could help health authorities reduce the impact of NoV outbreaks on public health.
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23
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Egorov AI, Griffin SM, Ward HD, Reilly K, Fout GS, Wade TJ. Application of a salivary immunoassay in a prospective community study of waterborne infections. WATER RESEARCH 2018; 142:289-300. [PMID: 29890477 PMCID: PMC6781621 DOI: 10.1016/j.watres.2018.05.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 05/16/2018] [Accepted: 05/17/2018] [Indexed: 05/10/2023]
Abstract
Quantifying sporadic waterborne infections in community settings can be challenging. Salivary antibody immunoassays are a promising non-invasive tool that can be used in prospective studies of common infections, especially those involving children. This study was conducted in a Massachusetts city, which uses a microbiologically contaminated river as its water source, during summer-early winter periods before and after construction of a new drinking water treatment plant. Monthly saliva samples (7480 samples from 1170 children and 816 adults) were analyzed for immunoglobulin G (IgG) responses to recombinant proteins of Cryptosporidium, one genogroup I (GI) and two GII noroviruses. Immunoconversion was defined as at least four-fold increase in specific antibody responses between two monthly samples with a post-conversion response above a flexible age-dependent cut-off. Episodes of gastroenteritis (diarrhea or vomiting or cramps) were associated with 3.2 (95% confidence limits 1.1; 9.5) adjusted odds ratio (aOR) of immunoconversion to Cryptosporidium; episodes of combined diarrhea and vomiting symptoms were associated with 3.5 (0.8; 15.0) and 4.6 (1.7; 12.6) aORs of an immunoconversion to GI and GII noroviruses, respectively. Swimming in natural water bodies or chlorinated pools was associated with 2.3 (0.4; 15.4) and 4.9 (1.6; 15.5) aORs of immunoconversion to Cryptosporidium, respectively. In a subset of study participants who did not use home water filters, consumption of at least some amount of non-boiled tap water reported in a monthly recall survey was associated with 11.1 (1.2; 100.0) and 0.6 (0.1; 2.5) aORs of immunoconversion to Cryptosporidium before and after the new water treatment plant construction, respectively. Among individuals who used home water filters, associations between non-boiled tap water consumption and Cryptosporidium immunoconversion were not significant before and after new plant construction with aORs of 0.8 (0.2; 3.3) and 0.3 (0.1; 1.6), respectively. The interaction effect of study phase and non-boiled tap water consumption on Cryptosporidium immunoconversions was statistically significant in the entire study population with aOR of 5.4 (1.1; 25.6). This was the first study that has used a salivary antibody immunoassay to demonstrate significant associations between gastrointestinal symptoms and Cryptosporidium and norovirus infections, and between water-related exposures and Cryptosporidium infections.
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Affiliation(s)
- Andrey I Egorov
- National Health and Environmental Effects Research Laboratory, United States Environmental Protection Agency, RTP, NC, USA.
| | - Shannon M Griffin
- National Exposure Research Laboratory, United States Environmental Protection Agency, Cincinnati, OH, USA
| | - Honorine D Ward
- Division of Geographic Medicine and Infectious Diseases, Dept. of Medicine, Tufts Medical Center, Boston, MA, USA
| | - Kevin Reilly
- EPA Region 1 (New England), United States Environmental Protection Agency, Boston, MA, USA
| | - G Shay Fout
- National Exposure Research Laboratory, United States Environmental Protection Agency, Cincinnati, OH, USA
| | - Timothy J Wade
- National Health and Environmental Effects Research Laboratory, United States Environmental Protection Agency, RTP, NC, USA
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24
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Zhang L, Li X, Wu R, Chen H, Liu J, Wang Z, Xing Y, Ishaq HM, Wang J, Yu P, Xu J, Ma C. A gastroenteritis outbreak associated with drinking water in a college in northwest China. JOURNAL OF WATER AND HEALTH 2018; 16:508-515. [PMID: 30067234 DOI: 10.2166/wh.2018.202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
An acute gastroenteritis outbreak occurred at a private college in June 2014 in northwest China. This outbreak involved two teachers and 629 students (range: 17-27 years, average 21.3 years). The main symptoms included non-bloody watery diarrhea, stomach ache, nausea, and vomiting, and the duration of illness ranged from 1 to 7 days. Eight of 18 water samples were disqualified. Thirty-four norovirus (NoV) RNA-positive samples were identified from 48 stool-related samples (genotyping results: 13 GII, 13 GI and 8 GI + GII mixture). Fourteen NoV samples were successfully characterized for genotype, including two GII.6, five GI.6, four GI.3, and three GI.1. Enteropathogenic Escherichia coli (EPEC) and enteroadherent Escherichia coli (EAEC) DNA was detected from patient stool specimens and water samples from well one; two EAEC strains and one EPEC strain were isolated from patient stool specimens. The risk ratios (RRs) associated with wells one and two were 1.66 and 1.49, respectively, and the RR associated with living in north dormitory building one was 2.59. The patients' epidemiological characteristics, symptoms, and duration of illness indicated that NoV-contaminated water might be the origin of this outbreak, and RR analysis suggested that the two wells were linked to the outbreak.
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Affiliation(s)
- Lixia Zhang
- Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shaanxi 710043, China; Shaanxi Provincial People's Hospital, No. 256, Youyi West Road, Xi'an, Shaanxi 710068, China
| | - Xiu'E Li
- Xi'an No. 1 Hospital, No. 30, Fenxiang, Xi'an, Shaanxi 710002, China
| | - Rui Wu
- Xi'an Center for Disease Control and Prevention, No. 599, Xiying Road, Xi'an, Shaanxi 710054, China E-mail:
| | - Hailong Chen
- Xi'an Center for Disease Control and Prevention, No. 599, Xiying Road, Xi'an, Shaanxi 710054, China E-mail:
| | - Jifeng Liu
- Xi'an Center for Disease Control and Prevention, No. 599, Xiying Road, Xi'an, Shaanxi 710054, China E-mail:
| | - Zengguo Wang
- Xi'an Center for Disease Control and Prevention, No. 599, Xiying Road, Xi'an, Shaanxi 710054, China E-mail:
| | - Yuan Xing
- Xi'an Center for Disease Control and Prevention, No. 599, Xiying Road, Xi'an, Shaanxi 710054, China E-mail:
| | - Hafiz Muhammad Ishaq
- Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shaanxi 710043, China
| | - Jingjun Wang
- Shaanxi Center for Disease Control and Prevention, No. 3, Jiandong Street, Xi'an, Shaanxi 710054, China
| | - Pengbo Yu
- Shaanxi Center for Disease Control and Prevention, No. 3, Jiandong Street, Xi'an, Shaanxi 710054, China
| | - Jiru Xu
- Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shaanxi 710043, China
| | - Chaofeng Ma
- Xi'an Center for Disease Control and Prevention, No. 599, Xiying Road, Xi'an, Shaanxi 710054, China E-mail:
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Waterborne Norovirus outbreak at a seaside resort likely originating from municipal water distribution system failure. Epidemiol Infect 2018; 146:879-887. [DOI: 10.1017/s095026881800081x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
AbstractIn May 2016 a Norovirus (NoV) gastroenteritis outbreak involved a high school class visiting a seaside resort near Taormina (Mascali, Sicily). Twenty-four students and a teacher were affected and 17 of them showed symptoms on the second day of the journey, while the others got ill within the following 2 days. Symptoms included vomiting, diarrhoea and fever, and 12 students required hospitalisation. Stool samples tested positive for NoV genome by Real-Time polymerase chain reaction assay in all 25 symptomatic subjects. The GII.P2/GII.2 NoV genotype was linked to the outbreak by ORF1/ORF2 sequence analysis. The epidemiological features of the outbreak were consistent with food/waterborne followed by person-to-person and/or vomit transmission. Food consumed at a shared lunch on the first day of the trip was associated to illness and drinking un-bottled tap water was also considered as a risk factor. The analysis of water samples revealed the presence of bacterial indicators of faecal contamination in the water used in the resort as well as in other areas of the municipal water network, linking the NoV gastroenteritis outbreak to tap water pollution from sewage leakage. From a single water sample, an amplicon whose sequence corresponded to the capsid genotype recovered from patients could be obtained.
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Kato R, Asami T, Utagawa E, Furumai H, Katayama H. Pepper mild mottle virus as a process indicator at drinking water treatment plants employing coagulation-sedimentation, rapid sand filtration, ozonation, and biological activated carbon treatments in Japan. WATER RESEARCH 2018; 132:61-70. [PMID: 29306700 DOI: 10.1016/j.watres.2017.12.068] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 12/13/2017] [Accepted: 12/23/2017] [Indexed: 05/12/2023]
Abstract
To assess the potential of pepper mild mottle virus (PMMoV) as a viral process indicator, its reduction through coagulation-sedimentation (CS) and rapid sand filtration (RSF) were compared with those of Escherichia coli, previously used viral indicators, and norovirus genotype II (NoV GII; enteric virus reference pathogen) in a bench-scale experiment. PMMoV log10 reductions in CS (1.96 ± 0.30) and RSF (0.26 ± 0.38) were similar to those of NoV GII (1.86 ± 0.61 and 0.28 ± 0.46). PMMoV, the most abundant viruses in the raw water, was also determined during CS, RSF, and advanced treatment processes at two full-scale drinking water treatment plants under strict turbidity management over a 13-month period. PMMoV was concentrated from large-volume water samples (10-614 L) and quantified by Taqman-based quantitative polymerase chain reaction. The PMMoV log10 reduction in CS (2.38 ± 0.74, n = 13 and 2.63 ± 0.76, n = 10 each for Plant A and B) and in ozonation (1.91 ± 1.18, n = 5, Plant A) greatly contributed to the overall log10 reduction. Our results suggest that PMMoV can act as a useful treatment process indicator of enteric viruses and can be used to monitor the log10 reduction of individual treatment processes at drinking water treatment plants due to its high and consistent copy numbers in source water.
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Affiliation(s)
- Ryuichi Kato
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Tatsuya Asami
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Etsuko Utagawa
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Hiroaki Furumai
- Research Center for Water Environment Technology, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Hiroyuki Katayama
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan; Vietnam - Japan University, Luu Huu Phuoc Str., My Dinh I Ward, Nam Tu Liem Dist., Hanoi, Viet Nam.
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Kumthip K, Khamrin P, Maneekarn N. Molecular epidemiology and genotype distributions of noroviruses and sapoviruses in Thailand 2000-2016: A review. J Med Virol 2018; 90:617-624. [DOI: 10.1002/jmv.25019] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 12/28/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Kattareeya Kumthip
- Faculty of Medicine; Department of Microbiology; Chiang Mai University; Chiang Mai Thailand
- Center of Excellence in Emerging and Re-emerging Diarrheal Viruses; Chiang Mai University; Chiang Mai Thailand
| | - Pattara Khamrin
- Faculty of Medicine; Department of Microbiology; Chiang Mai University; Chiang Mai Thailand
- Center of Excellence in Emerging and Re-emerging Diarrheal Viruses; Chiang Mai University; Chiang Mai Thailand
| | - Niwat Maneekarn
- Faculty of Medicine; Department of Microbiology; Chiang Mai University; Chiang Mai Thailand
- Center of Excellence in Emerging and Re-emerging Diarrheal Viruses; Chiang Mai University; Chiang Mai Thailand
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Detection of waterborne norovirus genogroup I strains using an improved real time RT-PCR assay. Arch Virol 2017; 162:3389-3396. [PMID: 28779231 DOI: 10.1007/s00705-017-3505-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 06/23/2017] [Indexed: 10/19/2022]
Abstract
Noroviruses (NoVs) are the major global source of acute gastroenteritis (AGE) outbreaks. To detect NoVs, real-time reverse transcription-quantitative PCR (RT-qPCR) assays have been widely employed since the first decade of the 21st century. We developed a redesigned probe, JJV1PM, for RT-qPCR assay detection of NoV genogroup (G) I strains. The new RT-qPCR assay using the JJV1PM-probe showed broader strain reactivity for 10 NoV GI genotypes, while the old method, using the JJV1PT-probe assay, detected only 7 NoV GI genotypes in a validation panel using human fecal specimens. The improved RT-qPCR assay was also successfully applied to water samples. The JJV1PM-probe assay identified 7 NoV GI genotypes, whereas the JJV1PT-probe assay detected only 2 NoV GI genotypes from water samples. Notably, groundwater-borne NoV GI strains detected by the improved JJV1PM-probe assay were associated with groundwater-borne AGE outbreaks in South Korea. The results of this study underscore the importance of the evaluation of RT-qPCR assays using recently circulating NoV strains prior to field application.
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Jeong MI, Park SY, Ha SD. Thermal inactivation of human norovirus on spinach using propidium or ethidium monoazide combined with real-time quantitative reverse transcription-polymerase chain reaction. Food Control 2017. [DOI: 10.1016/j.foodcont.2017.02.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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30
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Van Abel N, Schoen ME, Kissel JC, Meschke JS. Comparison of Risk Predicted by Multiple Norovirus Dose-Response Models and Implications for Quantitative Microbial Risk Assessment. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2017; 37:245-264. [PMID: 27285380 DOI: 10.1111/risa.12616] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 02/26/2016] [Accepted: 03/01/2016] [Indexed: 05/06/2023]
Abstract
The application of quantitative microbial risk assessments (QMRAs) to understand and mitigate risks associated with norovirus is increasingly common as there is a high frequency of outbreaks worldwide. A key component of QMRA is the dose-response analysis, which is the mathematical characterization of the association between dose and outcome. For Norovirus, multiple dose-response models are available that assume either a disaggregated or an aggregated intake dose. This work reviewed the dose-response models currently used in QMRA, and compared predicted risks from waterborne exposures (recreational and drinking) using all available dose-response models. The results found that the majority of published QMRAs of norovirus use the 1 F1 hypergeometric dose-response model with α = 0.04, β = 0.055. This dose-response model predicted relatively high risk estimates compared to other dose-response models for doses in the range of 1-1,000 genomic equivalent copies. The difference in predicted risk among dose-response models was largest for small doses, which has implications for drinking water QMRAs where the concentration of norovirus is low. Based on the review, a set of best practices was proposed to encourage the careful consideration and reporting of important assumptions in the selection and use of dose-response models in QMRA of norovirus. Finally, in the absence of one best norovirus dose-response model, multiple models should be used to provide a range of predicted outcomes for probability of infection.
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Affiliation(s)
- Nicole Van Abel
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Mary E Schoen
- Soller Environmental, Berkeley, Inc., Berkeley, CA, USA
| | - John C Kissel
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - J Scott Meschke
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
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31
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An outbreak of norovirus GI-6 infection following a wedding in North West England. Epidemiol Infect 2017; 145:1239-1245. [PMID: 28132650 DOI: 10.1017/s0950268816003368] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
In August 2015 a gastroenteritis outbreak occurred following a wedding. An outbreak investigation was undertaken and a cohort study was conducted using an online survey. Of 140 guests, 134 received the survey and 113 responded (84·3% response rate). Seventy respondents met the case definition of vomiting and/or diarrhoea within 72 h of the wedding (61·9% attack rate). Fifteen exposures were associated with illness; on stratification, all were confounded by the ham hock starter. Multivariable analysis showed a significant association with exposure to ham hock (risk ratio 6·62, 95% confidence interval 2·19-20·03). Eight guests and two catering staff submitted stool samples. All tested positive for norovirus GI-6 infection, including a food handler who had vomiting less than 48 h before the wedding. A single genotype was detected among all samples, suggesting a single source of contamination. The transmission pattern suggested point-source exposure. The most plausible cause of the outbreak was transmission from an infected food handler via contaminated food. This highlights the importance of appropriate exclusions for symptomatic food handlers. Additionally, the food handler's stool sample was submitted 7 days after symptom resolution. The potential for extended viral excretion, and the extremely low infective dose of norovirus, may mean that current exclusion guidelines are not of sufficient duration.
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Kumazaki M, Usuku S. Norovirus genotype distribution in outbreaks of acute gastroenteritis among children and older people: an 8-year study. BMC Infect Dis 2016; 16:643. [PMID: 27821133 PMCID: PMC5100332 DOI: 10.1186/s12879-016-1999-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 10/29/2016] [Indexed: 02/05/2023] Open
Abstract
Background Noroviruses (NoVs) are the most frequent cause of acute gastroenteritis worldwide among people of all ages and the leading cause of gastrointestinal disease outbreaks in various settings. To clarify the differences in epidemic situations among different settings, we investigated epidemiological trends and the distribution of NoV genotypes in Yokohama, Japan. Methods Between September 2007 and August 2015, 746 outbreaks of NoV gastroenteritis were reported in kindergarten/nursery schools (K/Ns), primary schools (PSs), and nursing homes for the aged (NHs). Stool samples were collected for NoV testing, and the NoV gene was amplified and sequenced to determine the genotype. Results During the eight seasons, 248 NoV outbreaks occurred in K/Ns, 274 outbreaks in PSs, and 224 outbreaks in NHs. These outbreaks occurred throughout the year, except in August, and the number increased in November and peaked in December. The number of outbreaks that occurred from November to February comprised 76.8 % of all outbreaks. The outbreaks originated in K/Ns or PSs in every season, except for one season. Five genogroup (G)I and nine GII genotypes in K/Ns, six GI and 10 GII genotypes in PSs, and three GI and six GII genotypes in NHs were detected during the eight seasons. GII.4 was the most prevalent genotype in K/Ns and NHs. However, GII.6 was the most prevalent genotype in PSs. The epidemic genotypes in K/Ns and PSs changed by NoV season, although GII.4 was always predominant in NHs. Moreover, the distribution of genotypes was significantly different between epidemic and non-epidemic periods in each facility (p < 0.01 for all). Conclusions The epidemic situation of NoV outbreaks differs by facility, NoV season, and month. The genotype distribution is likely dependent on the facility and is significantly different between epidemic and non-epidemic periods.
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Affiliation(s)
- Makoto Kumazaki
- Microbiological Testing and Research Division, Yokohama City Institute of Public Health, Kanagawa, Japan. .,Yokohama City Institute of Public Health, 2-7-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan.
| | - Shuzo Usuku
- Microbiological Testing and Research Division, Yokohama City Institute of Public Health, Kanagawa, Japan.,Yokohama City Institute of Public Health, 2-7-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan
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33
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Kim MS, Koo ES, Choi YS, Kim JY, Yoo CH, Yoon HJ, Kim TO, Choi HB, Kim JH, Choi JD, Park KS, Shin Y, Kim YM, Ko G, Jeong YS. Distribution of Human Norovirus in the Coastal Waters of South Korea. PLoS One 2016; 11:e0163800. [PMID: 27681683 PMCID: PMC5040428 DOI: 10.1371/journal.pone.0163800] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 09/14/2016] [Indexed: 02/02/2023] Open
Abstract
The presence of human norovirus in the aquatic environment can cause outbreaks related to recreational activities and the consumption of norovirus-contaminated clams. In this study, we investigated the prevalence of norovirus genogroups I (GI) and II (GII) in the coastal aquatic environment in South Korea (March 2014 to February 2015). A total of 504 water samples were collected periodically from four coastal areas (total sites = 63), of which 44 sites were in estuaries (clam fisheries) and 19 were in inflow streams. RT-PCR analysis targeting ORF2 region C revealed that 20.6% of the water samples were contaminated by GI (13.3%) or GII (16.6%). The prevalence of human norovirus was higher in winter/spring than in summer/fall, and higher in inflow streams (50.0%) than in estuaries (7.9%). A total of 229 human norovirus sequences were identified from the water samples, and phylogenetic analysis showed that the sequences clustered into eight GI genotypes (GI.1, 2, 3, 4, 5, 6, 7, and 9) and nine GII genotypes (GII.2, 3, 4, 5, 6, 11, 13, 17, and 21). This study highlighted three issues: 1) a strong correlation between norovirus contamination via inflow streams and coastal areas used in clam fisheries; 2) increased prevalence of certain non-GII.4 genotypes, exceeding that of the GII.4 pandemic variants; 3) seasonal shifts in the dominant genotypes of both GI and GII.
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Affiliation(s)
- Man Su Kim
- Department of Biology and Research Institute of Basic Sciences, Kyung Hee University, Seoul, South Korea
| | - Eung Seo Koo
- Department of Biology and Research Institute of Basic Sciences, Kyung Hee University, Seoul, South Korea
| | - Yong Seon Choi
- Department of Biology and Research Institute of Basic Sciences, Kyung Hee University, Seoul, South Korea
| | - Ji Young Kim
- Department of Biology and Research Institute of Basic Sciences, Kyung Hee University, Seoul, South Korea
| | - Chang Hoon Yoo
- Department of Biology and Research Institute of Basic Sciences, Kyung Hee University, Seoul, South Korea
| | - Hyun Jin Yoon
- Department of Seafood Science and Technology, Institute of Marine Industry, Gyeongsang National University, Tongyeong, Gyeongnam, South Korea
| | - Tae-Ok Kim
- Department of Food Science and Biotechnology, College of Ocean Science and Technology, Kunsan National University, Kunsan, South Korea
| | - Hyun Bae Choi
- Department of Environmental Engineering & Biotechnology, Mokpo National Maritime University, Mokpo, South Korea
| | - Ji Hoon Kim
- Department of Food Science and Technology, Pukyong National University, Busan, South Korea
| | - Jong Deok Choi
- Department of Seafood Science and Technology, Institute of Marine Industry, Gyeongsang National University, Tongyeong, Gyeongnam, South Korea
| | - Kwon-Sam Park
- Department of Food Science and Biotechnology, College of Ocean Science and Technology, Kunsan National University, Kunsan, South Korea
| | - Yongsik Shin
- Department of Environmental Engineering & Biotechnology, Mokpo National Maritime University, Mokpo, South Korea
| | - Young-Mog Kim
- Department of Food Science and Technology, Pukyong National University, Busan, South Korea
| | - GwangPyo Ko
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Yong Seok Jeong
- Department of Biology and Research Institute of Basic Sciences, Kyung Hee University, Seoul, South Korea
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Qin M, Dong XG, Jing YY, Wei XX, Wang ZE, Feng HR, Yu H, Li JS, Li J. A Waterborne Gastroenteritis Outbreak Caused by Norovirus GII.17 in a Hotel, Hebei, China, December 2014. FOOD AND ENVIRONMENTAL VIROLOGY 2016; 8:180-6. [PMID: 27084118 DOI: 10.1007/s12560-016-9237-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 03/31/2016] [Indexed: 05/06/2023]
Abstract
Norovirus (NoV) is responsible for an estimated 90 % of all epidemic nonbacterial outbreaks of gastroenteritis worldwide. Waterborne outbreaks of NoV are commonly reported. A novel GII.17 NoV strain emerged as a major cause of gastroenteritis outbreaks in China during the winter of 2014/2015. During this time, an outbreak of gastroenteritis occurred at a hotel in a ski park in Hebei Province, China. Epidemiological investigations indicated that one water well, which had only recently been in use, was the probable source. GII.17 NoV was detected by real-time reverse-transcription polymerase chain reaction from samples taken from cases, from concentrated water samples from water well, and from the nearby sewage settling tank. Nucleotide sequences of NoV extracted from clinical and water specimens were genetically identical and had 99 % homology with Beijing/CHN/2015. All epidemiological data indicated that GII.17 NoV was responsible for this outbreak. This is the first reported laboratory-confirmed waterborne outbreak caused by GII.17 NoV genotype in China. Strengthening management of well drinking water and systematica monitoring of NoV is essential for preventing future outbreaks.
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Affiliation(s)
- Meng Qin
- Fengtai District Center for Disease Control and Prevention of Beijing, 3 Xi An St., Feng-Tai District, Beijing, 100071, China
| | - Xiao-Gen Dong
- Fengtai District Center for Disease Control and Prevention of Beijing, 3 Xi An St., Feng-Tai District, Beijing, 100071, China
| | - Yan-Yan Jing
- Fengtai District Center for Disease Control and Prevention of Beijing, 3 Xi An St., Feng-Tai District, Beijing, 100071, China
| | - Xiu-Xia Wei
- Fengtai District Center for Disease Control and Prevention of Beijing, 3 Xi An St., Feng-Tai District, Beijing, 100071, China
| | - Zhao-E Wang
- Fengtai District Center for Disease Control and Prevention of Beijing, 3 Xi An St., Feng-Tai District, Beijing, 100071, China
| | - Hui-Ru Feng
- Fengtai District Center for Disease Control and Prevention of Beijing, 3 Xi An St., Feng-Tai District, Beijing, 100071, China
| | - Hong Yu
- Fengtai District Center for Disease Control and Prevention of Beijing, 3 Xi An St., Feng-Tai District, Beijing, 100071, China
| | - Jin-Song Li
- China CDC, National Institute for Viral Disease Control and Prevention, 100 Ying-Xin St., Xuan-Wu District, Beijing, 100052, China.
| | - Jie Li
- Fengtai District Center for Disease Control and Prevention of Beijing, 3 Xi An St., Feng-Tai District, Beijing, 100071, China.
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Wankar S, Turner NW, Krupadam RJ. Polythiophene nanofilms for sensitive fluorescence detection of viruses in drinking water. Biosens Bioelectron 2016; 82:20-5. [PMID: 27031187 DOI: 10.1016/j.bios.2016.03.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 03/07/2016] [Accepted: 03/10/2016] [Indexed: 12/13/2022]
Abstract
Molecular imprints of the tobacco necrosis virus (TNV) have been formed within polythiophene nanofilms with an approximate thickness of 200nm. These films have been electrochemically deposited onto conducting Au surfaces. Upon rebinding, the TNV-polythiophene complex changes the fluorescence intensity of the nanofilm. The fluorescence intensity at 410nm was observed to be proportional to the concentration of viruses in the range of 0.1-10ngL(-1) (0.15-15pg) with the lower calculated detection limit of 2.29ngL(-1) (3.4pg). The intensity of the fluorescence emission is not affected by the thickness of the polythiophene film and the nature of TNV specific binding sites. Kinetic data analyses showed that the nanofilm responds to TNV within 2min; and cross-selectivity studies with tobacco mosaic virus (TMV) showed an excellent specificity for the targeted TNV. These binding experiments demonstrate the potential of fluorescence emission for the specific, label free and rapid detection of viruses using nanofilm sensors. Taking into account the lower limit of detection, the fluorescence sensing reported here is reliable, simple to perform, rapid, cost-effective and offers a sensitive analytical method for virus detection in water resources.
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Affiliation(s)
- Shashwati Wankar
- Environmental Impact and Risk Assessment Division, CSIR-National Environmental Engineering Research Institute, Nehru Marg, Nagpur 440020, India
| | - Nicholas W Turner
- Faculty of Science, The Open University, Walton Hall, Milton Keynes, Buckinghamshire MK7 6AA, United Kingdom
| | - Reddithota J Krupadam
- Environmental Impact and Risk Assessment Division, CSIR-National Environmental Engineering Research Institute, Nehru Marg, Nagpur 440020, India.
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Zyara AM, Torvinen E, Veijalainen AM, Heinonen-Tanski H. The effect of chlorine and combined chlorine/UV treatment on coliphages in drinking water disinfection. JOURNAL OF WATER AND HEALTH 2016; 14:640-9. [PMID: 27441859 DOI: 10.2166/wh.2016.144] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Chlorine disinfection is a globally used method to ensure the safety of drinking water. However, it has not always been successful against viruses and, therefore, it is important to find new methods to disinfect water. Seventeen different coliphages were isolated from the treated municipal wastewater. These coliphages and MS2 were treated with different dosages of chlorine in drinking water, and a combined chlorine/ultraviolet irradiation treatment for the chlorine-resistant coliphages. Chlorine disinfection with 0.3-0.5 mg/L total chlorine (free Cl-dosage 0.12-0.21 mg/L) for 10 min achieved 2.5-5.7 Log10-reductions for 11 sensitive coliphages. The six most resistant coliphages showed no reduction with these chlorine concentrations. MS2 was intermediate in chlorine resistance, and thus it is not a good indicator for viruses in chlorine disinfection. In the combined treatment total chlorine of 0.05-0.25 mg/L (free Cl-dosage 0.02-0.08 mg/L) and ultraviolet irradiation (14-22 mWs/cm(2)) were more effective than chlorine alone, and 3-5 Log10-reductions were achieved for the chlorine-resistant strains. The chlorination efficiency could be increased by higher dosages and longer contact times, but this could increase the formation of disinfection by-products. Therefore, the combination treatment is a recommended disinfection method.
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Affiliation(s)
- Alyaa M Zyara
- Department of Environmental and Biological Sciences, University of Eastern Finland, PO Box 1627, FI 70211 Kuopio, Finland E-mail: ; Department of Biology, University of Baghdad, College of Sciences for Women, Baghdad, Iraq
| | - Eila Torvinen
- Department of Environmental and Biological Sciences, University of Eastern Finland, PO Box 1627, FI 70211 Kuopio, Finland E-mail:
| | - Anna-Maria Veijalainen
- Department of Environmental and Biological Sciences, University of Eastern Finland, PO Box 1627, FI 70211 Kuopio, Finland E-mail:
| | - Helvi Heinonen-Tanski
- Department of Environmental and Biological Sciences, University of Eastern Finland, PO Box 1627, FI 70211 Kuopio, Finland E-mail:
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Sweileh WM, Zyoud SH, Al-Jabi SW, Sawalha AF, Shraim NY. Drinking and recreational water-related diseases: a bibliometric analysis (1980-2015). Ann Occup Environ Med 2016; 28:40. [PMID: 27606064 PMCID: PMC5013610 DOI: 10.1186/s40557-016-0128-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 08/31/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Water - related diseases are worldwide health concern. Microbial contamination and contaminant products in water are a source of disease outbreaks and development of cumulative toxic effects. Ensuring safe water is one of the goals to be achieved at the global level. The aim of this study was to assess publications on drinking and recreational water from a health point of view to understand current problems and future research trends in this field. METHODS Scopus, the largest scientific electronic database, was used to retrieve related articles and present the results as bibliometric tables and maps. Search query was modified manually using related terms to maximize accuracy. RESULTS A total of 2267 publications were retrieved with an average of 16.82 citations per article. The h-index of retrieved articles was 88. Visual mapping showed that E. coli, diarrhea, cryptosporidiosis, fluoride, arsenic, cancer, chlorine, trihalomethane, and H. pylori were most frequently encountered terms in title and abstract of retrieved articles. The number of articles on water microbiology was a significant (P < 0.01) predictor of worldwide productivity of water - related disease publications. Journal of Water and Health ranked first in number of publications with 136 (6.00 %) articles. The United States of America ranked first in productivity with a total of 623 (27.48 %) articles. Germany (15.44 %), India (16.00 %) and China (20.66 %) had the least international collaboration in water-related disease research. Environmental Protection Agency and Centers for Disease Prevention and Control were among top ten productive institutions. In the top ten cited articles, there were three articles about arsenic, one about aluminum, one about trihalomethane, one about nitrate, one about toxoplasmosis, one about gastroenteritis, and the remaining two articles were general ones. CONCLUSIONS There was a linear increase in the number of publications on water - related diseases in the last decade. Arsenic, in drinking water is a serious concern. Cryptosporidiosis and other infectious gastroenteritis remain a major health risk of exposure to contaminated water. Increased number of publications from Asian countries was not associated with a high percentage of international collaboration.
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Affiliation(s)
- Waleed M. Sweileh
- Department of Pharmacology/ Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Samah W. Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ansam F. Sawalha
- Department of Pharmacology/ Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Naser Y. Shraim
- Department of Pharmaceutical Chemistry and Technology, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
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Petterson S, Grøndahl-Rosado R, Nilsen V, Myrmel M, Robertson LJ. Variability in the recovery of a virus concentration procedure in water: Implications for QMRA. WATER RESEARCH 2015; 87:79-86. [PMID: 26383122 DOI: 10.1016/j.watres.2015.09.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 09/01/2015] [Accepted: 09/02/2015] [Indexed: 05/18/2023]
Abstract
Methods for analysing water for viruses are known to have variable and relatively poor recovery efficiencies. Quantitative method recovery data are needed to correct virus enumeration results so that estimates of virus concentrations in surface waters for QMRA are not too low. Obtaining quantitative data representing method recoveries for different pathogenic viruses is a significant challenge. In this study, we investigated the use of mengovirus process control data for quantifying recovery efficiency of human adenovirus (AdV) and noroviruses GI (NoVGI) and GII (NoVGII) from surface waters. Samples were collected from the inlet to a drinking water treatment plant on the Glomma River, Norway. Performance of the sample concentration procedure was quantified by comparing the virus concentrations found in concentrated and unconcentrated samples. The mean recovery of viruses (1.2%, 0.31%, 0.15% and 0.053% for mengovirus (n = 86), AdV (n = 20), NoVGI (n = 33) and NoVGII (n = 21) respectively) estimated in this study were lower than expected, and the between sample variability in estimated recovery was very high, spanning around 6 orders of magnitude for mengovirus. Within-sample correlation between the estimated recovery of mengovirus and human viruses was poor, and therefore sample specific mengovirus data could not be used to correct all human virus concentrations. Instead beta distributions were fitted to human virus-specific recovery estimates. The magnitude and variability of virus concentration when corrected for the variable recovery efficiency was orders of magnitude higher than the uncorrected concentration. Better estimates of virus concentration could be achieved if a sample-specific spiking control could be developed that mimicked closely the behaviour of human viruses in environmental samples.
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Affiliation(s)
- Susan Petterson
- Water & Health Pty Ltd. P.O. Box 648, Salamander Bay 2317, Australia; Department of Mathematical Sciences and Technology, Faculty of Environmental Science and Technology, Norwegian University of Life Sciences, Campus Ås, P.O. Box 5003, N-1432 ÅS, Norway.
| | - Ricardo Grøndahl-Rosado
- Department of Food Safety and Infection Biology, Faculty of Veterinary Science and Biomedicine, Norwegian University of Life Sciences, Campus Adamstuen, P.O. Box 8146 Dep., N-0033 Oslo, Norway
| | - Vegard Nilsen
- Department of Mathematical Sciences and Technology, Faculty of Environmental Science and Technology, Norwegian University of Life Sciences, Campus Ås, P.O. Box 5003, N-1432 ÅS, Norway
| | - Mette Myrmel
- Department of Food Safety and Infection Biology, Faculty of Veterinary Science and Biomedicine, Norwegian University of Life Sciences, Campus Adamstuen, P.O. Box 8146 Dep., N-0033 Oslo, Norway
| | - Lucy J Robertson
- Department of Food Safety and Infection Biology, Faculty of Veterinary Science and Biomedicine, Norwegian University of Life Sciences, Campus Adamstuen, P.O. Box 8146 Dep., N-0033 Oslo, Norway
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Wang X, Yong W, Shi L, Qiao M, He M, Zhang H, Guo B, Xie G, Zhang M, Jin M, Ding J. An outbreak of multiple norovirus strains on a cruise ship in China, 2014. J Appl Microbiol 2015; 120:226-33. [DOI: 10.1111/jam.12978] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 10/08/2015] [Accepted: 10/12/2015] [Indexed: 11/28/2022]
Affiliation(s)
- X. Wang
- Nanjing Municipal Center for Disease Control and Prevention; Jiangsu China
| | - W. Yong
- Nanjing Municipal Center for Disease Control and Prevention; Jiangsu China
| | - L. Shi
- Nanjing Municipal Center for Disease Control and Prevention; Jiangsu China
| | - M. Qiao
- Nanjing Municipal Center for Disease Control and Prevention; Jiangsu China
| | - M. He
- Nanjing Municipal Center for Disease Control and Prevention; Jiangsu China
| | - H. Zhang
- Nanjing Municipal Center for Disease Control and Prevention; Jiangsu China
| | - B. Guo
- Nanjing Municipal Center for Disease Control and Prevention; Jiangsu China
| | - G. Xie
- Nanjing Municipal Center for Disease Control and Prevention; Jiangsu China
| | - M. Zhang
- Gulou District Center for Disease Control and Prevention; Nanjing Jiangsu China
| | - M. Jin
- National Institute for Viral Disease Control and Prevention; China CDC; Beijing China
| | - J. Ding
- Nanjing Municipal Center for Disease Control and Prevention; Jiangsu China
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Park JH, Jung S, Shin J, Lee JS, Joo IS, Lee DY. Three gastroenteritis outbreaks in South Korea caused by the consumption of kimchi tainted by norovirus GI.4. Foodborne Pathog Dis 2015; 12:221-7. [PMID: 25764445 DOI: 10.1089/fpd.2014.1879] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In April 2013, outbreaks of acute gastroenteritis were reported at three schools in Jeonju, South Korea. Epidemiological investigations were performed to characterize the outbreaks and implement appropriate control measures. MATERIALS AND METHODS Retrospective cohort studies were performed at these schools. Stool and environmental samples were collected for bacterial and viral assessment. A food supplier of the schools, food company X, was inspected, and samples of cabbage kimchi and groundwater were tested for norovirus by real-time reverse-transcriptase polymerase chain reaction. The relatedness of the detected norovirus strains was evaluated by phylogenetic analysis. RESULTS Of the 3347 questionnaires distributed, 631 (attack rate: 18.9%) met the case definition. Among the consumed food items, kimchi products (i.e., cabbage and fresh kimchi) were significantly associated with illness. The kimchi products were supplied by food company X. Among stool samples from 95 students and 34 food handlers at the 3 schools, 39 (41.1%) and 14 (41.2%) samples, respectively, were positive for norovirus. The samples of groundwater and cabbage kimchi at food company X were positive for norovirus. The predominant genotype of norovirus detected in the patient, groundwater, and cabbage kimchi samples, GI.4, shared high nucleotide identity. CONCLUSIONS Kimchi products tainted with norovirus GI.4 from contaminated groundwater were linked to the acute gastroenteritis outbreaks. Therefore, kimchi manufacturers in South Korea should apply chlorine disinfection when using groundwater. Moreover, more stringent sanitation requirements and strict regulations for food companies are recommended.
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Affiliation(s)
- Ji-Hyuk Park
- 1 Department of Preventive Medicine, Donngguk University College of Medicine , Gyeongju-si, Gyeongsangbuk-do, South Korea
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Cho HW. Norovirus outbreaks occurred in different settings in the Republic of Korea. Osong Public Health Res Perspect 2015; 6:281-2. [PMID: 26730354 PMCID: PMC4677506 DOI: 10.1016/j.phrp.2015.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Kabue JP, Meader E, Hunter PR, Potgieter N. Human Norovirus prevalence in Africa: a review of studies from 1990 to 2013. Trop Med Int Health 2015; 21:2-17. [PMID: 26436862 DOI: 10.1111/tmi.12617] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To assess the contribution of Human Norovirus to diarrhoeal diseases in Africa. METHODS We conducted a systematic review of the PubMed and EMBASE databases for published articles of Human Norovirus in Africa between 1990 and 2013. Data were extracted from selected studies and analysed. RESULTS A total of 208 eligible studies were identified, of which 55 (from 19 countries) met the inclusion criteria. Many cases were of sporadic gastroenteritis (70.9%) in children (82%), 65.4% of which were seen in an outpatient setting. Over half (59.4%) of the affected children were under 5 years of age. The pooled prevalence rate of Human NoV was 11% (95% CI 8-14%), and the meta-analysis indicated significant heterogeneity between the studies. However, the conditional negative binomial regression could not clearly find the factors affecting the Human NoV prevalence rates reported. A close relationship was found between Human Norovirus strains from environmental and clinical samples. CONCLUSION Unreported sporadic gastroenteritis cases of Human Norovirus are common in Africa. Most are community-associated infections. Possible environmental transmission routes have been documented. Combined environmental and clinical studies are required for targeted actions to control transmission of Human Norovirus in Africa. Systematic surveillance of Human Norovirus is needed to measure the burden of Norovirus-induced gastroenteritis in Africa and support any requirements for vaccine development.
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Affiliation(s)
- Jean Pierre Kabue
- Department of Microbiology, School of Mathematical and Natural Sciences, University of Venda, Thohoyandou, RSA
| | - Emma Meader
- School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK
| | - Paul R Hunter
- School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK.,Department of Environmental Health, Tshwane University of Technology, Pretoria, RSA
| | - Natasha Potgieter
- Department of Microbiology, School of Mathematical and Natural Sciences, University of Venda, Thohoyandou, RSA
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Jung S, Hwang BM, Jeong HJ, Chung GT, Yoo CK, Kang YH, Lee DY. Occurrence of Norovirus GII.4 Sydney Variant-related Outbreaks in Korea. Osong Public Health Res Perspect 2015; 6:322-6. [PMID: 26929914 PMCID: PMC4677502 DOI: 10.1016/j.phrp.2015.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 10/02/2015] [Accepted: 10/02/2015] [Indexed: 11/25/2022] Open
Abstract
Human noroviruses are major causative agents of food and waterborne outbreaks of nonbacterial acute gastroenteritis. In this study, we report the epidemiological features of three outbreak cases of norovirus in Korea, and we describe the clinical symptoms and distribution of the causative genotypes. The incidence rates of the three outbreaks were 16.24% (326/2,007), 4.1% (27/656), and 16.8% (36/214), respectively. The patients in these three outbreaks were affected by acute gastroenteritis. These schools were provided unheated food from the same manufacturing company. Two genotypes (GII.3 and GII.4) of the norovirus were detected in these cases. Among them, major causative strains of GII.4 (Hu-jeju-47-2007KR-like) were identified in patients, food handlers, and groundwater from the manufacturing company of the unheated food. In the GII.4 (Hu-jeju-47-2007KR-like) strain of the norovirus, the nucleotide sequences were identical and identified as the GII.4 Sydney variant. Our data suggests that the combined epidemiological and laboratory results were closely related, and the causative pathogen was the GII.4 Sydney variant strain from contaminated groundwater.
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Affiliation(s)
- Sunyoung Jung
- Division of Enteric Diseases, Center for Infectious Diseases, Korea National Institute of Health, KCDC, Osong, Korea
| | - Bo-Mi Hwang
- Division of Enteric Diseases, Center for Infectious Diseases, Korea National Institute of Health, KCDC, Osong, Korea
| | - Hyun Ju Jeong
- Division of Enteric Diseases, Center for Infectious Diseases, Korea National Institute of Health, KCDC, Osong, Korea
| | - Gyung Tae Chung
- Division of Enteric Diseases, Center for Infectious Diseases, Korea National Institute of Health, KCDC, Osong, Korea
| | - Cheon-Kwon Yoo
- Division of Enteric Diseases, Center for Infectious Diseases, Korea National Institute of Health, KCDC, Osong, Korea
| | - Yeon-Ho Kang
- Division of Bio-Safety Evaluation and Control, Korea National Institute of Health, KCDC, Osong, Korea
| | - Deog-Yong Lee
- Division of Enteric Diseases, Center for Infectious Diseases, Korea National Institute of Health, KCDC, Osong, Korea
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GRILC E, GALE I, VERŠIČ A, ŽAGAR T, SOČAN M. Drinking Water Quality and the Geospatial Distribution of Notified Gastro-Intestinal Infections. Zdr Varst 2015; 54:194-203. [PMID: 27646727 PMCID: PMC4820156 DOI: 10.1515/sjph-2015-0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 03/16/2015] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Even brief episodes of fecal contamination of drinking water can lead directly to illness in the consumers. In water-borne outbreaks, the connection between poor microbial water quality and disease can be quickly identified. The impact of non-compliant drinking water samples due to E. coli taken for regular monitoring on the incidence of notified acute gastrointestinal infections has not yet been studied. METHODS The objective of this study was to analyse the geographical distribution of notified acute gastrointestinal infections (AGI) in Slovenia in 2010, with hotspot identification. The second aim of the study was to correlate the fecal contamination of water supply system on the settlement level with the distribution of notified AGI cases. Spatial analysis using geo-information technology and other methods were used. RESULTS Hot spots with the highest proportion of notified AGI cases were mainly identified in areas with small supply zones. The risk for getting AGI was drinking water contaminated with E. coli from supply zones with 50-1000 users: RR was 1.25 and significantly greater than one (p-value less than 0.001). CONCLUSION This study showed the correlation between the frequency of notified AGI cases and non-compliant results in drinking water monitoring.
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Affiliation(s)
- Eva GRILC
- National Institute of Public Health, Centre for Communicable diseases, Zaloška 29, 1000 Ljubljana, Slovenia
| | - Ivanka GALE
- National Institute of Public Health, Centre for environmental threats, Trubarjeva 2, 1000 Ljubljana, Slovenia
| | - Aleš VERŠIČ
- Slovenian Environmental Agency, Vojkova 1b, 1000 Ljubljana, Slovenia
| | - Tina ŽAGAR
- Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia
| | - Maja SOČAN
- National Institute of Public Health, Centre for Communicable diseases, Zaloška 29, 1000 Ljubljana, Slovenia
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Deciphering the Diversities of Astroviruses and Noroviruses in Wastewater Treatment Plant Effluents by a High-Throughput Sequencing Method. Appl Environ Microbiol 2015; 81:7215-22. [PMID: 26253673 DOI: 10.1128/aem.02076-15] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 07/30/2015] [Indexed: 11/20/2022] Open
Abstract
Although clinical epidemiology lists human enteric viruses to be among the primary causes of acute gastroenteritis in the human population, their circulation in the environment remains poorly investigated. These viruses are excreted by the human population into sewers and may be released into rivers through the effluents of wastewater treatment plants (WWTPs). In order to evaluate the viral diversity and loads in WWTP effluents of the Paris, France, urban area, which includes about 9 million inhabitants (approximately 15% of the French population), the seasonal occurrence of astroviruses and noroviruses in 100 WWTP effluent samples was investigated over 1 year. The coupling of these measurements with a high-throughput sequencing approach allowed the specific estimation of the diversity of human astroviruses (human astrovirus genotype 1 [HAstV-1], HAstV-2, HAstV-5, and HAstV-6), 7 genotypes of noroviruses (NoVs) of genogroup I (NoV GI.1 to NoV GI.6 and NoV GI.8), and 16 genotypes of NoVs of genogroup II (NoV GII.1 to NoV GII.7, NoV GII.9, NoV GII.12 to NoV GII.17, NoV GII.20, and NoV GII.21) in effluent samples. Comparison of the viral diversity in WWTP effluents to the viral diversity found by analysis of clinical data obtained throughout France underlined the consistency between the identified genotypes. However, some genotypes were locally present in effluents and were not found in the analysis of the clinical data. These findings could highlight an underestimation of the diversity of enteric viruses circulating in the human population. Consequently, analysis of WWTP effluents could allow the exploration of viral diversity not only in environmental waters but also in a human population linked to a sewerage network in order to better comprehend viral epidemiology and to forecast seasonal outbreaks.
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Karim MR, Fout GS, Johnson CH, White KM, Parshionikar SU. Propidium monoazide reverse transcriptase PCR and RT-qPCR for detecting infectious enterovirus and norovirus. J Virol Methods 2015; 219:51-61. [DOI: 10.1016/j.jviromet.2015.02.020] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 01/09/2015] [Accepted: 02/11/2015] [Indexed: 02/02/2023]
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Prevost B, Lucas FS, Goncalves A, Richard F, Moulin L, Wurtzer S. Large scale survey of enteric viruses in river and waste water underlines the health status of the local population. ENVIRONMENT INTERNATIONAL 2015; 79:42-50. [PMID: 25795193 DOI: 10.1016/j.envint.2015.03.004] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/20/2015] [Accepted: 03/03/2015] [Indexed: 05/18/2023]
Abstract
Although enteric viruses constitute a major cause of acute waterborne diseases worldwide, environmental data about occurrence and viral load of enteric viruses in water are not often available. In this study, enteric viruses (i.e., adenovirus, aichivirus, astrovirus, cosavirus, enterovirus, hepatitis A and E viruses, norovirus of genogroups I and II, rotavirus A and salivirus) were monitored in the Seine River and the origin of contamination was untangled. A total of 275 water samples were collected, twice a month for one year, from the river Seine, its tributaries and the major WWTP effluents in the Paris agglomeration. All water samples were negative for hepatitis A and E viruses. AdV, NVGI, NVGII and RV-A were the most prevalent and abundant populations in all water samples. The viral load and the detection frequency increased significantly between the samples collected the most upstream and the most downstream of the Paris urban area. The calculated viral fluxes demonstrated clearly the measurable impact of WWTP effluents on the viral contamination of the Seine River. The viral load was seasonal for almost all enteric viruses, in accordance with the gastroenteritis recordings provided by the French medical authorities. These results implied the existence of a close relationship between the health status of inhabitants and the viral contamination of WWTP effluents and consequently surface water contamination. Subsequently, the regular analysis of wastewater could serve as a proxy for the monitoring of the human viruses circulating in both a population and surface water.
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Affiliation(s)
- B Prevost
- LEESU (UMR MA 102, Université Paris-Est, Agro ParisTech), Université Paris-Est Créteil, 61, Avenue du Général-de-Gaulle, 94010 Créteil cedex, France
| | - F S Lucas
- LEESU (UMR MA 102, Université Paris-Est, Agro ParisTech), Université Paris-Est Créteil, 61, Avenue du Général-de-Gaulle, 94010 Créteil cedex, France
| | - A Goncalves
- SIAAP, Direction du développement et de la prospective, 82, Avenue Kléber, 92700 Colombes, France
| | - F Richard
- SIAAP, Direction du développement et de la prospective, 82, Avenue Kléber, 92700 Colombes, France
| | - L Moulin
- Eau de Paris, DRDQE, R&D biologie, 33, Avenue Jean Jaurès, 94200 Ivry sur Seinze, France.
| | - S Wurtzer
- Eau de Paris, DRDQE, R&D biologie, 33, Avenue Jean Jaurès, 94200 Ivry sur Seinze, France
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Ayukekbong JA, Mesumbe HN, Oyero OG, Lindh M, Bergström T. Role of noroviruses as aetiological agents of diarrhoea in developing countries. J Gen Virol 2015; 96:1983-1999. [PMID: 26002299 DOI: 10.1099/vir.0.000194] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Diarrhoea is considered to be the second leading cause of death due to infections among children < 5 years of age worldwide that may be caused by bacteria, parasites, viruses and non-infectious agents. The major causative agents of diarrhoea in developing countries may vary from those in developed countries. Noroviruses are considered to be the most common cause of acute diarrhoea in both children and adults in industrialized countries. On the other hand, there is a lack of comprehensive epidemiological evidence from developing countries that norovirus is a major cause of diarrhoea. In these regions, asymptomatic norovirus infections are very common, and similar detection rates have been observed in patients with diarrhoea and asymptomatic persons. This review summarizes the current knowledge of norovirus infection in developing countries and seeks to position infections with noroviruses among those of other enteropathogens in terms of disease burden in these regions.
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Affiliation(s)
- James Ayukepi Ayukekbong
- Section for Clinical Research, Redeem Biomedical System, Buea, Cameroon
- Department of Infectious Diseases/Section of Clinical Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | | | - Olufunmilayo G Oyero
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Nigeria
| | - Magnus Lindh
- Department of Infectious Diseases/Section of Clinical Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Tomas Bergström
- Department of Infectious Diseases/Section of Clinical Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
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Application of salivary antibody immunoassays for the detection of incident infections with Norwalk virus in a group of volunteers. J Immunol Methods 2015; 424:53-63. [PMID: 25985985 DOI: 10.1016/j.jim.2015.05.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 04/23/2015] [Accepted: 05/06/2015] [Indexed: 02/06/2023]
Abstract
Norovirus infection is the most common cause of acute gastroenteritis in developed countries. Developing an assay based on a non-invasive biomarker for detecting incident norovirus infections could improve disease surveillance and epidemiological investigations. This project involved analysis of IgA and IgG norovirus-specific antibody responses in saliva samples from a Norwalk virus (Genogroup I, genotype 1 norovirus) challenge study involving infected and symptomatic, and non-infected asymptomatic individuals. Saliva was collected at the challenge, and two weeks and 40 days post-challenge. Samples were analyzed using the Luminex fluorometric and Meso Scale Discovery (MSD) electrochemiluminescence immunoassays. Recombinant P domains of Norwalk virus capsid protein, as well as similar recombinant proteins of two genogroup II noroviruses (VA387 and VA207) were used as antigens. Immunoconversions were defined as >4-fold increase in antibody responses to the norovirus antigens. Various sample pre-treatment options, buffers, saliva dilution ratios, and data adjustment approaches to control for sample-to-sample variability in saliva composition were compared using the Luminex assay. The results suggest that adjusting responses to the norovirus antigens for responses to the protein purification tag, glutathione-S-transferase (GST), significantly improved the odds of producing a correct immunoconversion test result. IgG-based tests were more accurate compared to IgA-based tests. At optimal conditions, both Luminex and MSD assays for Norwalk-specific IgG antibodies correctly identified all infected and non-infected individuals. There was no evidence of cross-reactivity of anti-Norwalk virus antibodies with genogroup II noroviruses. These results suggest that salivary antibody responses can be used for the detection of incident infections with Norwalk virus in prospective surveys.
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Lopes-João A, Costa I, Mesquita JR, Oleastro M, Penha-Gonçalves C, Nascimento MSJ. Multiple enteropathogenic viruses in a gastroenteritis outbreak in a military exercise of the Portuguese Army. J Clin Virol 2015; 68:73-5. [PMID: 26071340 DOI: 10.1016/j.jcv.2015.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 05/10/2015] [Accepted: 05/11/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Gastroenteritis is one of the most common infectious diseases in the military populations and can diminish operational effectiveness and impede force readiness. OBJECTIVES The present study investigates the cause and the source of an acute gastroenteritis outbreak that occurred during a military exercise of the Portuguese Army, in February 2013. STUDY DESIGN A retrospective investigation was performed and stool samples, food items and water were screened for common foodborne bacteria and viruses, namely Norovirus GI, Norovirus GII, Astrovirus, Rotavirus, Adenovirus and Sapovirus. RESULTS From the total of 160 soldiers that participated in the military exercise 20 developed gastroenteritis (attack rate of 12.5%). Symptoms were predominantly vomiting (n=17, 85%) and diarrhoea (n=9, 45%). The first cases occurred 24-48h after drinking water from the creek, the plausible origin of the outbreak. The epidemic peak was registered 2 days after and the last cases 6 days after, upon returning to base. No pathogenic bacteria were found in stools however virological analysis revealed the presence of multiple enteropathogenic viruses, namely Norovirus GI (GI.3), Norovirus GII (GII.4 New Orleans 2009), Astrovirus and Sapovirus, as single or co-infections. Food and water samples were not tested for the presence of viruses due to exhaustion of samples on bacteriological analysis. CONCLUSIONS To the best of our knowledge this is the first report of a viral gastroenteritis outbreak among military personnel in the Portuguese Army.
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Affiliation(s)
- António Lopes-João
- Laboratório de Bromatologia e Defesa Biológica do Exército, Lisboa, Portugal.
| | - Inês Costa
- Laboratório de Biologia Molecular, Departamento de Doenças Infecciosas, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal.
| | - João R Mesquita
- Escola Superior Agrária de Viseu, Instituto Politécnico de Viseu, Viseu, Portugal; CIBIO/UP, Centro de Investigação em Biodiversidade e Recursos Genéticos/Universidade do Porto, Campus Agrário de Vairão, Vairão, Portugal.
| | - Mónica Oleastro
- Laboratório de Biologia Molecular, Departamento de Doenças Infecciosas, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal; Laboratório Nacional de Referência para as Infeções Gastrointestinais, Departamento de Doenças Infecciosas, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal.
| | | | - Maria S J Nascimento
- CIBIO/UP, Centro de Investigação em Biodiversidade e Recursos Genéticos/Universidade do Porto, Campus Agrário de Vairão, Vairão, Portugal; Laboratório de Microbiologia, Departamento de Ciências Biológicas, Faculdade de Farmácia da Universidade do Porto, Porto, Portugal.
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