Epidemiology and Genotype Analysis of Emerging Sapovirus-Associated Infections across Europe

Abstract

Sapoviruses (SaVs) belong to the Caliciviridae family and can cause gastroenteritis in humans and swine. Despite extensive testing, human sapoviruses have been found only in sporadic cases and in one mixed outbreak in children between 1994 and 2007 in the Netherlands. Here we describe a change in sapovirus epidemiology in the Netherlands resulting in sapovirus outbreaks and infections in adults. From November 2007 to January 2009, 478 outbreaks of acute gastroenteritis were reported to the National Institute for Public Health and the Environment in the Netherlands as a part of ongoing surveillance. Sapoviruses were found to be the most likely cause of 19 outbreaks (4%). During the same 2-year period, sapovirus infections were reported in Sweden, Slovenia, and Hungary. In the Netherlands, further characterization of outbreak strains showed that 12 (63%) sapovirus outbreaks were caused by genotype I.2 viruses. Most patients were adults older than 60 years (range, 1 to 100 years). Phylogenetic analysis using all presently available SaV sequences showed high homology between genotype I.2 strains detected in different geographical regions (Sweden, Slovenia, Taiwan, Japan, and Russia) since 2007. These first reported outbreaks of sapovirus infections in adults in the Netherlands were remarkable. Detection of identical genotypes in many samples might suggest that these viruses have the same origin, and since the infection is spreading fast, the prevalence of sapovirus infection may be increasing. The incidence of sapovirus infections in these countries suggests that a substantial part of Europe is affected by this virus.

Diverse sapovirus genotypes identified in children hospitalised with gastroenteritis in selected regions of South Africa

“…Genogroup IV has been frequently reported in children as well as adults with gastroenteritis [4,10,32,33] and particularly in SaV-associated outbreaks [7,8,34,35]. The second most prevalent and widely-distributed genotype, GI.2, is also frequently reported in patients with gastroenteritis worldwide [6,8,10,30,31]. Strains from SA shared even higher nucleotide identity (99-100%) with SaVs from other countries, particularly recent strains reported in Asia (2012) [18] and Japan (2003) [5].…”

“…It also suggests stability of the genotype as older strains from 2003 shared high nucleotide identities over the partial capsid gene region to strains as recent as 2012 and 2013. Genogroup IV has been frequently reported in children as well as adults with gastroenteritis [4,10,32,33] and particularly in SaV-associated outbreaks [7,8,34,35]. The second most prevalent and widely-distributed genotype, GI.2, is also frequently reported in patients with gastroenteritis worldwide [6,8,10,30,31].…”

“…The virus is predominantly reported in outbreaks and sporadic cases of gastroenteritis in children [2][3][4][5][6], but has more recently been reported in adult populations [7][8][9][10]. Sapoviruses are small, non-enveloped, single-stranded RNA viruses.…”

Detection and genotyping of human adenovirus and sapovirus in children with acute gastroenteritis in Belém, Pará, between 1990 and 1992: first detection of GI.7 and GV.2 sapoviruses in Brazil

“…A previous study in Belém showed that SaV was detected in 4.9% (15/ SaV GI.1 is known to be the predominant genotype worldwide. In Europe, this genotype was identified as the cause of 11 outbreaks of gastroenteritis; in most of them, the patients were adults older than 60 years 33 . In addition, genotype GII.1 presents a high prevalence compared to other SaV genotypes.…”

Mechanism of Cell Culture Adaptation of an Enteric Calicivirus, the Porcine Sapovirus Cowden Strain

“…SaVs are often associated with sporadic, selflimiting gastroenteritis, the severity of which is reportedly milder than that of NoVs (5,6). However, SaVs also cause outbreaks worldwide (7)(8)(9)(10), and deaths associated with SaV infection have been reported for long-term-care facilities (11).…”