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

Abstract

Noroviruses (NVs) are important causes of nonbacterial gastroenteritis in humans, but the role of NVs as a cause of diseases in the Chinese people, particularly in Chinese military personnel, remains unclear. This study investigated antibody prevalence and factors that associate with the prevalence of antibody to NVs among students attending a military medical university. Serum specimens were tested by an enzyme-linked immunosorbent assay for immunoglobulin G antibody to recombinant capsid antigens of three NVs (rNorwalk, rMxV, and rVA387). Of 588 serum samples tested, the antibody prevalence was 88.9, 54.1, or 90.0% for the three antigens, respectively. There were significant differences in the prevalence of antibody to rMxV between blood types (P < 0.05); the prevalence for type O was the highest (62.5%), and the prevalence for type B was the lowest (49.1%). The average optical density values for antibody to rNorwalk and rMxV were lowest among students with type B. The number of students who did not have antibody to any of the three antigens was the highest for blood type B (6.9%) compared to other blood types (0.8 to 3.4% [P < 0.006]). The antibody prevalence also varied with the hometown residencies of the students before joining the military, with the highest rates for students from rural areas, lower rates for students from small towns or villages, and the lowest rates for students from large cities. The numbers of students who did not have antibody to any of the three antigens were highest for students from the large cities, lower for students from small towns or villages, and lowest for students from rural areas. The distribution of ABO blood types did not differ among the three groups. These data suggest that NVs are prevalent in China and that both genetic and environmental factors play a role in NV infection.

Noroviruses: A comprehensive review

“…63,64 NoV infections occur worldwide and although some studies demonstrated a greater prevalence and younger age of acquisition of antibody among children in developing countries compared with those in industrialized countries, these differences were not consistently observed. 65 Infections with genogroup II NoVs occur more commonly than those with genogroup I NoVs.…”

Comparison of Age-Stratified Seroprevalence of Antibodies against Norovirus GII in India and the United Kingdom

“…A number of factors are known to play a role in the increased prevalence of some infectious diseases in developing countries. These include poor hygiene and sanitation, less access to healthcare, overcrowding as well as socio-cultural differences wherein people in India live in larger family units when compared to developed countries [25]–[28]. Norovirus infections, similar to rotavirus infections, are endemic in infants and children.…”

Norovirus–host interaction: implications for disease control and prevention

“…Eight receptor-binding patterns have been described (Table 1) ( Refs 51,52,53,54,61). The association of NV infection with HBGA types has also been demonstrated by outbreak investigations and antibody prevalence against certain types of NVs ( Refs 62,63,64,65,66). In addition, the HBGAs in human milk were also found to block NVs from binding to their receptors ( Refs 67,68,69,70), suggesting that the milk HBGAs could serve as a potential decoy receptor in the Polymorphism of the human HBGA system…”