Comprehensive Analysis of a Norovirus-Associated Gastroenteritis Outbreak, from the Environment to the Consumer

Abstract

Noroviruses have been recognized to be the predominant agents of nonbacterial gastroenteritis outbreaks in humans, and their transmission via contaminated shellfish consumption has been demonstrated. Norovirus laboratory experiments, volunteer challenge studies, and community gastroenteritis outbreak investigations have identified human genetic susceptibility factors related to histo-blood group antigen expression. Following a banquet in Brittany, France, in February 2008, gastroenteritis cases were linked to oyster consumption. This study identified an association of the norovirus illnesses with histo-blood group expression, and oyster contamination with norovirus was confirmed by qualitative and quantitative analyses. The secretor phenotype was associated with illness, especially for the non-A subgroup. The study showed that, in addition to accidental climatic events that may lead to oyster contamination, illegal shellfish collection and trading are also risk factors associated with outbreaks.

Comprehensive Review of Human Sapoviruses

“…have also been reported among acute gastroenteritis outbreaks (10,178,230,231,(235)(236)(237)239). Coinfections with different sapovirus strains (i.e., different genogroups/ genotypes) were also identified from oyster/clam-associated gastroenteritis outbreaks (178,236).…”

Genetic Diversity and Histo-Blood Group Antigen Interactions of Rhesus Enteric Caliciviruses

“…Due to the homotypic distribution of HBGAs in the subset of 500 macaques tested, recovirus infection could not be linked to a particular HBGA type, although both type B and type O macaques were infected with recoviruses. Future studies of macaques possessing more-heterogeneous HBGA distribution are needed to determine a potential association between HBGA phenotypes and susceptibility to recovirus infection in a population-based study as described for NoVs (3,23,35).…”

Randomized, Double-Blinded Clinical Trial for Human Norovirus Inactivation in Oysters by High Hydrostatic Pressure Processing

“…Final diluted inoculum aliquots were not quantified by quantitative RT-PCR (qRT-PCR) because they were too close to the qRT-PCR limit of detection for an accurate measure (36). The study team selected a dose of 1.0 ϫ 10 4 GEC for seeding of the oysters because published reports on norovirus contamination of oysters reported genogroup I norovirus contamination ranges of 966 to 1,690 GEC/g of oyster digestive tissue (33,34) and HPP was shown to inactivate 4 logs of murine norovirus (25). The HuNoV inoculum used in this study was tested for infectivity in a pilot study (n ϭ 7) prior to the start of phases 1 to 3.…”