Norovirus GII.4 variant 2006b caused epidemics of acute gastroenteritis in Australia during 2007 and 2008 |
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| Affiliation: | 1. School of Biotechnology and Biomolecular Sciences, Faculty of Science, University of New South Wales, Sydney 2052, New South Wales, Australia;2. School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia;3. Virology Division, Department of Microbiology, SEALS, Prince of Wales Hospital, Randwick, New South Wales, Australia;4. Public Health Virology, Queensland Health Scientific Services, Brisbane, Queensland, Australia;5. Victorian Infectious Diseases Reference Laboratory, North Melbourne, Victoria, Australia;6. PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia;7. Communicable Diseases Branch, New South Wales Department of Health, North Sydney, New South Wales, Australia;1. Pediatric Department A, Mother and Child Hospital, Mohammed VI Teaching Hospital, Cadi Ayyad University, Medical School of Marrakesh, Marrakesh, Morocco;2. Pediatric Intensive Care Medicine, Mother and Child Hospital, Mohammed VI Teaching Hospital, Cadi Ayyad University, Medical School of Marrakesh, Marrakesh, Morocco;1. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China;2. Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China;3. Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China;1. Department of Laboratory Medicine, Shanghai First Maternity and Infant Hospital, Tongji University, Shanghai, China;2. Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China;3. Department of Clinical Laboratory, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China;4. Department of Pathogen Diagnosis and Biosafety, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China;5. Department of Infectious Diseases, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China;6. Key Lab of Medical Molecular Virology, School of Basic Medical Science, Shanghai Medical College, Fudan University, Shanghai, China;1. Laboratory of Virology, National Reference Centre for Enteric Viruses, Public Hospital of Dijon, Dijon, France;2. Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA |
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| Abstract: | BackgroundOver the last decade, four epidemics of norovirus-associated gastroenteritis have been reported in Australia. These epidemics were characterized by numerous outbreaks in institutional settings such as hospitals and nursing homes, as well as increases in requests for NoV testing in diagnostic centers. During 2007 and 2008, widespread outbreaks of acute gastroenteritis were once again seen across Australia, peaking during the winter months.ObjectivesThe primary objective of this study was to characterize two winter epidemics of NoV-associated gastroenteritis in 2007 and 2008 in Australia. Following this, we aimed to determine if these epidemics were caused by a new GII.4 variant or a previously circulating NoV strain.Study designNoV-positive fecal samples (n = 219) were collected over a 2-year period, December 2006 to December 2008, from cases of acute gastroenteritis in Australia. NoV RNA was amplified from these samples using a nested RT-PCR approach targeting the 5′ end of the capsid gene, termed region C. Further, characterization was performed by sequence analysis of the RdRp and capsid genes and recombination was identified using SimPlot.ResultsFrom 2004 to 2008, peaks in the numbers of NoV-positive EIA tests from the Prince of Wales Hospital Laboratory correlated with the overall number of gastroenteritis outbreaks reported to NSW Health, thereby supporting recent studies showing that NoV is the major cause of outbreak gastroenteritis. The predominant NoV GII variant identified during the 2007–2008 period was the GII.4 pandemic variant, 2006b (71.51%, 128/179), which replaced the 2006a variant identified in the previous Australian epidemic of 2006. Four novel GII variants were also identified including the three GII.4 variants: NoV 2008, NoV Osaka 2007 and NoV Cairo 2007, and one novel recombinant NoV designated GII.e/GII.12.ConclusionThe increase in acute gastroenteritis outbreaks in 2007 and 2008 were associated with the spread of the NoV GII.4 variant 2006b. |
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