Prevalence of Norovirus among Visitors from the United States to Mexico and Guatemala Who Experience Traveler's Diarrhea

Abstract

Traveler's diarrhea (TD) is the most common infectious illness acquired by visitors to developing nations. The purpose of this study was to utilize molecular diagnostic techniques to determine the prevalence of norovirus (NoV) in TD occurring among visitors from the United States to Guatemala and Mexico. Stool samples (n ‫؍‬ 54) were collected from 34 TD cases and analyzed for NoV by reverse transcription-PCR and oligoprobe confirmation. The overall prevalence of NoV was 65%. Interestingly, all NoV-positive stool samples were identified as genogroup I NoVs, and time spent at travel destinations was found to be an important factor in determining the frequency of infection (P ‫؍‬ 0.003). Eleven NoV-positive stool samples also tested positive for enterotoxigenic Escherichia coli, indicating that dual infections with this leading bacterial cause of TD were very common. Results of this study suggest that NoV infection is a frequent occurrence among travelers to Mexico and Guatemala who experience episodes of TD. In addition, the simple molecular detection method utilized here will serve to facilitate more in-depth epidemiological studies of this emergent viral pathogen in travelers and other at-risk populations.

Risk factors for symptomatic and asymptomatic norovirus infection in the community

“…This risk has been demonstrated in previous studies [33], and may be attributable to changes in risk behaviours while travelling, or exposure to a different spectrum of norovirus strains. However, recent foreign travel increases the likelihood that an individual with IID due to any pathogen will present to a GP [34] ; the majority of the norovirus cases in this study (73 %) were ascertained after Tables 2 and 3, except a baby in the household for older children and adults and infectious contact variable.…”

Noroviruses as a Cause of Traveler's Diarrhea among Students from the United States Visiting Mexico

“…High rates (Ͼ70%) of coinfections with other bacterial and parasite pathogens were found in the present study, as was the case in a recent study (3). In order to evaluate a causal relationship between NoV and clinical symptoms in a setting of a high rate of coinfection, we used a multivariate regression model, adjusting for infection by a variety of enteric pathogens.…”

Noroviruses as a Cause of Diarrhea in Travelers to Guatemala, India, and Mexico

“…The two reports demonstrated significant but variable prevalence rates of NoV diarrhea of 17% and 65% in persons visiting Mexico or Mexico and Guatemala, respectively. Interestingly, both studies identified GI NoVs as the genogroup most frequently detected (7,16). The present study was designed to compare patterns of prevalence of NoV infection in international travelers with diarrhea acquired in Mexico over several time periods and in different developing regions of the world, including Mexico, Guatemala, and India, and to characterize the symptoms associated with NoV diarrhea.…”