Sapporo virus: history and recent findings

Morphologically distinct caliciviruses of human origin were first found in stools of children with gastroenteritis in 1976. Sapporo virus, or human calicivirus Sapporo, with typical surface morphology was first detected during a gastroenteritis outbreak in a home for infants in Sapporo, Japan, in 1977. Since then, morphologically and antigenically identical virus has been detected frequently in the same institution in association with outbreaks of gastroenteritis. Sapporo virus is widely distributed worldwide, as evidenced by the appearance of antigenically or genetically similar viruses and seroepidemiologic findings. Sapporo virus plays an important role in outbreaks of infantile gastroenteritis and is less important in foodborne outbreaks. Sapporo virus has been approved as the type species of the genus "Sapporo-like viruses in the family Caliciviridae. The history of and recent findings, as obtained by newly developed techniques, about Sapporo viruses are presented.     

Incidence and prevalent types of Norwalk virus, Sapporo virus and human astrovirus in pediatric gastroenteritis in Hiroshima Prefecture

The incidence and prevalent types of Norwalk virus (NV), Sapporo virus (SV), and human astrovirus (HAstV) in pediatric gastroenteritis in Hiroshima Prefecture were investigated in 7 cold seasons, between 1995/96 and 2001/02. The incidences of NV, SV, and HAstV were 23.6% ranging from 16.3 to 34.4, 2.5% ranging from 1.5 to 4.7, and 3.2% ranging from 1.5 to 6.0, respectively. The peak of the incidence of NV was found in November and December. No accumulation of monthly incidence in SV or HAstV was noted. Most NVs detected belonged to genogroup II. A probe type of G2F, according to Fukuda et al., was predominant in NV, followed by G2E and G2B. The probe types of LON and SAP, according to Vinje et al., were predominant in SV. Serotype 1 was predominant in HAstV.     

Surveillance of viral gastroenteritis in Japan: pediatric cases and outbreak incidents

Surveillance results from pediatric cases and outbreaks of viral gastroenteritis in Japan are presented. In winter, both small round structured virus (SRSV, or Norwalk-like viruses) and rotavirus were detected from infants with gastroenteritis; however, in recent years, the prevailing time of SRSV infection has preceded that of rotavirus infection. Most nonbacterial gastroenteritis outbreaks were related to SRSV infection, and >60% of the outbreaks were caused by contaminated food. In small-sized outbreaks, raw oysters were the primary source of transmission. In large-sized outbreaks, school lunches and catered meals that were served at schools, banquet halls, and hospitals were most often implicated in the transmission of foodborne gastroenteritis.     

Effects of handwashing on Feline Calicivirus removal as Norovirus surrogate

Viral gastroenteritis caused by Norovirus (NV) mainly appears during the winter season. In fact, outbreaks and patients with NV gastroenteritis are the major cause of community disease in the winter. Strategies to avoid gastroenteritis caused by NV are thus needed. No effective method for evaluating virus inactivation and removal exists for of NV, which cannot be cultured using cell-lines. Trials using Feline Calici Virus (FCV; a member of the calicivirus family) as a NV surrogate have been conducted by culturing FCV in CRFK cells. By washing one's hands, about 99% of the viruses can be removed, compared with simply rinsing one's hands in running water. Washing one's hands with alcohol, chlorhexidine, quaternary ammonium, or 3 other kinds of hand soaps (containing povidone-iodine, triclosan, and isopropylmethyl phenol, respectively), was also effective for removing viruses. These results suggest that washing one's hands may be an effective method of preventing viral gastroenteritis.     

Comparison of the number of Norovirus genome copies in patients and healthy persons

In viral gastroenteritis outbreaks occurred by Norovirus (NV), NV was detected not only from patients but also from healthy persons who have taken the same food, and also detected from healthy staff members working at community places such as hospital, school and nursing home. The number of fecal NV genome copies of patients, healthy persons and food handlers are examined by real-time PCR method, to investigate foodborne gastroenteritis and person to person transmission outbreaks. There is no significant difference on the number of NV genome copies in feces between patients, and NV-detected healthy persons. Those result indicate asymptomatic carrier of NV who were working as food handlers or staff members at community places will become an origin of food-borne gastroenteritis or person to person transmission outbreaks.     

Evidence for two subtypes of Ebola virus based on oligonucleotide mapping of RNA

Ebola viruses isolated during outbreaks of acute hemorrhagic fever in Africa from 1976 to 1979 were examined by T1 oligonucleotide mapping of virion RNA. Two Ebola virus subtypes distinguishable by their oligonucleotide patterns were involved in the outbreaks of the disease during this three-year period. The first type was isolated in Zaire in 1976 and again in 1977; the second type caused outbreaks in Sudan in 1976 and again in 1979. Oligonucleotide patterns of the two groups of Ebola viruses (Zaire and Sudan) were remarkably similar within the group but differed between groups by approximately 60 oligonucleotides. We can conclude from this study (1) that the outbreaks of hemorrhagic fever which occurred concurrently in 1976 in Zaire and Sudan were caused by viruses that are genetically distinct; (2) that compared with other RNA viruses there was an unusually high genetic stability among viruses within Zaire and Sudan over two- and three-year periods, respectively; and (3) that the two genetic subtypes probably evolved from a common ancestor since they share common oligonucleotides.     

Evidence of simian virus 40 infection in multiple organ transplant recipients with renal dysfunction

Electron microscopy (EM), real-time polymerase chain reaction (PCR) and conventional PCR were used to identify viruses associated with infection in 2 transplantation patients. An autologous haematopoietic stem cell, liver and renal transplant recipient was found to be positive for simian virus 40 (SV40). Dual BK virus and SV40 infection was found in a heart and renal transplantation patient. SV40 infection can occur in immunocompromised patients.     

Combined infection of Norwalk-like virus and verotoxin-producing bacteria associated with a gastroenteritis outbreak

Detection of multiple pathogens, particularly a combination of viruses and bacteria, is infrequently documented in outbreaks of gastroenteritis. This paper reports the presence of Norwalk-like virus (NLV) and enterohaemorrhagic verotoxin-producing Escherichia coli in one individual, and NLV and verotoxin-producing Aeromonas sobria in another individual, both part of a large gastroenteritis outbreak. The causes of gastroenteritis in such outbreaks may be more complex than previously thought.     

A food poisoning outbreak caused by purple Washington clam contaminated with norovirus (Norwalk-like virus) and hepatitis A virus

A party of 57 people dined together in a restaurant in Hamamatsu City on December 11, 2001. The next day, 22 of them developed symptoms of acute gastroenteritis, such as diarrhea, vomiting, and fever. Examination of 4 fecal specimens from these patients by ELISA for Norovirus (Norwalk-like virus, NV) detected both genogroup I (GI) and genogroup II (GII) NV in all the 4 specimens. In addition, RT-PCR and real-time PCR methods for NV detected the NV gene. Approximately one month after the outbreak of the food poisoning (acute gastroenteritis) by NV, 4 individuals in the same party developed type A hepatitis. Both RT-PCR and real-time PCR methods for hepatitis A virus (HAV) detected the HAV gene in their fecal specimens. The party of these patients ate purple Washington clam (Saxidomus purpuratus, imported from China) steamed with red pepper. Since this food appeared to have caused the viral infections, the one with the same lot number was subjected to viral examinations, which successfully detected the NV GI, NV GII, and HAV genes. These results led to the conclusion that the clam contaminated with NV and HAV had caused the food poisoning. The DNA sequences of the NV detected in the patients and the clam had 74 to 99% homology, indicating strains of various genotypes. All the strains of HAV that were derived from the patients and the clam were genotype 1A, and these sequences had over 95% homology, but were not completely identical. This outbreak led to the demonstration of imported fishery products as a cause of type A hepatitis, and indicated the need for guiding and enlightening people on the importance of adequate cooking of bivalves.     

Antigenic relationships between human caliciviruses and Norwalk virus

We investigated antigenic relationships between human calicivirus (HCV) strains and Norwalk virus by using immune electron microscopy (IEM) and radioimmunoassay (RIA). Three serologically distinct HCV strains, UK1, UK2, and Japan, were demonstrated by IEM, as was evidence for two additional strains, UK3 and UK4. Although HCV strains and Norwalk virus were distinct by IEM, 12 of 20 patients with gastroenteritis due to HCV UK4 and two of eight with gastroenteritis due to UK2 showed seroconversions to Norwalk virus by RIA. These naturally occurring antibody responses in humans, as detected by RIA, support the concept that Norwalk virus belongs to the family Caliciviridae. An RIA for HCV Japan antigen also detected HCV UK1, UK2, and UK4 and thus appears to identify a group-specific antigen for these viruses. An RIA for antibody to HCV Japan failed to identify seroconversions in 45 of 47 patients with gastroenteritis due to HCV UK. These results may reflect different reactivities of various immunologic tests for the identification of infections due to small gastroenteritis viruses.     

Norovirus gastroenteritis general outbreak associated with raw shellfish consumption in South Italy

Background  

Despite Noroviruses (NV, previously "Norwalk-like viruses") being a leading cause of acute gastroenteritis outbreaks, the impact of NV infection is at present unknown and little information is available about strains circulating in Italy. In April 2002 an outbreak of gastroenteritis occurred in the province of Bari (South-east Italy), involving several households.     

Epidemiology of calicivirus infections in Sweden, 1994-1998

Outbreaks of acute gastroenteritis are frequently caused by caliciviruses. Electron microscopy was used to search for these viruses in fecal samples from patients with acute gastroenteritis. Of 5800 samples collected and analyzed from November 1994 to June 1998, 3700 were associated with outbreaks. A total of 676 outbreaks were analyzed, and viruses were found in 67%. Caliciviruses, usually Norwalk-like viruses (NLVs), were found in 407 (89%) of 455 outbreaks, while Sapporo-like viruses were identified in nine outbreaks, including six that were suspected to include foodborne transmission. Sixty percent of the 1041 patients with calicivirus infections were between 70 and 90 years of age. Food- and waterborne infections were associated with 66 calicivirus outbreaks. Virus-positive outbreaks were documented mainly during winter and spring. The longitudinal survey showed that caliciviruses, and especially the NLVs, cause most nosocomial and community-associated outbreaks in Sweden.     

Norwalk-like virus infection in military forces: epidemic potential, sporadic disease, and the future direction of prevention and control efforts

The impact of Norwalk-like virus (NLV) infection on military forces is evaluated in this report. NLVs were a major cause of both outbreaks and sporadic disease among crowded US ground troops in the 1991 war with Iraq. NLVs also have been found to be a cause of acute gastroenteritis in other ground and shipboard deployments. Four large outbreaks of acute gastroenteritis were investigated aboard US Navy aircraft carriers between 1992 and 1997. In these outbreaks, NLVs were identified as the probable cause, and crowding was a major risk factor for transmission. An evaluation of a routine shipboard deployment also suggests that NLVs cause sporadic gastroenteritis. These data indicate that NLV infection is a major cause of acute morbidity in military forces. Because of the limitations of available prevention and control methods, development of a vaccine against these viruses may be the best solution in the military environment.     

南京地区人感染杯状病毒的病原学检测

目的了解南京地区病毒性腹泻患者中杯状病毒的感染情况,明确该地区杯状病毒的主要基因型和分子进化特点。方法收集南京市儿童医院疑似病毒性腹泻粪便标本155例,南京市某三甲医院成人腹泻标本8例,采用RT-PCR方法检测粪便中诺如病毒和札如病毒的多聚酶区核酸片段,并测序以明确基因型,对核苷酸序列使用CLUSTALW和phylip软件分析病毒的分子进化和亲缘关系。结果婴幼儿的155例标本共检出15例杯状病毒阳性,检出率达到9.7%,成人检出5份阳性,与婴幼儿感染的诺如病毒核酸在多聚酶区未发现显著差异,均为GⅡ4型,与GENBANK上序列号为EU074213(苏州)、EU096514、EF200699的毒株有较高的同源性;婴儿腹泻中有一例经核酸序列比对确认为札如病毒感染,为SGⅡ型,与GENBANK上序列号为AF439862的有94%的同源性。结论杯状病毒是本地区病毒性腹泻的重要病原体,感染的该病毒以诺如病毒GⅡ4型为主,与近年多个地区发现的该病毒有较近的亲缘关系。南京地区存在札如病毒感染。     

Detection of norwalk-like virus in shellfish implicated in illness

In the 1990s, Norwalk-like viruses (NLVs) were identified in patient specimens as the primary pathogen associated with shellfish-borne gastroenteritis in the United States. Identification of these viruses from implicated shellfish has been difficult due to inefficient recovery of viruses, natural polymerase chain reaction (PCR) inhibitors in shellfish, and low virus contamination. Recent improvements to the method of detecting NLVs in shellfish include enhanced processing of virus and shellfish samples, application of nested PCR and nucleotide sequencing, and increased knowledge of NLV genetic diversity. Using a newly developed and sensitive method, an NLV G2 strain was identified in 2 oyster samples implicated in a 1998 California outbreak involving 171 cases. NLV capsid primers demonstrated a greater specificity of PCR detection than did polymerase primers. The 175-base viral capsid nucleotide sequences derived from oysters were 100% identical to those derived from a patient stool sample. This finding supports the epidemiologic associations indicating that contaminated shellfish serve as the vehicle for NLV transmission.     

Multi-state outbreaks of acute gastroenteritis traced to fecal-contaminated oysters harvested in Louisiana

Norwalk-like viruses (NLVs), or small round structured viruses, are known to cause acute gastroenteritis associated with eating contaminated shellfish. Between 1993 and 1996, three oyster-related gastroenteritis outbreaks attributed to NLV occurred in Louisiana. Intensive trace-back and environmental investigations revealed that the overboard disposal of sewage by oyster harvesters into oyster-bed waters was the most likely source of contamination in at least two of the outbreaks. The small infectious dose of NLV, the large quantity of virus particles in stool, and the ability of oysters to concentrate virus particles suggest that oyster-related outbreaks will continue unless strong control measures are established. Efforts to halt improper sewage disposal in oyster-harvesting waters, including overboard sewage discharge, must be undertaken if future outbreaks are to be prevented.     

Reduced passive measles immunity in infants of mothers who have not been exposed to measles outbreaks.

Natural measles infection usually confers life-long immunity which is transferred from mothers to their offspring, protecting them from natural measles until the age of about 12 months. Recently, however, natural measles has been observed with increased frequency in infants under the age of 12 months. Natural measles outbreaks in the city of Sapporo have been suppressed by widely applied measles vaccination. Passive measles immunity in 160 neonates (cord blood), born during the last 17 y in Sapporo, Japan was determined by a neutralization (NT) antibody test. The mothers of these infants had had natural measles infection during childhood. Geometric mean titres (GMTs) of cord blood NT antibodies gradually decreased after 1989 and the GMTs of the most recently born infants were significantly lower than those of infants born in the first few years of the study. These observations suggest that even in mothers who experienced natural measles in childhood, recurrent exposure to natural measles is necessary in order to maintain adequate antibody levels for effective passive immunity of their infants.     

Taxonomy of the caliciviruses

The International Committee on Taxonomy of Viruses (ICTV) has recently approved several proposals submitted by the present Caliciviridae Study Group. These proposals include the division of the family into 4 new genera designated Lagovirus, Vesivirus, "Norwalk-like viruses (NLVs), and "Sapporo-like viruses (SLVs); the latter 2 genera were assigned temporary names until acceptable names can be determined by the scientific community. The genera have been further divided into the following species: Feline calicivirus and Vesicular exanthema of swine virus (genus Vesivirus), Rabbit hemorrhagic disease virus and European brown hare syndrome virus (genus Lagovirus), Norwalk virus (genus NLV), and Sapporo virus (genus SLV). In addition, the ICTV approved a proposal to remove the hepatitis E virus from the Caliciviridae into an "unassigned classification status.