Molecular epidemiology and genetic diversity of norovirus among hospitalized children with acute gastroenteritis in Tianjin, China, 2018–2020

Abstract

Background Norovirus (NoV) is a major cause of viral acute gastroenteritis (AGE) in children worldwide. Epidemiological analysis with respect to the virus strains is limited in China. This study aimed to investigate the prevalence, patterns, and molecular characteristics of NoV infection among children with AGE in China. Methods A total 4848 stool samples were collected from children who were admitted with AGE in Tianjin Children’s Hospital from August 2018 to July 2020. NoV was preliminarily detected using real-time reverse transcription polymerase chain reaction (RT-PCR). Partial sequences of the RNA-dependent RNA polymerase (RdRp) and capsid genes of positive samples were amplified by conventional RT-PCR and then sequenced. The NoV genotype was determined by online Norovirus Typing Tool Version 2.0, and phylogenetic analysis was conducted using MEGA 6.0. Results The prevalence of NoV was 26.4% (1280/4848). NoV was detected in all age groups, with the 7–12 months group having the highest detection rate (655/2014, 32.5%). NoV was detected during most part of the year with higher frequency in winter than other seasons. Based on the genetic analysis of RdRp, GII. Pe was the most predominant genotype detected at 70.7% (381/539) followed by GII.P12 at 25.4% (137/539). GII.4 was the most predominant capsid genotype detected at 65.3% (338/518) followed by GII.3 at 26.8% (139/518). Based on the genetic analysis of RdRp and capsid sequences, the strains were clustered into 10 RdRp–capsid genotypes: GII.Pe-GII.4 Sydney 2012 (65.5%), GII.P12-GII.3 (27.2%), GII.P16-GII.2 (1.8%), GII.P12-GII.2 (0.2%), GII.P17-GII.17 (1.1%), GII.Pe-GII.3 (1.8%), GII.Pe-GII.2 (1.1%), GII.Pe-GII.1 (0.4%), GII.16-GII.4 Sydney 2012 (0.7%), and GII.P7-GII.6 (0.2%). The predominant NoV genotypes changed from GII.Pe-GII.4 Sydney 2012 and GII.P12-GII.3 between August 2018 and July 2019 to GII.Pe-GII.4 Sydney 2012 and GII.P16-GII.2 between August 2019 and July 2020. The patients with GII.Pe-GII.4 Sydney 2012 genotype were more likely to suffer from vomiting symptom than those with GII.P12-GII.3. Conclusions NoV is an important pathogen responsible for viral AGE among children in China. GII.Pe-GII.4 Sydney 2012 and GII.P12-GII.3 were major recombinant genotypes. Knowledge of circulating genotypes and seasonal trends is of great importance for disease prevention and surveillance.

Rotavirus and Norovirus Infections in Children Under 5 Years Old with Acute Gastroenteritis in Southwestern China, 2018–2020

“…Thus, the current study first reported that the overall detection rate of norovirus was 26.1% in children under five years old from 2018 to 2020 in Southwest China. The detection rate was similar to some hospital-based sentinel surveillances for norovirus diarrhea in other regions of China, while was higher than the globally norovirus incidence (about 20%) [ 14 , 18 , 24 ]. Regional differences in norovirus in China are also noteworthy, and norovirus was more prevalent in North China than in South China [ 21 , 24 ].…”

Serological Humoral Immunity Following Natural Infection of Children with High Burden Gastrointestinal Viruses

“…Non-GII.4 genotypes, peak and ebb in prevalence [113,123,140]. GII.3, GII.6, GII.2, GII.12 and GII.17 are frequently detected [123,[141][142][143]. GI.3 is the most frequently detected GI genotype [122,123].…”

“…Capsid genes commonly circulate with interchangeable polymerase types, as recombinant viruses [144]. The difference in virulence between recombinant viruses compared to non-recombinant viruses is under investigation but hampered by the lack of tools for evaluation [141,[145][146][147][148]. Co-infection with other AGE viruses, bacteria and parasites are also common and understudied [137,[149][150][151].…”

Diarrhea: Novel Advances and Future Perspectives in the Etiological Diagnosis and Management

“…Acute diarrheal diseases ranked seventh among the reasons of mortality in LMIC in the international disorder burden collection, 2013, with an envisioned 1. Three million deaths (2 Four %).1 Most of those deaths arise in kids under the age of 5 years in LMIC and diarrhea stays among the top 5 causes of all deaths among children more youthful than age 5 years, as tabulated in 2013 [11][12][13][14][15][16][17][18][19][20].…”