Detection of Norwalk-Like Virus Infection Aboard Two

Abstract

Two U.S. Navy ships experienced outbreaks of gastroenteritis following port visits to Southeast Asia during August to September 1999. The USS Peleliu (LHA 5) had 162 (6% attack rate) medical visits and the USS Constellation (CV 64) had 425 medical visits (9% attack rate). Navy Environmental and Preventive Medicine Unit No. 5 personnel conducted on-board molecular diagnostic assays to presumptively detect the presence of genogroup I Norwalk-like viruses (NLV) in both outbreaks. NLV RNA were detected in 4 (80%) of 5 Peleliu stool specimens and in 9 (36%) of 25 from the Constellation. Significant antibody titer rises to NLV antigens were measured in 18 (62%) of 29 Peleliu and 69 (68%) of 102 Constellation cases, but only in 1 (4%) of 28 asymptomatic controls. All environmental swipes were negative for NLV. Stools yielded no bacterial or parasitic enteropathogens. No point source was found for either ship. The on-site laboratory investigation can provide important information for outbreak control and prevention while new cases are still presenting.

Homologous versus Heterologous Immune Responses to Norwalk‐Like Viruses among Crew Members after Acute Gastroenteritis Outbreaks on 2 US Navy Vessels

“…These 2 clusters are found circulating in other parts of the world [22][23][24][25][26]. Additional indicators that NLVs caused these outbreaks include the significantly higher antibody responses to NLVs, particularly to GI NLVs, among sick crew members, compared with the nonsick control subjects, and the high attack rates of diseases among embarked crew members in certain Marine units [16].…”

“…Detailed information about the outbreaks and onboard investigations is given elsewhere [16]. In brief, in 1999, we initiated a project to study HuCV-associated acute gastroenteritis outbreaks in US Navy ships in the Pacific Ocean.…”

“…The Constellation made August port visits to Singapore and Port Kelang, Malaysia, where the outbreak began. The Peleliu outbreak consisted of 162 cases (attack rate, 5.7%), and the Constellation outbreak consisted of 425 cases (attack rate, 9.5%) (figure 1) [16].…”

Seroprevalence of Antibodies against Noroviruses among Students in a Chinese Military Medical University

“…Such outbreaks can occur in a variety of settings, affecting all ages, including child care centers, schools, restaurants, summer camps, hospitals, nursing homes, cruise ships, and military settings. NV outbreaks have been a serious problem in nursing homes for the elderly (3,10,21), on board large commercial cruise ships (11,30), and in military camps and battleships during deployment and wartime (1,2,15,36).…”

Norovirus and cruise ships

“…The combination of these properties allows norovirus to survive in external environments for long periods. The virus often attacks in closed or semi-closed environments such as cruise ships, nursing homes, childcare centres and hospitals 11,12 .…”