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Wang T, Zeng H, Kang J, Lei L, Liu J, Zheng Y, Qian W, Fan C. Establishment of a Nucleic Acid Detection Method for Norovirus GII.2 Genotype Based on RT-RPA and CRISPR/Cas12a-LFS. Pol J Microbiol 2024; 73:253-262. [PMID: 38905280 PMCID: PMC11192556 DOI: 10.33073/pjm-2024-023] [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: 03/09/2024] [Accepted: 05/09/2024] [Indexed: 06/23/2024] Open
Abstract
To establish a rapid detection method for norovirus GII.2 genotype, this study employed reverse transcription recombinase polymerase amplification (RT-RPA) combined with CRISPR/Cas12a and lateral flow strip (RT-RPA-Cas12a-LFS). Here, the genome of norovirus GII.2 genotype was compared to identify highly conserved sequences, facilitating the design of RT-RPA primers and crRNA specific to the conserved regions of norovirus GII.2. Subsequently, the reaction parameters of RT-RPA were optimized and evaluated using agar-gel electrophoresis and LFS. The results indicate that the conserved sequences of norovirus GII.2 were successfully amplified through RT-RPA at 37°C for 25 minutes. Additionally, CRISPR/Cas12a-mediated cleavage detection was achieved through LFS at 37°C within 10 minutes using the amplification products as templates. Including the isothermal amplification reaction time, the total time is 35 minutes. The established RT-RPA-Cas12a-LFS method demonstrated specific detection of norovirus GII.2, yielding negative results for other viral genomes, and exhibited an excellent detection limit of 10 copies/μl. The RT-RPA-Cas12a-LFS method was further compared with qRT-PCR by analyzing 60 food-contaminated samples. The positive conformity rate was 100%, the negative conformity rate was 95.45%, and the overall conformity rate reached 98.33%. This detection method for norovirus GII.2 genotype is cost-effective, highly sensitive, specific, and easy to operate, offering a promising technical solution for field-based detection of the norovirus GII.2 genotype.
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Affiliation(s)
- Ting Wang
- School of Biomedical and Pharmaceutical Sciences, Shaanxi University of Science and Technology, Xian, China
| | - Hao Zeng
- School of Biomedical and Pharmaceutical Sciences, Shaanxi University of Science and Technology, Xian, China
| | - Jie Kang
- Shaanxi Institute of Supervision and Testing on Product Quality, Xian, China
| | - Lanlan Lei
- Shaanxi Institute of Supervision and Testing on Product Quality, Xian, China
| | - Jing Liu
- Shaanxi Institute of Supervision and Testing on Product Quality, Xian, China
| | - Yuhong Zheng
- Shaanxi Institute of Supervision and Testing on Product Quality, Xian, China
| | - Weidong Qian
- School of Biomedical and Pharmaceutical Sciences, Shaanxi University of Science and Technology, Xian, China
| | - Cheng Fan
- Shaanxi Institute of Supervision and Testing on Product Quality, Xian, China
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Omatola CA, Mshelbwala PP, Okolo MLO, Onoja AB, Abraham JO, Adaji DM, Samson SO, Okeme TO, Aminu RF, Akor ME, Ayeni G, Muhammed D, Akoh PQ, Ibrahim DS, Edegbo E, Yusuf L, Ocean HO, Akpala SN, Musa OA, Adamu AM. Noroviruses: Evolutionary Dynamics, Epidemiology, Pathogenesis, and Vaccine Advances-A Comprehensive Review. Vaccines (Basel) 2024; 12:590. [PMID: 38932319 PMCID: PMC11209302 DOI: 10.3390/vaccines12060590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
Noroviruses constitute a significant aetiology of sporadic and epidemic gastroenteritis in human hosts worldwide, especially among young children, the elderly, and immunocompromised patients. The low infectious dose of the virus, protracted shedding in faeces, and the ability to persist in the environment promote viral transmission in different socioeconomic settings. Considering the substantial disease burden across healthcare and community settings and the difficulty in controlling the disease, we review aspects related to current knowledge about norovirus biology, mechanisms driving the evolutionary trends, epidemiology and molecular diversity, pathogenic mechanism, and immunity to viral infection. Additionally, we discuss the reservoir hosts, intra-inter host dynamics, and potential eco-evolutionary significance. Finally, we review norovirus vaccines in the development pipeline and further discuss the various host and pathogen factors that may complicate vaccine development.
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Affiliation(s)
- Cornelius Arome Omatola
- Department of Microbiology, Kogi State University, Anyigba 272102, Kogi State, Nigeria; (C.A.O.)
| | | | | | - Anyebe Bernard Onoja
- Department of Virology, University College Hospital, Ibadan 211101, Oyo State, Nigeria
| | - Joseph Oyiguh Abraham
- Department of Microbiology, Kogi State University, Anyigba 272102, Kogi State, Nigeria; (C.A.O.)
| | - David Moses Adaji
- Department of Biotechnology Science and Engineering, University of Alabama, Huntsville, AL 35899, USA
| | - Sunday Ocholi Samson
- Department of Molecular Biology, Biotechnology, and Biochemistry, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego 29, 50-370 Wrocław, Poland
| | - Therisa Ojomideju Okeme
- Department of Biological Sciences, Federal University Lokoja, Lokoja 260101, Kogi State, Nigeria
| | - Ruth Foluke Aminu
- Department of Microbiology, Kogi State University, Anyigba 272102, Kogi State, Nigeria; (C.A.O.)
| | - Monday Eneojo Akor
- Department of Microbiology, Kogi State University, Anyigba 272102, Kogi State, Nigeria; (C.A.O.)
| | - Gideon Ayeni
- Department of Biochemistry, Kogi State University, Anyigba 272102, Kogi State, Nigeria
| | - Danjuma Muhammed
- Epidemiology and Public Health Unit, Department of Biology, Universiti Putra, Seri Kembangan 43300, Malaysia
| | - Phoebe Queen Akoh
- Department of Microbiology, Kogi State University, Anyigba 272102, Kogi State, Nigeria; (C.A.O.)
| | | | - Emmanuel Edegbo
- Department of Microbiology, Kogi State University, Anyigba 272102, Kogi State, Nigeria; (C.A.O.)
| | - Lamidi Yusuf
- Department of Microbiology, Kogi State University, Anyigba 272102, Kogi State, Nigeria; (C.A.O.)
| | | | - Sumaila Ndah Akpala
- Department of Microbiology, Kogi State University, Anyigba 272102, Kogi State, Nigeria; (C.A.O.)
- Department of Biotechnology, Federal University Lokoja, Lokoja 260101, Kogi State, Nigeria
| | - Oiza Aishat Musa
- Department of Microbiology, Kogi State University, Anyigba 272102, Kogi State, Nigeria; (C.A.O.)
| | - Andrew Musa Adamu
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville 4811, QLD, Australia
- College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville 4811, QLD, Australia
- Centre for Tropical Biosecurity, James Cook University, Townsville 4811, QLD, Australia
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Tegegne D, Gelaw A, Alemayehu DH, Seyoum T, Leta D, Ferede G, Mulu A, Gelaw B. Genetic diversity and distribution of noroviruses among all age groups of patients with diarrhea in Amhara National Regional State, Ethiopia. PLoS One 2024; 19:e0303887. [PMID: 38771749 PMCID: PMC11108165 DOI: 10.1371/journal.pone.0303887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/03/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Norovirus (NoV) is the leading cause of diarrheal disease worldwide and the impact is high in developing countries, including Ethiopia. Moreover, there is a significant and fluctuating global genetic diversity that varies across diverse environments over time. Nevertheless, there is a scarcity of data on the genetic diversity of NoV in Ethiopia. OBJECTIVE This study was aimed to assess the genetic diversity and distribution of NoVs circulating in the Amhara National Regional State, Ethiopia, by considering all age groups. METHODS A total of 519 fecal samples were collected from diarrheal patients from May 01/2021 to November 30/ 2021. The fecal samples were screened for the presence of NoVs using real-time RT-PCR by targeting a portion of the major capsid protein coding region. The positive samples were further amplified using conventional RT-PCR, and sequenced. RESULTS The positivity rate of NoV was (8.9%; 46/519). The detection rate of NoV genogroup II (GII) and genogroup I (GI) was 38 (82.6%) and 8 (17.4%), respectively. Overall, five distinct GII (GII.3, GII.6, GII.10, GII.17, and GII.21) and two GI (GI.3 and GI.5) genotypes were detected. Within the GII types, GII.3 was the predominant (34.2%) followed by GII.21 (15.8%), GII.17 (10.5%), GII.6 and GII.10 each (2.6%). Norovirus GII.21 is reported for the first time in Ethiopia. The genetic diversity and distribution of NoVs were significantly different across the four sampling sits and age groups. The phylogenetic analysis revealed close relatedness of the current strains with published strains from Ethiopia and elsewhere. CONCLUSION The distribution and genetic diversity of NoV was considerably high, with predominance of non-GII.4 genotypes. The GII.21 genotype is a new add on the growing evidences on the genetic diversity of NoVs in Ethiopia. Future nationwide surveillance studies are necessary to gain comprehensive data in Ethiopia.
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Affiliation(s)
- Dessie Tegegne
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Medical Laboratory Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Aschalew Gelaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | | | - Dereje Leta
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Getachew Ferede
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Baye Gelaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Hu X, He P, Jiang T, Shen J. Development and Evaluation of a Rapid GII Norovirus Detection Method Based on CRISPR-Cas12a. Pol J Microbiol 2024; 73:89-97. [PMID: 38437462 PMCID: PMC10911698 DOI: 10.33073/pjm-2024-009] [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: 10/28/2023] [Accepted: 01/22/2024] [Indexed: 03/06/2024] Open
Abstract
Norovirus is highly infectious and rapidly transmissible and represents a major pathogen of sporadic cases and outbreaks of acute gastroenteritis worldwide, causing a substantial disease burden. Recent years have witnessed a dramatic increase in norovirus outbreaks in China, significantly higher than in previous years, among which GII norovirus is the predominant prevalent strain. Therefore, rapid norovirus diagnosis is critical for clinical treatment and transmission control. Hence, we developed a molecular assay based on RPA combined with the CRISPER-CAS12a technique targeting the conserved region of the GII norovirus genome, the results of which could be displayed by fluorescence curves and immunochromatographic lateral-flow test strips. The reaction only required approximately 50 min, and the results were visible by the naked eye with a sensitivity reaching 102 copies/μl. Also, our method does not cross-react with other common pathogens that cause intestinal diarrhea. Furthermore, this assay was easy to perform and inexpensive, which could be widely applied for detecting norovirus in settings including medical institutions at all levels, particularly township health centers in low-resource areas.
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Affiliation(s)
- Xinyi Hu
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Public Health Clinical Center, Hefei, China
| | - Pei He
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Public Health Clinical Center, Hefei, China
| | - Tong Jiang
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Public Health Clinical Center, Hefei, China
| | - Jilu Shen
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Public Health Clinical Center, Hefei, China
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Li T, Peng J, Li Q, Li B, Yuan Y, Yang C, Yang D, Tang W, Qi L. Investigation of two norovirus outbreaks linked to drinking water contaminated with multiple GII strains in a rural county-Chongqing, China, 2021. Front Public Health 2023; 11:1259584. [PMID: 38162601 PMCID: PMC10756231 DOI: 10.3389/fpubh.2023.1259584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Backgrounds Norovirus is leading cause of non-bacterial gastroenteritis outbreaks globally, characterized by different strains prevalent in different countries and regions. Methods Cases were defined as individuals experiencing diarrhea ≥3 times/24 h, and/or vomiting ≥2 times/24 h in two villages between January 28 and February 9, 2021. Investigations were conducted to identify causes. Cases were interviewed using a standardized in-person form to collect data on potential risk factors. A retrospective cohort study was conducted to investigate the role of the spring water supply as the outbreak source. Residents from neighboring villages with different water sources served as the unexposed population. Stool specimens, rectal swabs, and water samples were tested using quantitative real-time Polymerase Chain Reaction, with subsequent sequencing performed on pathogen-positive specimens. Results Village-specific attack rates were 21.93% (123/561) and 26.99% (88/326), respectively. Evidence from both epidemiological and laboratory tests was consistent. Drinking spring water was statistically associated with the two outbreaks (RR = 41.8 and 79.2, respectively). In both outbreaks, stool specimens, rectal swabs, and water samples tested positive for norovirus. Specifically, GII.2 (P16) and GII.17 (P17) were identified in outbreak A, and GII.4 Sydney (P16) and GII.1 (P16) in outbreak B. Conclusion These two independent gastroenteritis outbreaks share similarities, both being linked to norovirus GII strains. The contaminated spring drinking water was identified as the probable source and was promptly closed and subjected to disinfection procedures. These findings reinforce the importance of implementing sanitation and environmental disinfection measures in rural areas, especially during the periods of increased rainfall.
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Affiliation(s)
- Tingting Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing, China
| | - Jingyao Peng
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing, China
| | - Qin Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing, China
| | - Baisong Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing, China
| | - Yi Yuan
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing, China
| | - Chuan Yang
- Xiushan County Center for Disease Control and Prevention, Chongqing, China
| | - Di Yang
- Xiushan County Center for Disease Control and Prevention, Chongqing, China
| | - Wenge Tang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing, China
| | - Li Qi
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- Chongqing Municipal Key Laboratory for High Pathogenic Microbes, Chongqing, China
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Parrón I, Carol M, Bes N, Izquierdo C, Godoy P, Barrabeig I, Sala MR, Minguell S, Ferras J, Rius C, Martínez AI, Domínguez À. The impact of COVID-19 pandemic on the incidence of acute gastroenteritis outbreaks in Catalonia (Spain). Epidemiol Infect 2023; 152:e10. [PMID: 38073577 PMCID: PMC10804134 DOI: 10.1017/s0950268823001851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/29/2023] [Accepted: 11/16/2023] [Indexed: 01/19/2024] Open
Abstract
We carried out a retrospective study of acute gastroenteritis (AGE) outbreaks reported between 1 January 2015 and 31 December 2021 in Catalonia (Spain) to compare the incidence from 2015 to 2019 with that observed from 2020 to 2021. We observed a higher incidence rate of outbreaks during the prepandemic period (16.89 outbreaks/1,000,000 person-years) than during the pandemic period (6.96 outbreaks/1,000,000 person-years) (rate ratio (RR) 0.41; 95% confidence interval (CI) 0.34 to 0.51). According to the aetiology of the outbreak, those of viral aetiology decreased from 7.82 to 3.38 outbreaks/1,000,000 person-years (RR 2.31; 95% CI 1.72 to 3.12), and those of bacterial aetiology decreased from 5.01 to 2.78 outbreaks/1,000,000 person-years (RR 1.80; 95% CI 1.29 to 2.52). There was a great reduction in AGE outbreaks in Catalonia. This reduction may have been due to the effect of the nonpharmaceutical measures applied to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the collapse of the healthcare system and epidemiological surveillance services may also have had a strong influence.
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Affiliation(s)
- Ignasi Parrón
- Agència de Salut Pública de Catalunya, Barcelona, Spain
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Mònica Carol
- Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Núria Bes
- Agència de Salut Pública de Catalunya, Barcelona, Spain
| | | | - Pere Godoy
- Facultat de Medicina, Universitat de Lleida, Spain
- Grup d’Epidemiologia Aplicada, Institut de Recerca Biomédica (IRBLleida), Lleida, Spain
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Irene Barrabeig
- Agència de Salut Pública de Catalunya, Barcelona, Spain
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - M. Rosa Sala
- Agència de Salut Pública de Catalunya, Barcelona, Spain
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | | | | | - Cristina Rius
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - Àngela Domínguez
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
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Yu F, Fu J, Tan M, Xu R, Tian Y, Jia L, Zhang D, Wang Q, Gao Z. Norovirus outbreaks in hospitals in China: a systematic review. J Hosp Infect 2023; 142:32-38. [PMID: 37805116 DOI: 10.1016/j.jhin.2023.09.016] [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: 08/02/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Norovirus outbreaks in hospitals can potentially impair patient care and result in significant financial expenses. There is currently limited information on hospital norovirus outbreaks in the Chinese mainland. AIM To systematically review the published literature to describe the characteristics of norovirus outbreaks in Chinese mainland hospitals to facilitate prompt identification and control of outbreaks. METHODS A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis standards. Databases including PubMed, Web of Science, and Chinese Journals Online databases (China National Knowledge Infrastructure (CNKI), Chinese Wan Fang digital database (WANFANG) were searched from inception to July 18th, 2022. FINDINGS A total of 41 norovirus Chinese hospital outbreaks occurring before July 18th, 2022 were reported in 32 articles. Most reported outbreaks were from Shanghai and Beijing, and occurred in December and January. Cases were mainly adults. The male:female ratio was 1.22:1. The majority of cases in norovirus outbreaks were hospitalized patients (56.82%); medical staff were affected in 15 outbreaks. Norovirus outbreaks occurred in both private and public hospitals, and in secondary and tertiary care centres, and occurred mainly in internal medicine and geriatric departments. Person-to-person transmission was the primary transmission mode and GII was more prevalent. CONCLUSION Norovirus outbreaks in hospitals can affect both patients and healthcare workers, sometimes causing serious financial losses. In order to have a more complete understanding of the disease burden caused by norovirus outbreaks, surveillance needs to be established in hospitals.
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Affiliation(s)
- F Yu
- The University of Hong Kong, School of Public Health, Hong Kong, China
| | - J Fu
- China Medical University, School of Public Health, Shenyang, China
| | - M Tan
- China Medical University, School of Public Health, Shenyang, China
| | - R Xu
- China Medical University, School of Public Health, Shenyang, China
| | - Y Tian
- China Medical University, School of Public Health, Shenyang, China
| | - L Jia
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - D Zhang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Q Wang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Z Gao
- Beijing Center for Disease Prevention and Control, Beijing, China.
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8
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Zhong Y, Lu H, Jiang Y, Tan D, Pan Y, Liabsuetrakul T. Detection rates of norovirus gastroenteritis and factors associated with the infection before and during COVID-19 pandemic: a secondary analysis of surveillance data in Guangxi Zhuang Autonomous Region, Southern China. Infect Ecol Epidemiol 2023; 13:2278246. [PMID: 38187165 PMCID: PMC10769525 DOI: 10.1080/20008686.2023.2278246] [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: 04/26/2023] [Accepted: 10/29/2023] [Indexed: 01/09/2024] Open
Abstract
Background: Changes in oral and hand hygiene behaviors have been reported during the COVID-19 pandemic in 2020 which may be associated with the incidence of the norovirus infection, a common cause of gastroenteritis. Objective: To estimate the trends of detection rates of norovirus gastroenteritis and associated factors before COVID-19 in 2015-2019 and during the COVID-19 in 2020 in Guangxi, China. Methods: A secondary analysis of Guangxi surveillance data of gastroenteritis patients was conducted. The detection rate in 2020 was predicted using an autoregressive integrated moving average modeland associated factors were analyzed using multiple logistic regression adjusted for interaction effects. Results: Of 7,903 gastroenteritis patients, the overall detection rate of norovirus gastroenteritis was 12.8%, (14.3% before and 6.1% during COVID-19). Detection rates gradually decreased from 2015 to 2020, of which the slope of predicted line was slightly flatter than the actual line. The odds ratios of detection were double to triple increase during COVID-19 in the younger age group and having food intake outside their homes. Tourist city, season, and types of food were independent associated factors. Conclusion: The detection rates were higher during the COVID-19 year among the population aged 45 years or less and those who consumed food outside their home.
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Affiliation(s)
- Yanxu Zhong
- Food Safety Monitoring and Evaluation Department, Guangxi Zhuang Autonomous Region Centre for Disease Control and Prevention (Guangxi CDC), Nanning, Guangxi Region, China
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Huan Lu
- Infectious Department, The Fourth People’s Hospital of Nanning, Nanning, Guangxi Region, China
| | - Yuyan Jiang
- Food Safety Monitoring and Evaluation Department, Guangxi Zhuang Autonomous Region Centre for Disease Control and Prevention (Guangxi CDC), Nanning, Guangxi Region, China
| | - Dongmei Tan
- Food Safety Monitoring and Evaluation Department, Guangxi Zhuang Autonomous Region Centre for Disease Control and Prevention (Guangxi CDC), Nanning, Guangxi Region, China
| | - Yuli Pan
- Food Safety Monitoring and Evaluation Department, Guangxi Zhuang Autonomous Region Centre for Disease Control and Prevention (Guangxi CDC), Nanning, Guangxi Region, China
| | - Tippawan Liabsuetrakul
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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9
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Wang Y, Gao Z, Lu Q, Liu B, Jia L, Shen L, Tian Y, Li W, Yan H, Zhang D, Yang P, Fang L, Wang Q, Cui F. Transmissibility quantification of norovirus outbreaks in 2016-2021 in Beijing, China. J Med Virol 2023; 95:e29153. [PMID: 37804388 DOI: 10.1002/jmv.29153] [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: 07/11/2023] [Revised: 09/08/2023] [Accepted: 09/25/2023] [Indexed: 10/09/2023]
Abstract
The transmissibility is a crucial feature for norovirus, yet its quantitative estimation has been limited. Our objective was to estimate the basic reproduction number (R0 ) of norovirus and investigate its variation characteristics. Norovirus outbreaks reported from September 2016 to August 2021 in Beijing were analyzed. The susceptible-infected-removed compartment model was established to estimate R0 . Linear regression models and logistic regression models were used to explore the factors affecting the transmissibility of norovirus. The overall median R0 of norovirus was estimated as 2.1 (interquartile range [IQR] 1.8-2.5), with 650 norovirus outbreaks. The transmissibility of norovirus varied by year, outbreak setting and genotype. The R0 of norovirus during September 2019 to August 2020 (median 2.1, IQR 1.8-2.4) and September 2020 to August 2021 (median 2.0, IQR 1.7-2.3) was lower than that of September 2016 to August 2017 (median 2.3, IQR 1.8-2.7) (β = 0.94, p = 0.05; β = 0.93, p = 0.008). The R0 of norovirus for all other settings was lower than that for kindergarten (median 2.4, IQR 2.0-2.9) (primary school: median 2.0, IQR 1.7-2.4, β = 0.94, p = 0.001; secondary school: median 1.7, IQR 1.5-2.0, β = 0.87, p < 0.001; college: median 1.7, IQR 1.5-1.8, β = 0.89, p = 0.03; other closed settings: median 1.8, IQR 1.5-2.0, β = 0.90, p = 0.004). GⅡ.2[P16] outbreaks had a median R0 of 2.2 (IQR 1.8-2.7), which was higher than that for GⅡ.6[P7] outbreaks (median 1.8, IQR: 1.8-2.0, odds ratio = 0.19, p = 0.03; GⅡ.2[P16] as reference) and mixed-genotype outbreaks (median 1.7, IQR: 1.5-1.8, β = 0.92, p = 0.02; mixed-genotype as reference). In kindergartens and primary schools, norovirus shows increased transmissibility, emphasizing the vulnerable population and high-risk settings. Furthermore, the transmissibility of norovirus may change over time and with virus evolution, necessitating additional research to uncover the underlying mechanisms.
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Affiliation(s)
- Yu Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Zhiyong Gao
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Qingbin Lu
- Department of Laboratory Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Baiwei Liu
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Lei Jia
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Lingyu Shen
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Yi Tian
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Weihong Li
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Hanqiu Yan
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Daitao Zhang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Peng Yang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Liqun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Quanyi Wang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Fuqiang Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Department of Laboratory Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
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10
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Li TT, Xu Q, Liu MC, Wang T, Che TL, Teng AY, Lv CL, Wang GL, Hong F, Liu W, Fang LQ. Prevalence and Etiological Characteristics of Norovirus Infection in China: A Systematic Review and Meta-Analysis. Viruses 2023; 15:1336. [PMID: 37376635 DOI: 10.3390/v15061336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/04/2023] [Accepted: 06/04/2023] [Indexed: 06/29/2023] Open
Abstract
Norovirus is a common cause of sporadic cases and outbreaks of gastroenteritis worldwide, although its prevalence and the dominant genotypes responsible for gastroenteritis outbreaks remain obscure. A systematic review was conducted on norovirus infection in China between January 2009 and March 2021. A meta-analysis and beta-binomial regression model were used to explore the epidemiological and clinical characteristics of norovirus infection and the potential factors contributing to the attack rate of the norovirus outbreaks, respectively. A total of 1132 articles with 155,865 confirmed cases were included, with a pooled positive test rate of 11.54% among 991,786 patients with acute diarrhea and a pooled attack rate of 6.73% in 500 norovirus outbreaks. GII.4 was the predominant genotype in both the etiological surveillance and outbreaks, followed by GII.3 in the etiological surveillance, and GII.17 in the outbreaks, with the proportion of recombinant genotypes increasing in recent years. A higher attack rate in the norovirus outbreaks was associated with age group (older adults), settings (nurseries, primary schools, etc.) and region (North China). The nation-wide pooled positive rate in the etiological surveillance of norovirus is lower than elsewhere in the global population, while the dominant genotypes are similar in both the etiological surveillance and the outbreak investigations. This study contributes to the understanding of norovirus infection with different genotypes in China. The prevention and control of norovirus outbreaks during the cold season should be intensified, with special attention paid to and enhanced surveillance performed in nurseries, schools and nursing homes from November to March.
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Affiliation(s)
- Ting-Ting Li
- School of Public Health, Guizhou Medical University, Guiyang 550025, China
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
| | - Qiang Xu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
| | - Mei-Chen Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
- School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Tao Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
| | - Tian-Le Che
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
| | - Ai-Ying Teng
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
| | - Chen-Long Lv
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
| | - Guo-Lin Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
| | - Feng Hong
- School of Public Health, Guizhou Medical University, Guiyang 550025, China
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
- School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Li-Qun Fang
- School of Public Health, Guizhou Medical University, Guiyang 550025, China
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
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11
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Chen Y, Liu B, Wang Y, Zhang Y, Yan H, Li W, Shen L, Tian Y, Jia L, Zhang D, Yang P, Gao Z, Wang Q. Spatio-temporal distribution and influencing factors of norovirus outbreaks in Beijing, China from 2016 to 2020. BMC Infect Dis 2023; 23:270. [PMID: 37131193 PMCID: PMC10152695 DOI: 10.1186/s12879-023-08243-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 04/11/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Noroviruses are a leading cause of acute gastroenteritis (AGE) worldwide. The geographical characteristics of norovirus outbreaks in Beijing and their influencing factors remain unknown. This study aimed to explore the spatial distributions, geographical characteristics, and influencing factors of norovirus outbreaks in Beijing, China. METHODS Epidemiological data and specimens were collected through the AGE outbreak surveillance system in all 16 districts of Beijing. Data on spatial distribution, geographical characteristics, and influencing factors of norovirus outbreaks were analyzed using descriptive statistics methods. We measured spatial, geographical clustering of high- or low-value deviance from random distribution using Z-scores and P-values as statistical significance measures with Global Moran's I statistics and Getis-Ord Gi in ArcGIS. Linear regression and correlation methods were used to explore influencing factors. RESULTS Between September 2016 and August 2020, 1,193 norovirus outbreaks were laboratory-confirmed. The number of outbreaks varied seasonally, typically peaking in spring (March to May) or winter (October to December). Outbreaks primarily occurred around central districts at the town level, and spatial autocorrelation was evident in both the entire study period and in individual years. Hotspots of norovirus outbreaks in Beijing were primarily found in contiguous areas between three central districts (Chaoyang, Haidian, Fengtai) and four suburban districts (Changping, Daxing, Fangshan, Tongzhou). The average population numbers, mean number of all schools, and mean number of kindergartens and primary schools for towns in central districts and hotspot areas were higher than those in suburban districts and non-hotspot areas respectively. Additionally, population numbers and densities of kindergartens and primary schools were influencing factors at the town level. CONCLUSIONS Hotspots of norovirus outbreaks in Beijing were in contiguous areas between central and suburban districts with high populations, and high kindergarten and primary school densities were the likely driving forces. Outbreak surveillance needs to focus on contiguous areas between central and suburban districts with increased monitoring, medical resources, and health education.
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Affiliation(s)
- Yanwei Chen
- Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China
| | - Baiwei Liu
- Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China
| | - Yu Wang
- Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China
| | - Yewu Zhang
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Hanqiu Yan
- Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China
| | - Weihong Li
- Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China
| | - Lingyu Shen
- Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China
| | - Yi Tian
- Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China
| | - Lei Jia
- Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China
| | - Daitao Zhang
- Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China
| | - Peng Yang
- Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China
| | - Zhiyong Gao
- Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China.
| | - Quanyi Wang
- Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Street, Dongcheng District, Beijing, 100013, China.
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12
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Qi Y, Dong X, Cheng X, Xu H, Wang J, Wang B, Chen Y, Sun B, Zhang L, Yao Y. Epidemiological Characteristics of Norovirus Outbreaks in Shenyang from 2017 to 2021. J Microbiol 2023; 61:471-478. [PMID: 36972002 DOI: 10.1007/s12275-023-00033-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/17/2023] [Accepted: 02/17/2023] [Indexed: 03/29/2023]
Abstract
Norovirus is one of the leading causes of acute gastroenteritis outbreaks worldwide. This study aimed to identify the epidemiological characteristics of norovirus outbreaks and to provide evidence for public health entities. Specimens and epidemiological survey data were collected to determine if there were differences in the attack rate of norovirus in terms of the year, season, transmission route, exposure setting, and region and to determine whether there were relationships between the reporting interval, the number of illnesses in a single outbreak and the duration of the outbreak. Norovirus outbreaks were reported throughout the year, with seasonal characteristics (i.e., high rates in spring and winter). Among all regions in Shenyang with the exception of Huanggu and Liaozhong, norovirus outbreaks had been reported, and the primary genotype was GII.2[P16]. Vomiting was the most common symptom. The main places of occurrence were childcare institutions and schools. The person-to-person route was the main transmission route. The median duration of norovirus was 3 days (IQR [interquartile range]: 2-6 days), the median reporting interval was 2 days (IQR: 1-4 days), the median number of illnesses in a single outbreak was 16 (IQR: 10-25); there was a positive correlation between these parameters. Norovirus surveillance and genotyping studies still need to be further strengthened to increase knowledge regarding the pathogens and their variant characteristics, to better characterize the patterns of norovirus outbreaks and to provide information for outbreak prevention. Norovirus outbreaks should be detected, reported and handled early. Public health entities and the government should develop corresponding measures for different seasons, transmission routes, exposure settings, and regions.
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Affiliation(s)
- Ying Qi
- Shenyang Center for Disease Control and Prevention, Shenyang, 110102, Liaoning, People's Republic of China
| | - Xinxin Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, Jilin, People's Republic of China
| | - Xiaowei Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, Jilin, People's Republic of China
| | - Han Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, Jilin, People's Republic of China
| | - Jin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, Jilin, People's Republic of China
| | - Bing Wang
- Shenyang Center for Disease Control and Prevention, Shenyang, 110102, Liaoning, People's Republic of China
| | - Ye Chen
- Shenyang Center for Disease Control and Prevention, Shenyang, 110102, Liaoning, People's Republic of China
| | - Baijun Sun
- Shenyang Center for Disease Control and Prevention, Shenyang, 110102, Liaoning, People's Republic of China
| | - Linlin Zhang
- Shenyang Center for Disease Control and Prevention, Shenyang, 110102, Liaoning, People's Republic of China
| | - Yan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, Jilin, People's Republic of China.
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13
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Cornejo-Sánchez T, Soldevila N, Coronas L, Alsedà M, Godoy P, Razquín E, Sabaté S, Guix S, Rodríguez Garrido V, Bartolomé R, Domínguez A, Belver AI, Camps N, Minguell S, Carol M, Izquierdo C, Parrón I, Pérez C, Rovira A, Sabaté M, Sala MR, Vileu RM, Barrabeig I, Jané M, Martínez A, Torner N, de Benito J, Moreno-Martínez A, Rius C, de Andres A, Camprubí E, Cunillé M, Forns ML, de Simón M. Epidemiology of GII.4 and GII.2 norovirus outbreaks in closed and semi-closed institutions in 2017 and 2018. Sci Rep 2023; 13:1659. [PMID: 36717621 PMCID: PMC9886968 DOI: 10.1038/s41598-023-28448-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 01/18/2023] [Indexed: 01/31/2023] Open
Abstract
Norovirus infections are a leading cause of acute gastroenteritis outbreaks worldwide, with genotypes GII.2 and GII.4 being the most prevalent. The aim of this study was to compare the characteristics of GII.2 and GII.4 norovirus outbreaks reported in Catalonia in closed or semi-closed institutions in 2017 and 2018. The epidemiological and clinical characteristics of GII.2 and GII.4 outbreaks were compared using the chi-square test or Fisher's exact test for categorical variables and the Mann-Whitney U test for continuous variables. Odds ratios and their 95% confidence intervals were estimated. 61 outbreaks were reported: GII.4 was the causative agent in 12 outbreaks (30%) and GII.2 in 9 outbreaks (22.5%). GII.2 outbreaks were detected more frequently in schools or summer camps (66.7%) and GII.4 outbreaks in nursing homes (91.7%) (p = 0.01). Ninety-three people were affected in GII.2 outbreaks and 94 in GII.4 outbreaks. The median age was 15 years (range: 1-95 years) in GII.2 outbreaks and 86 years (range: 0-100 years) in GII.4 outbreaks (p < 0.001). Nausea, abdominal pain, and headache were observed more frequently in persons affected by GII.2 outbreaks (p < 0.05). Symptomatic cases presented a higher viral load suggestive of greater transmission capacity, although asymptomatic patients presented relevant loads indicative of transmission capacity.
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Affiliation(s)
| | - Núria Soldevila
- CIBER Epidemiología y Salut Pública (CIBERSP), Madrid, Spain. .,Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.
| | - Lorena Coronas
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.,Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Miquel Alsedà
- Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Pere Godoy
- CIBER Epidemiología y Salut Pública (CIBERSP), Madrid, Spain.,Agència de Salut Pública de Catalunya, Barcelona, Spain.,Institut de Recerca Biomédica de Lleida, IRB Lleida, Lleida, Spain
| | - Efrén Razquín
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Sara Sabaté
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Susana Guix
- Departament de Genètica Microbiologia i Estadística, Grup de Virus Entèrics, Universitat de Barcelona, Barcelona, Spain.,Nutrition and Food Safety Research Institute (INSA·UB), Universitat de Barcelona, 08921, Santa Coloma de Gramenet, Spain
| | | | - Rosa Bartolomé
- Laboratori de Microbiologia, Hospital Universitari Vall d'Hebrón, Barcelona, Spain
| | - Angela Domínguez
- CIBER Epidemiología y Salut Pública (CIBERSP), Madrid, Spain.,Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
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14
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Yu F, Jiang B, Guo X, Hou L, Tian Y, Zhang J, Li Q, Jia L, Yang P, Wang Q, Pang X, Gao Z. Norovirus outbreaks in China, 2000-2018: A systematic review. Rev Med Virol 2022; 32:e2382. [PMID: 35946340 DOI: 10.1002/rmv.2382] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 11/09/2022]
Abstract
To understand epidemiological characteristics of norovirus outbreaks in China from 2000 to 2018 the literature on norovirus outbreaks was identified by searching WANFANG, CNKI, PubMed, and Web of Science databases before 31 December 2018. Statistical analyses were performed using Statistical Product Service Solutions software. RStudio1.4.1717 and ArcGIS trial version were used for plotting bar graphs and maps. A total of 419 norovirus outbreaks were reported in the 394 included articles, which occurred between June 2000 and October 2018, showing an overall increasing trend. The majority of outbreaks occurred in schools (52.28%, 218/417) and kindergartens (55/417, 13.19%). Person-to-person transmission (41.64%, 137/329) was most common, followed by food-borne transmission (75/329, 22.80%) and water-borne transmission (72/329, 21.88%). GII was the most predominant norovirus genogroup, with GII.4, GII.17 and GII.2 being the dominant genotypes in 2007-2013, 2014-2015, 2016-2017, respectively. Increased outbreaks were associated with the prevalence of new variants. Most norovirus outbreaks were reported in the southeast of the country. The number of norovirus outbreaks was positively associated with the per capita gross domestic product and the year-end resident population. Norovirus outbreaks have become an important public health problem in China. It is necessary to establish surveillance in hospitals and nursing homes. Genotyping of noroviruses is important for monitoring the circulating strains and improving the vaccine design, so it should be carried out in more regions.
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Affiliation(s)
- Fan Yu
- China Medical University School of Public Health, Shenyang, China.,Beijing Center for Disease Prevention and Control, Beijing, China
| | - Bo Jiang
- Capital Medical University School of Public Health, Beijing, China
| | - Xinhui Guo
- Fangshan District Center for Disease Prevention and Control, Beijing, China
| | - Liyu Hou
- Capital Medical University School of Public Health, Beijing, China
| | - Yi Tian
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Jiaying Zhang
- Capital Medical University School of Public Health, Beijing, China
| | - Qianqian Li
- Shanghai Institute of Technology, Shanghai, China
| | - Lei Jia
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Peng Yang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Quanyi Wang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Xinghuo Pang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Zhiyong Gao
- China Medical University School of Public Health, Shenyang, China.,Beijing Center for Disease Prevention and Control, Beijing, China
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15
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Improper handling of vomitus as a risk factor in the human norovirus outbreak in a kindergarten in Wuyi County, Zhejiang Province, China. Epidemiol Infect 2022; 150:e111. [PMID: 35578778 PMCID: PMC9214846 DOI: 10.1017/s0950268822000826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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16
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Outbreaks of Gastroenteritis Due to Norovirus in Schools and Summer Camps in Catalonia, 2017-2019. Microbiol Spectr 2022; 10:e0011922. [PMID: 35543555 PMCID: PMC9241749 DOI: 10.1128/spectrum.00119-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We studied outbreaks of acute gastroenteritis due to norovirus in schools and summer camps during 2017–2019 in Catalonia (Spain). The overall attack rate was 21.27% in schools and 33.42% in summer camps (RR 0.64 [95% CI 0.58–0.70]) and 52.63% of outbreaks occurred in cold months and 47.37% in warm months. The mean delay in reporting was 5.61 days (SD 5.58 days) and the mean duration was 6.11 days (SD 6.08 days), with a Pearson correlation coefficient of 0.84 (P < 0.001) between these variables. In outbreaks with person-to-person transmission, the aOR was higher the longer the delay in reporting: 3.07 (95% CI 1.21–7.81) when the delay was 5–8 days and 3.81 when it was >9 days (95% CI 1.42–10.23). The cold months posed a higher risk than the warm months. In common source outbreaks the risk was higher in children in secondary-higher education and in summer camps. IMPORTANCE Norovirus is the main cause of viral acute gastroenteritis outbreaks worldwide. The low infectious dose and the lack of long-term immunity in infected persons means that norovirus often causes outbreaks in institutions and closed and semiclosed centers. Norovirus gastroenteritis are usually mild, with no complications, but occasionally can result in hospital admission. Understanding the risk factors involved in a norovirus outbreak can reduce the spread, severity, and duration of the outbreak and, when a vaccine becomes available, this understanding would help us identify the population groups need to get vaccinated. Here, we show the outbreaks due to norovirus in schools and summer camps, the correlation between the delay in reporting and duration of outbreaks and the relationship of the attack rate and the size of the groups.
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17
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Lu Y, Zhang Z, Xie H, Su W, Wang H, Wang D, Lu J. The Rise in Norovirus-Related Acute Gastroenteritis During the Fight Against the COVID-19 Pandemic in Southern China. Front Public Health 2022; 9:785373. [PMID: 35087785 PMCID: PMC8787315 DOI: 10.3389/fpubh.2021.785373] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/06/2021] [Indexed: 12/22/2022] Open
Abstract
Background: There has been a significant decline in the morbidity of almost all infectious diseases during the COVID-19 pandemic. However, while the incidence of norovirus-related acute gastroenteritis declined in Guangzhou, China during the initial period of the pandemic, incidence increased significantly once the new school year began in September 2020. Methods: Norovirus-related acute gastroenteritis clusters and outbreaks were assessed in Guangzhou from 2015 to 2020. Medians and interquartile ranges were compared between groups using the Mann–Whitney U-test, and attack rates were calculated. Results: While 78,579 cases of infectious diarrhea were reported from 2015 to 2019, with an average of 15,716 cases per year, only 12,065 cases of infectious diarrhea were reported in 2020. The numbers of sporadic cases and outbreaks reported from January to August 2020 were lower than the average numbers reported during the same time period each year from 2015 to 2019 but began to increase in September 2020. The number of cases in each reported cluster ranged from 10 to 70 in 2020, with a total of 1,280 cases and an average attack rate of 5.85%. The median number of reported cases, the cumulative number of cases, and the attack rate were higher than the average number reported each year from 2015 to 2019. The intervention time in 2020 was also higher than the average intervention time reported during 2015–2019. The main norovirus genotypes circulating in Guangzhou during 2015–2020 included genogroup 2 type 2 (GII.2) (n = 79, 26.69%), GII.17 (n = 36, 12.16%), GII.3 (n = 27, 9.12%), GII.6 (n = 8, 2.7%), GII.4 Sydney_2012 (n = 7, 2.36%), and GII.4 (n = 6, 2.03%). Conclusions: Our findings illustrate the importance of maintaining epidemiological surveillance for viral gastroenteritis during the COVID-19 pandemic. Local disease prevention and control institutions need to devote sufficient human resources to control norovirus clusters.
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Affiliation(s)
- Ying Lu
- Department for Infectious Diseases Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Zhoubin Zhang
- Director's Office, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Huaping Xie
- Department of Virology and Immunology, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Wenzhe Su
- Department of Virology and Immunology, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Hui Wang
- Department for Infectious Diseases Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Dahu Wang
- Department for Infectious Diseases Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Jianyun Lu
- Department for Infectious Diseases Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
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18
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Ai J, Zhu Y, Fu J, Cheng X, Zhang X, Ji H, Liu W, Rui J, Xu J, Yang T, Wang Y, Liu X, Yang M, Lin S, Guo X, Bao C, Li Q, Chen T. Study of Risk Factors for Total Attack Rate and Transmission Dynamics of Norovirus Outbreaks, Jiangsu Province, China, From 2012 to 2018. Front Med (Lausanne) 2022; 8:786096. [PMID: 35071268 PMCID: PMC8777030 DOI: 10.3389/fmed.2021.786096] [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: 09/29/2021] [Accepted: 12/01/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: To describe the epidemiological characteristics of norovirus outbreaks in Jiangsu Province, utilize the total attack rate (TAR) and transmissibility (Runc) as the measurement indicators of the outbreak, and a statistical difference in risk factors associated with TAR and transmissibility was compared. Ultimately, this study aimed to provide scientific suggestions to develop the most appropriate prevention and control measures. Method: We collected epidemiological data from investigation reports of all norovirus outbreaks in Jiangsu Province from 2012 to 2018 and performed epidemiological descriptions, sequenced the genes of the positive specimens collected that were eligible for sequencing, created a database and calculated the TAR, constructed SEIAR and SEIARW transmission dynamic models to calculate Runc, and performed statistical analyses of risk factors associated with the TAR and Runc. Results: We collected a total of 206 reported outbreaks, of which 145 could be used to calculate transmissibility. The mean TAR in was 2.6% and the mean Runc was 12.2. The epidemiological characteristics of norovirus outbreaks showed an overall increasing trend in the number of norovirus outbreaks from 2012 to 2018; more outbreaks in southern Jiangsu than northern Jiangsu; more outbreaks in urban areas than in rural areas; outbreaks occurred mostly in autumn and winter. Most of the sites where outbreaks occurred were schools, especially primary schools. Interpersonal transmission accounted for the majority. Analysis of the genotypes of noroviruses revealed that the major genotypes of the viruses changed every 3 years, with the GII.2 [P16] type of norovirus dominating from 2016 to 2018. Statistical analysis of TAR associated with risk factors found statistical differences in all risk factors, including time (year, month, season), location (geographic location, type of settlement, type of premises), population (total number of susceptible people at the outbreak site), transmission route, and genotype (P < 0.05). Statistical analysis of transmissibility associated with risk factors revealed that only transmissibility was statistically different between sites. Conclusions: The number of norovirus outbreaks in Jiangsu Province continues to increase during the follow-up period. Our findings highlight the impact of different factors on norovirus outbreaks and identify the key points of prevention and control in Jiangsu Province.
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Affiliation(s)
- Jing Ai
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yuanzhao Zhu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Jianguang Fu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xiaoqing Cheng
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xuefeng Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hong Ji
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Wendong Liu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jia Rui
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Jingwen Xu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Tianlong Yang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Yao Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Xingchun Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Meng Yang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Shengnan Lin
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Xiaohao Guo
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Changjun Bao
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Qun Li
- Public Health Emergency Center, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
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Li W, Yan H, Liu B, Tian Y, Chen Y, Jia L, Gao Z, Wang Q. Epidemiological characteristics and genetic diversity of norovirus infections among outpatient children with diarrhea under 5 years of age in Beijing, China, 2011-2018. Gut Pathog 2021; 13:77. [PMID: 34952625 PMCID: PMC8709959 DOI: 10.1186/s13099-021-00473-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background Human noroviruses are the leading cause of sporadic cases and outbreaks of viral acute gastroenteritis in all age groups worldwide. Methods Epidemiological data and fecal specimens were collected between January 2011 and December 2018 from 4911 children < 5 years of age with diarrhea in three districts of Beijing. From 2011 to 2013, One-Step Reverse Transcription Polymerase Chain Reaction (RT-PCR) was used to detect noroviruses, and from January 2014 to December 2018, norovirus GI and GII were screened using duplex quantitative real-time RT-PCR (qRT-PCR). One-Step RT-PCR and RT-seminested PCR were performed to amplify the RNA-dependent polymerase and capsid genes of noroviruses in positive sample. Amplified products were sequenced directly; norovirus was typed using the online Norovirus Genotyping Tool v2.0 and phylogenetic analyses were conducted using MEGA-X. Results From 2011 to 2018, noroviruses were detected in 16.5% of specimens from children with diarrhea. The highest prevalence was observed in children aged 12 to 23 months (22.4%, 319/1421), followed by children aged 6 to 11 months (17.6%, 253/1441). The highest prevalence of norovirus infections occurred in autumn followed by winter, spring, and summer. From 2011 to 2018, the most prevalent dual types (genotype and polymerase type) were GII.4 Sydney[P31] (51.6%, 239/463), followed by GII.3[P12] (24.0%, 111/463), GII.4 2006b[P4 2006b] (7.3%, 34/463), GII.2[P16] (5.0%, 23/463), GII.17[P17] (2.6%, 12/463) and GII.6[P7] (2.6%, 12/463). GII.4 2006b[P4 2006b] predominated in 2011 and 2012. GII.4 Sydney[P31] predominated from 2013 to 2018. In total, 15 genotypes, 15 P-types and 19 dual types were detected in this study, reflecting the genetic diversity. Conclusions There were significant epidemiological characteristics and genetic diversity among outpatient children with norovirus infections < 5 years of age in Beijing from 2011 to 2018. These characteristics differ from those of norovirus outbreaks in Beijing. The complete genome sequences of each genotype are needed to better understand norovirus evolutionary mechanisms.
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Affiliation(s)
- Weihong Li
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control and Beijing Research Center for Preventive Medicine, Beijing, China
| | - Hanqiu Yan
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control and Beijing Research Center for Preventive Medicine, Beijing, China
| | - Baiwei Liu
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control and Beijing Research Center for Preventive Medicine, Beijing, China
| | - Yi Tian
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control and Beijing Research Center for Preventive Medicine, Beijing, China
| | - Yanwei Chen
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control and Beijing Research Center for Preventive Medicine, Beijing, China
| | - Lei Jia
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control and Beijing Research Center for Preventive Medicine, Beijing, China
| | - Zhiyong Gao
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control and Beijing Research Center for Preventive Medicine, Beijing, China.
| | - Quanyi Wang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control and Beijing Research Center for Preventive Medicine, Beijing, China.
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20
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Seasonal occurrence and abundance of norovirus in pre- and postharvest lettuce samples in Nanjing, China. Lebensm Wiss Technol 2021. [DOI: 10.1016/j.lwt.2021.112226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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21
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Parrón I, Barrabeig I, Alseda M, Rius C, Cornejo-Sánchez T, Jané M, Pérez C, Guix S, Domínguez À. Norovirus outbreaks in long-term care facilities in Catalonia from 2017 to 2018. Sci Rep 2021; 11:23218. [PMID: 34853333 PMCID: PMC8636624 DOI: 10.1038/s41598-021-02348-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 11/10/2021] [Indexed: 11/09/2022] Open
Abstract
Norovirus is the leading cause of outbreaks of acute viral gastroenteritis. We carried out this study to investigate outbreaks in long-term care facilities reported in 2017 and 2018 in Catalonia (Spain). The characteristics of the centers, exposed persons and the genogroups responsible were analyzed. Viral loads were estimated. The attack rate (AR) of the outbreaks studied, and the rate ratio (RR) and the odds ratio (OR) and their 95% confidence intervals as measures of association were calculated. The mean cycle thresholds were compared using the t-test for independent means. We included 30 outbreaks (4631 exposed people). The global AR was 25.93%. The RR of residents vs. staff was 2.28 (95% CI 2.0–2.6). The RR between AR in residents with total or severe dependence vs. residents with moderate, low or no-dependence was 1.23 (95% CI 1.05–1.45). The AR were higher in smaller centers than in larger ones (38.47% vs. 19.25% and RR 2; 95% CI 1.82–2.2). GII was responsible for 70% of outbreaks. No association was found between the genogroup and presenting symptoms (OR 0.96; 95% CI 0.41–2.26). Viral loads were higher in symptomatic than in asymptomatic patients (p = 0.001).
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Affiliation(s)
- Ignacio Parrón
- Sub-Direcció Regional a Barcelona del Departament de Salut, Barcelona, Spain. .,Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.
| | - Irene Barrabeig
- Sub-Direcció Regional a Barcelona del Departament de Salut, Barcelona, Spain.,CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Miquel Alseda
- Sub-Direcció Regional a Lleida del Departament de Salut, Lleida, Spain
| | - Cristina Rius
- CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain.,Agència de Salut Pública de Barcelona, Barcelona, Spain
| | | | - Mireia Jané
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.,CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain.,Sub-Direcció General de Vigilància i Resposta a Emergències de Salut Pública, Barcelona, Spain
| | - Cristina Pérez
- Sub-Direcció Regional a Barcelona del Departament de Salut, Barcelona, Spain
| | - Susana Guix
- Departament de Genètica Microbiologia i Estadística, Grup de Virus Entèrics, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca en Nutrició i Seguretat Alimentària (INSA-UB), Universitat de Barcelona, Santa Coloma de Gramenet, Spain
| | - Àngela Domínguez
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.,CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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An Increased Risk of School-Aged Children with Viral Infection among Diarrhea Clusters in Taiwan during 2011-2019. CHILDREN-BASEL 2021; 8:children8090807. [PMID: 34572239 PMCID: PMC8465071 DOI: 10.3390/children8090807] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/10/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022]
Abstract
Acute diarrhea is mainly caused by norovirus and rotavirus. Numerous factors modify the risk of diarrhea cluster infections and outbreaks. The purpose of this study was to explore the epidemiological characteristics, differences, and trends in the distribution of viral and bacterial pathogens that cause diarrhea cluster events as well as the public places where diarrhea cluster events took place in Taiwan from 2011 to 2019. We examined publicly available, annual summary data on 2865 diarrhea clusters confirmed by the Taiwan Centers for Disease Control (CDC) from 2011 to 2019. There were statistically significant differences (p < 0.001) in event numbers of diarrhea clusters among viral and bacterial pathogens, and statistically significant differences (p < 0.001) in event numbers of diarrhea clusters among bacterial pathogens. There were also statistically significant differences (p < 0.001) in the event numbers of diarrhea clusters among public places. Norovirus infections were the first most numerous (77.1%, 1810/2347) diarrhea clusters among viral and bacterial infections. Among bacterial infections, Staphylococcus aureus infections accounted for the greatest number of diarrhea clusters (35.5%, 104/293). Schools were the places with the greatest number of diarrhea clusters (49.1%, 1406/2865) among various institutions. Norovirus single infection (odds ratio, OR = 4.423), Staphylococcus aureus single infection (OR = 2.238), and school (OR = 1.983) were identified as risk factors. This is the first report of confirmed events of diarrhea clusters taken from surveillance data compiled by Taiwan's CDC (2011-2019). This study highlights the importance of long-term and geographically extended studies, particularly for highly fluctuating pathogens, to understand the implications of the transmission of diarrhea clusters in Taiwan's populations. Importantly, big data have been identified that can inform future surveillance and research efforts in Taiwan.
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23
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Carol M, Guadalupe-Fernández V, Rius C, Soldevila N, Razquin E, Guix S, Dominguez A. A Waterborne Gastroenteritis Outbreak Caused by a GII Norovirus in a Holiday Camp in Catalonia (Spain), 2017. Viruses 2021; 13:v13091792. [PMID: 34578373 PMCID: PMC8473012 DOI: 10.3390/v13091792] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 01/26/2023] Open
Abstract
On 2 February 2017, Epidemiological Surveillance Services were notified of an outbreak of acute gastroenteritis (AGE) among schoolchildren who had taken part of a school trip from 30 January to 3 February 2017 at a holiday camp in Catalonia. A retrospective cohort study was performed to identify the causative agent, estimate the magnitude of the outbreak and identify its source, as well as to determine the route of transmission. Data collected by standardised questionnaires identified 41 episodes of AGE among 174 individuals who attended the camp. Cases had mainly symptoms of abdominal pain (73.8%), nausea (64.3%), vomiting (54.8%), diarrhoea (45.2%) and headache (42.9%). Consumption of water was associated with gastroenteritis (crude RR: 1.72, 95%CI: 1.01–2.92; adjusted RR: 1.88, 95%CI 1.03–3.56). NoV GII was detected in faeces (5 out of 13) and water samples. Additionally, faecal indicator bacteria and protozoa were detected in water samples. The outbreak showed a high attack rate and was caused by a natural water fountain not properly treated and not monitored for safety quality. There could have been a discharge of wastewater at a point close to the fountain; however, the source of contamination of the water could not be identified. Health education may be useful to eliminate risks associated with the consumption of untreated water from natural fountains.
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Affiliation(s)
- Mònica Carol
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, 08005 Barcelona, Spain;
| | - Víctor Guadalupe-Fernández
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, 08005 Barcelona, Spain;
- Correspondence:
| | - Cristina Rius
- Epidemiological Service of Public Health Agency of Barcelona (ASPB), 08023 Barcelona, Spain;
- CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Nuria Soldevila
- CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto Salud Carlos III, 28029 Madrid, Spain
- Medicine Department, University of Barcelona (UB), 08036 Barcelona, Spain; (N.S.); (A.D.)
| | - Efrén Razquin
- Laboratory of Barcelona Public Health Agency (ASPB), 08001 Barcelona, Spain;
| | - Susana Guix
- Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, Institute of Nutrition and Food Safety (INSA), School of Biology, University of Barcelona (UB), 08028 Barcelona, Spain;
| | - Angela Dominguez
- CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto Salud Carlos III, 28029 Madrid, Spain
- Medicine Department, University of Barcelona (UB), 08036 Barcelona, Spain; (N.S.); (A.D.)
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Lo M, Mitra S, De P, Banerjee A, Deb AK, Miyoshi SI, Manna A, Ghosh SK, Okamoto K, Dutta S, Chawla-Sarkar M. Genetic characterization and evolutionary analysis of norovirus genotypes circulating among children in eastern India during 2018-2019. Arch Virol 2021; 166:2989-2998. [PMID: 34383167 PMCID: PMC8358548 DOI: 10.1007/s00705-021-05197-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/11/2021] [Indexed: 01/13/2023]
Abstract
Noroviruses are significant etiological agents of acute gastroenteritis (AGE) across all age groups, especially in children under 5 years of age. Although the prevalence of norovirus infection is known to have increased in various countries, in India there are few reports pertaining to the norovirus disease burden. We investigated the epidemiology and molecular characteristics of noroviruses in children seeking health care at two hospitals in Kolkata, Eastern India. Faecal specimens were collected between January 2018 and December 2019 from 2812 children under 5 years of age with acute gastroenteritis. Noroviruses were detected in 6.04% (170/2812) of the samples, and 12.9% (22/170) of these were cases of coinfection with rotavirus. Among children (≤5 years), a higher infection rate (8.2%, n = 94/1152) was observed in the 6 to 12 month age group. GII.4 Sydney 2012 was the dominant norovirus capsid genotype (n = 75/90, 83.3%), followed by GII.3 (n = 10/90, 11.1%). Other capsid types GII.13 (n = 4/90, 4.4%) and GII.17 (n = 1/90; 1.1%) were also detected at low frequency. Phylogenetic analysis showed that the GII.P16 polymerase of strains in this region clustered with those of the phylogenetically distinct monophyletic clade of GII.P16 strains, whose members have been circulating worldwide since 2014. Inter-genotypic norovirus recombinants such as GII.P16-GII.3 (n = 10) and GII.P16-GII.13 (n = 4) were also observed among the circulating strains. In comparison to previous studies from eastern India, the present study shows a higher detection rate of norovirus infection in the paediatric population suffering from acute gastroenteritis. Continuous surveillance is required for predicting the emergence of novel genotypes and recombinant strains and for future vaccine development.
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Affiliation(s)
- Mahadeb Lo
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, P-33, C.I.T. Road Scheme-XM, Beliaghata, Kolkata, 700010, India
| | - Suvrotoa Mitra
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, P-33, C.I.T. Road Scheme-XM, Beliaghata, Kolkata, 700010, India
| | - Papiya De
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, P-33, C.I.T. Road Scheme-XM, Beliaghata, Kolkata, 700010, India
| | - Anindita Banerjee
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, P-33, C.I.T. Road Scheme-XM, Beliaghata, Kolkata, 700010, India
| | - Alok Kumar Deb
- Division of Epidemiology, ICMR-National Institute of Cholera and Enteric Diseases, P-33, C.I.T. Road Scheme-XM, Beliaghata, Kolkata, 700010, India
| | - Shin-Ichi Miyoshi
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.,Collaborative Research Centre of Okayama University for Infectious Disease, ICMR-National Institute of Cholera and Enteric Diseases, P-33, C.I.T. Road Scheme-XM, Beliaghata, Kolkata, 700010, India
| | - Asis Manna
- Infectious diseases and Beliaghata General (ID & BG) Hospital, Beliaghata, Kolkata, 700010, India
| | - Sanat Kumar Ghosh
- Dr. B.C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, 700054, India
| | - Keinosuke Okamoto
- Collaborative Research Centre of Okayama University for Infectious Disease, ICMR-National Institute of Cholera and Enteric Diseases, P-33, C.I.T. Road Scheme-XM, Beliaghata, Kolkata, 700010, India
| | - Shanta Dutta
- Regional Virus Research and Diagnostic Laboratory, ICMR-National Institute of Cholera and Enteric Diseases, P-33, C.I.T. Road Scheme-XM, Beliaghata, Kolkata, 700010, India
| | - Mamta Chawla-Sarkar
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, P-33, C.I.T. Road Scheme-XM, Beliaghata, Kolkata, 700010, India.
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Zhang Z, Liu D, Li S, Zhang Z, Hou J, Wang D, Wu Q, Jiang Y, Tian Z. Imported human norovirus in travelers, Shanghai port, China 2018: An epidemiological and whole genome sequencing study. Travel Med Infect Dis 2021; 43:102140. [PMID: 34271206 DOI: 10.1016/j.tmaid.2021.102140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/01/2021] [Accepted: 07/08/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Global mobility of the population has accelerated spread of the Human Norovirus (HuNoV), with long-distance travel in enclosed spaces increasing the opportunity for viral outbreaks. However, surveillance of HuNoV transmission is still lacking, especially in cross-border transportation. METHOD From 533 self-reported patients, 83 swab samples (15.6%) tested positive for HuNoV by RT-qPCR. Positive samples were sequenced using next-generation sequencing (NGS). Epidemiological investigation and whole genome analysis were then conducted. RESULTS Most cases occurred in February and March, with large outbreaks involving more than 34 people. A total of 74 HuNoV sequences that could be genotyped were obtained, with near-complete genomes (>7 kb) accounting for most sequences (57/74). A total of 19 different genotypes of viral whole genome sequences were included. The first whole genome sequence of GII.9[P7] was obtained. Rarely reported genotypes including GI.3[P10], GI.3[P13], GII.7[P7], GII.8[P8], and GIX.1[GII.P15] were sequenced and assembled successfully. Four possible sources of virus outbreaks in China were traced. Beyond HuNoV, whole genome sequences of food-borne viruses including Salivirus, Kobuvirus, and Enterovirus were obtained in further assembly. CONCLUSIONS Surveillance of the etiology and epidemiology of HuNoV global spread through travelers will improve pre-travel health advice, empirical treatment, and estimates of vaccine-preventable diseases.
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Affiliation(s)
- Zilong Zhang
- Shanghai International Travel Healthcare Center, Shanghai Customs District PR China, Shanghai, 200335, China
| | - Danlei Liu
- Department of Food Science and Technology, School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, 200240, China; State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology, Guangzhou, China
| | - Shenwei Li
- Shanghai International Travel Healthcare Center, Shanghai Customs District PR China, Shanghai, 200335, China
| | - Zilei Zhang
- Inspection and Quarantine Technology Communication Department, Shanghai Customs College, Shanghai, China
| | - Jian Hou
- Shanghai International Travel Healthcare Center, Shanghai Customs District PR China, Shanghai, 200335, China
| | - Dapeng Wang
- Department of Food Science and Technology, School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Qingping Wu
- Department of Food Science and Technology, School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, 200240, China; State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology, Guangzhou, China
| | - Yuan Jiang
- Shanghai International Travel Healthcare Center, Shanghai Customs District PR China, Shanghai, 200335, China.
| | - Zhen'gan Tian
- Shanghai International Travel Healthcare Center, Shanghai Customs District PR China, Shanghai, 200335, China.
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Jin M, Wu S, Kong X, Xie H, Fu J, He Y, Feng W, Liu N, Li J, Rainey JJ, Hall AJ, Vinjé J, Duan Z. Norovirus Outbreak Surveillance, China, 2016-2018. Emerg Infect Dis 2021; 26:437-445. [PMID: 32091361 PMCID: PMC7045832 DOI: 10.3201/eid2603.191183] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
CaliciNet China, a network of provincial, county, and city laboratories coordinated by the Chinese Centers for Disease Control and Prevention, was launched in October 2016 to monitor the epidemiology and genotype distribution of norovirus outbreaks in China. During October 2016–September 2018, a total of 556 norovirus outbreaks were reported, and positive fecal samples from 470 (84.5%) outbreaks were genotyped. Most of these outbreaks were associated with person-to-person transmission (95.1%), occurred in childcare centers or schools (78.2%), and were reported during November–March of each year (63.5%). During the 2-year study period, 81.2% of all norovirus outbreaks were typed as GII.2[P16]. In China, most norovirus outbreaks are reported by childcare centers or schools; GII.2[P16] is the predominant genotype. Ongoing surveillance by CaliciNet China will provide information about the evolving norovirus genotype distribution and outbreak characteristics important for the development of effective interventions, including vaccines.
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27
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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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Characterization of a hospital-based gastroenteritis outbreak caused by GII.6 norovirus in Jinshan, China. Epidemiol Infect 2020; 148:e289. [PMID: 33292874 PMCID: PMC7770467 DOI: 10.1017/s0950268820002538] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
An acute gastroenteritis (AGE) outbreak caused by a norovirus occurred at a hospital in Shanghai, China, was studied for molecular epidemiology, host susceptibility and serological roles. Rectal and environmental swabs, paired serum samples and saliva specimens were collected. Pathogens were detected by real-time polymerase chain reaction and DNA sequencing. Histo-blood group antigens (HBGA) phenotypes of saliva samples and their binding to norovirus protruding proteins were determined by enzyme-linked immunosorbent assay. The HBGA-binding interfaces and the surrounding region were analysed by the MegAlign program of DNAstar 7.1. Twenty-seven individuals in two care units were attacked with AGE at attack rates of 9.02 and 11.68%. Eighteen (78.2%) symptomatic and five (38.4%) asymptomatic individuals were GII.6/b norovirus positive. Saliva-based HBGA phenotyping showed that all symptomatic and asymptomatic cases belonged to A, B, AB or O secretors. Only four (16.7%) out of the 24 tested serum samples showed low blockade activity against HBGA-norovirus binding at the acute phase, whereas 11 (45.8%) samples at the convalescence stage showed seroconversion of such blockade. Specific blockade antibody in the population played an essential role in this norovirus epidemic. A wide HBGA-binding spectrum of GII.6 supports a need for continuous health attention and surveillance in different settings.
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Acute gastroenteritis outbreaks in closed and semi-closed facilities during 2017 in Catalonia, Spain. Eur J Clin Microbiol Infect Dis 2020; 40:1085-1089. [PMID: 33211224 DOI: 10.1007/s10096-020-04101-5] [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: 07/07/2020] [Accepted: 11/05/2020] [Indexed: 10/22/2022]
Abstract
Acute gastroenteritis (AGE) is a leading cause of disease worldwide. The aim of this prospective observational study is to describe the epidemiology of AGE in closed and semi-closed institutions in Catalonia. In 2017, 151 outbreaks were reported; 30.5% occurred in closed and semi-closed institutions; 71.7% caused by norovirus (NoV) (1532) cases. Person-to-person transmission accounted for 75.8% of NoV outbreaks vs 46.1% in non-NoV outbreaks (p < 0.001). Attack rate for NoV outbreaks was 33.1% vs 14.3% for non-NoV outbreaks (RR = 2.3; 95%CI: 2.0-2.7). The high number of affected underscores prompt and intense preventive measures to avoid the extension and perpetuation of outbreaks in these settings.
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Huang Z, Yao D, Xiao S, Yang D, Ou X. Full-genome sequences of GII.13[P21] recombinant norovirus strains from an outbreak in Changsha, China. Arch Virol 2020; 165:1647-1652. [PMID: 32356188 PMCID: PMC7223583 DOI: 10.1007/s00705-020-04643-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 04/01/2020] [Indexed: 12/27/2022]
Abstract
On 31 March 2019, 68 school students suffered from vomiting, diarrhea, and abdominal pain after participating in a group activity at a commercial park. In this outbreak, multiple norovirus genotypes were observed, including GII.2[P16], GII.17[P17], and GII.13[P21]. Further, we determined the full-genome sequences of two strains of GII.13[P21] recombinant noroviruses, which were 7434 nt long. Phylogenetic analysis based on open reading frames (ORFs) 1 and 2 revealed that these recombinants were related to stains of different genotypes from different countries. The full genome nucleotide sequences of the two isolates were 97.0% and 98.0% identical to those of strains from London and Thailand, respectively. Simplot analysis revealed the presence of a break point at nt 5059 in the ORF1 region. The histo-blood group antigen binding sites were conserved in both recombinant viruses. Our findings not only provide valuable genetic information about a recombinant norovirus but also contribute to our general understanding of the evolution, genetic diversity, and distribution of noroviruses.
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Affiliation(s)
- Zheng Huang
- Changsha Center for Disease Control and Prevention, Beside the Liuyang River Bridge, No. 509, Wanjiali Second North Road, Changsha, Hunan People’s Republic of China
| | - Dong Yao
- Changsha Center for Disease Control and Prevention, Beside the Liuyang River Bridge, No. 509, Wanjiali Second North Road, Changsha, Hunan People’s Republic of China
| | - Shan Xiao
- Changsha Center for Disease Control and Prevention, Beside the Liuyang River Bridge, No. 509, Wanjiali Second North Road, Changsha, Hunan People’s Republic of China
| | - Dong Yang
- Changsha Center for Disease Control and Prevention, Beside the Liuyang River Bridge, No. 509, Wanjiali Second North Road, Changsha, Hunan People’s Republic of China
| | - Xinhua Ou
- Changsha Center for Disease Control and Prevention, Beside the Liuyang River Bridge, No. 509, Wanjiali Second North Road, Changsha, Hunan People’s Republic of China
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Chen L, Xu D, Wu X, Liu G, Ji L. An increasing prevalence of non-GII.4 norovirus genotypes in acute gastroenteritis outbreaks in Huzhou, China, 2014-2018. Arch Virol 2020; 165:1121-1128. [PMID: 32221714 PMCID: PMC7222896 DOI: 10.1007/s00705-020-04599-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 02/27/2020] [Indexed: 01/29/2023]
Abstract
Since 2014, novel non-GII.4 norovirus (NoV) genotypes continue to be reported as the main cause of outbreaks worldwide. In this study, we analyzed the epidemiological and genetic features of NoV outbreaks from July 2014 to June 2018 in Huzhou, China. A total of 450 stool samples collected from 51 AGE outbreaks were tested for NoVs by real-time RT PCR. Partial polymerase and capsid sequences of NoV-positive samples were amplified and sequenced for phylogenetic analysis. NoVs were found to be responsible of 84.3% of AGE outbreaks in Huzhou over the past 5 years. Most NoV outbreaks were reported in the cool months (November-March) and occurred in primary schools and kindergartens. Changes in the diversity of genotypes and the distribution of predominant types were observed in recent years. At least eight genotypes were identified, and 91.9% of the genotyped outbreaks were caused by non-GII.4 strains. The top three circulating genotypes during the study period were GII.2[P16], GII.3[P12], and GII.17[P17]. The predominant NoV genotypes in outbreaks have changed from GII.4 variants to GII.17[P17] in 2014-2015, GII.3[P12] in 2015-2016, and then GII.2[P16] in 2016-2018. Non-GII.4 NoVs play an increasingly important role in outbreaks in Huzhou. Continuous surveillance is needed to monitor the emergence of novel NoV strains and help control NoV outbreaks in the next epidemic season.
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Affiliation(s)
- Liping Chen
- Huzhou Center for Disease Control and Prevention, 999 Changxing Road, Huzhou, 313000, Zhejiang, China
| | - Deshun Xu
- Huzhou Center for Disease Control and Prevention, 999 Changxing Road, Huzhou, 313000, Zhejiang, China
| | - Xiaofang Wu
- Huzhou Center for Disease Control and Prevention, 999 Changxing Road, Huzhou, 313000, Zhejiang, China
| | - Guangtao Liu
- Huzhou Center for Disease Control and Prevention, 999 Changxing Road, Huzhou, 313000, Zhejiang, China
| | - Lei Ji
- Huzhou Center for Disease Control and Prevention, 999 Changxing Road, Huzhou, 313000, Zhejiang, China.
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Zhou H, Wang S, von Seidlein L, Wang X. The epidemiology of norovirus gastroenteritis in China: disease burden and distribution of genotypes. Front Med 2019; 14:1-7. [PMID: 31823287 PMCID: PMC8320309 DOI: 10.1007/s11684-019-0733-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/31/2019] [Indexed: 01/12/2023]
Abstract
With the improvements of sanitation and nationwide safe water supply the occurrence of bacterial diarrhea declined remarkably, while viruses became the leading causes of acute gastroenteritis (AGE). Of these viruses, noroviruses (NoVs) are responsible for a considerable burden of gastroenteritis, especially in children < 2 years and elderly ⩾ 65 years. NoVs circulating in the Chinese population are antigenically highly diverse with the genotype GII.4 being the dominant strain followed by GII.3. Given the widespread contamination in environmental sources, and highly infectious nature of NoVs, vaccination would be the desirable strategy for the control of NoV infections. However, a better understanding of acquired immunity after infection, and a reliable immunological surrogate marker are urgently needed, since two vaccine candidates based on virus-like particles (VLPs) are currently moving into clinical evaluations in China.
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Affiliation(s)
- Honglu Zhou
- Key Laboratory of Medical Molecular Virology of MoE & MoH, and Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Songmei Wang
- Laboratory of Molecular Biology, Training Center of Medical Experiments, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
| | - Lorenz von Seidlein
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX1 2JD, UK
| | - Xuanyi Wang
- Key Laboratory of Medical Molecular Virology of MoE & MoH, and Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China.
- Children's Hospital, Fudan University, Shanghai, 200032, China.
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