Transmission of Norwalk Virus during a Football Game

Becker, Karen; Moe, Christine L.; Southwick, K; MacCormack, J N

doi:10.1056/nejm200010263431704

Cited by 111 publications

(57 citation statements)

References 17 publications

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“…The prechallenge immune status and response in terms of serum antibody titers, virus shedding, and clinical symptoms in all volunteers have been determined and will be described in more detail elsewhere. The NCFL viral strain was obtained from a specimen from a recent NLV outbreak that occurred during a football game in North Carolina (4).…”

Section: Virus and Cellsmentioning

confidence: 99%

“…Due to extensive sequence and antigenic variation among NLVs, an effective vaccine regimen should provide cross-protective immunity to a variety of GI and GII NLV strains. To test heterotypic immune induction, we determined whether serum from mice immunized with VRP-NV1 could cross-react with the capsid protein from NCFL, a heterotypic GI NLV strain isolated and characterized from a recent outbreak (4). BHK cells were transfected with RNA transcripts of a VEE replicon expressing the NCFL capsid and seeded onto slides.…”

Section: Systemic and Mucosal Immune Responses After Inoculation Withmentioning

confidence: 99%

See 1 more Smart Citation

Systemic, Mucosal, and Heterotypic Immune Induction in Mice Inoculated with Venezuelan Equine Encephalitis Replicons Expressing Norwalk Virus-Like Particles

Harrington¹,

Yount

Johnston³

et al. 2002

J Virol

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Norwalk-like viruses (NLVs) are a diverse group of single-stranded, nonenveloped, positive-polarity RNA viruses and are the leading cause of epidemic acute gastroenteritis in the United States. In this study, the major capsid gene of Norwalk virus, the prototype NLV, has been cloned and expressed in mammalian cells using a Venezuelan equine encephalitis (VEE) replicon expression system. Upon infection of baby hamster kidney (BHK) cells with VEE replicon particles (VRPs), the Norwalk virus capsid proteins self-assemble to generate high titers of Norwalk virus-like particles (VLPs) that are morphologically and antigenically analogous to wild-type Norwalk virus. Mice inoculated subcutaneously with VRPs expressing the Norwalk virus capsid protein (VRP-NV1) developed systemic and mucosal immune responses to Norwalk VLPs, as well as heterotypic antibody responses to the major capsid protein from another genogroup I NLV strain (NCFL) isolated from a recent outbreak. A second Norwalk virus capsid clone (NV2) containing three amino acid codon mutations from the NV1 clone was also expressed using VEE replicons (VRP-NV2), but upon infection of BHK cells failed to confer VLP self-assembly. Mice inoculated with VRP-NV2 elicited reduced systemic and mucosal immune responses to Norwalk VLPs, demonstrating the importance and potential utility of endogenous VLP presentation for maximum immune induction. Inoculation with either VRP-NV1 or VRP-NV2 resulted in serum antibody responses far superior to the induction in mice dosed orally with VLPs that were prepared using the VEE-NV1 replicon construct, a regimen similar to current models for NLV vaccination. Expression of NLV VLPs in mammalian cells offers a powerful approach for the design of novel NLV vaccines, either alone or in combination with current vaccination models.Norwalk-like viruses (NLVs) are the most frequent cause of epidemic gastroenteritis in the United States, infecting an estimated 23 million people each year, and have accounted for as much as 96% of selected outbreaks of acute, nonbacterial gastroenteritis (20,40,47). Persons of all ages are affected, and it is unclear whether infection typically confers long-term immunity (38). NLV outbreaks commonly occur within families, nursing homes, day care centers, schools, hospitals, and in the military (1,20,40,42). Infection with NLVs usually results in an episode of acute, self-limited gastroenteritis, with symptoms rarely more serious than nausea, vomiting, diarrhea, and lowgrade fever (40), and most outbreaks are likely not reported (47). However, using refined molecular detection methodologies, recent studies have extended the public health significance of NLV infections and suggest that NLVs are a common cause of severe diarrhea in children (22,53). Although further studies are necessary, NLVs may cause as much as 20% of endemic diarrheal disease in family settings in developed countries (42).The mortality attributable to NLV infection remains unclear, but fatalities among infected elderly may not be uncommon. It ...

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Section: Virus and Cellsmentioning

confidence: 99%

Section: Systemic and Mucosal Immune Responses After Inoculation Withmentioning

confidence: 99%

Systemic, Mucosal, and Heterotypic Immune Induction in Mice Inoculated with Venezuelan Equine Encephalitis Replicons Expressing Norwalk Virus-Like Particles

Harrington¹,

Yount

Johnston³

et al. 2002

J Virol

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“…Such outbreaks have been reported in a variety of settings including cruise ships, schools and universities, nursing homes, hospitals, restaurants, and events with catered meals (reviewed in Hutson et al [2004]). Transmission of NoV occurs via ingestion of faecal-contaminated food and water, exposure to contaminated fomites, aerosolized vomitus, direct person-to-person contact, and transplanted organs [Baron et al, 1982;Kuritsky et al, 1984;Lawson et al, 1991;Becker et al, 2000;Berg et al, 2000;Marks et al, 2000;Long et al, 2002;Kaufman et al, 2003;Nilsson et al, 2003]. Because of NoV's high transmissibility, high infectivity, and serious public health and economic impact, NoVs are classified by the Centers for Disease Control and Prevention (CDC) and National Institute of Allergy and Infectious Diseases as Bioterrorism Category B Priority Pathogens [Centers for Disease Control and Prevention, 2006;NIAID, 2006].…”

Section: Introductionmentioning

confidence: 99%

Molecular epidemiology of norovirus gastroenteritis outbreaks in North Carolina, United States: 1995–2000

Tseng

León

MacCormack

et al. 2006

Journal of Medical Virology

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Noroviruses (NoVs) are the most common cause of acute non-bacterial gastroenteritis outbreaks in the US. We investigated 16 gastroenteritis outbreaks in North Carolina (NC), from 1995 to 2000, to further characterize the epidemiology of NoV using RT-PCR on stool and ELISA on sera. NoV were identified in 14 outbreaks by RT-PCR. Sequence analyses of the amplicons indicated the outbreak strains belonged to the following clusters: five GII/4, three GI/3, one GI/4, one GII/2, one GII/5, one GII/7, and one GII/13 (prototype strain). We detected NoV in stool samples from one outbreak but could not determine its specific cluster within the GII genogroup based on polymerase sequence analysis. The five GII/4 strains were classified as the "95/96 US common strain" and occurred throughout the 5-year period. In contrast to national trends, the majority (86%) of NoV outbreaks identified in North Carolina were foodborne. Of the 12 food-related NoV outbreaks, we were able to document transmission by food handlers in two outbreaks. Person-to-person transmission from primary cases was suggested in three outbreaks. Our results indicate that NoVs are important agents of viral gastroenteritis outbreaks in NC.

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“…They are the most important viral agents responsible for human gastroenteritis worldwide, and their role in causing enteric disease among different animals has been increasingly recognized (1,4). Transmission of NoVs can occur through various routes, including food, environment, and personal contact (2), resulting in gastroenteritis outbreaks as well as sporadic cases in non-outbreak settings (3).…”

mentioning

confidence: 99%

Complete Genome Sequences of Novel Rat Noroviruses in Hong Kong

Tse

Chan

Lau

et al. 2012

J Virol

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We report two genome sequences of novel noroviruses isolated from fecal swab specimens of brown rats in Hong Kong. The complete genome is approximately 7.5 kb in length and consists of 3 overlapping open reading frames encoding ORF1 polyprotein, VP1, and VP2, respectively. Sequence analysis suggested that these noroviruses should be classified in genogroup V, but they are distinct from other known rodent noroviruses and represent a novel cluster within the genogroup.

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Transmission of Norwalk Virus during a Football Game

Abstract: This investigation documents person-to-person transmission of Norwalk virus among players during a football game. Persons with acute gastroenteritis should be excluded from playing contact sports.

Cited by 111 publications

References 17 publications

Systemic, Mucosal, and Heterotypic Immune Induction in Mice Inoculated with Venezuelan Equine Encephalitis Replicons Expressing Norwalk Virus-Like Particles

Systemic, Mucosal, and Heterotypic Immune Induction in Mice Inoculated with Venezuelan Equine Encephalitis Replicons Expressing Norwalk Virus-Like Particles

Molecular epidemiology of norovirus gastroenteritis outbreaks in North Carolina, United States: 1995–2000

Complete Genome Sequences of Novel Rat Noroviruses in Hong Kong

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