Using Molecular Epidemiology To Trace Transmission of Nosocomial Norovirus Infection

Sukhrie, Faizel H. A.; Beersma, Matthias F. C.; Wong, Albert; Veer, Bas van der; Vennema, Harry; Bogerman, Jolanda

doi:10.1128/jcm.01443-10

Cited by 49 publications

(40 citation statements)

References 26 publications

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“…Although NoV GII.17 seems to be prevalent in some parts of Africa this genotype was not identified in clinical specimens (Silva et al 2008;Abugalia et al 2011;Hassine-Zaafrane et al 2013;Huynen et al 2013;) and environmental samples (Sdiri-Loulizi et al 2010) from many other African regions and the GII.17 predominance appears to be peculiar to Kenya. Norovirus GII.17 is of clinical relevance as it has been implicated in nosocomial NoV infection (Sukhrie et al 2011) and chronic NoV infection in a kidney transplant patient (Schorn et al 2010). The genotype has also been widely reported in children with gastroenteritis in Central and South America (Bucardo et al 2009;Ferreira et al 2012;Gomes et al 2008), Korea (Park et al 2011) and Thailand (Kittigul et al 2010).…”

Section: Discussionmentioning

confidence: 99%

Norovirus GII.17 Predominates in Selected Surface Water Sources in Kenya

et al. 2014

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In this study the prevalence and genotypes of NoVs in selected water sources from rural, urban and refugee settings in Kenya was investigated. Ten liters each of river, household and borehole water were collected in rural (Mboone river), urban (Nairobi and Mutoine river), and refugee (Dadaab refugee camp) settings. Noroviruses were recovered from the water samples by a glass wool adsorption-elution technique and/or PEG/NaCl precipitation.Nucleic acid was extracted using the automated MagNA Pure platform. Noroviruses were detected with singleplex real-time reverse transcription-polymerase chain reaction assays and characterised by nucleotide sequence analysis. Noroviruses were detected in 63% (25/40) of the selected water samples comprising GII (42.5%), GI (2.5%) and mixed GI/GII (17.5%) positive samples. The prevalence of NoVs in the Mutoine river (urban area) was higher than in the Mboone river (rural area) (P=0.0013). Norovirus GI.1, GI.3, GI.9, GII.4, GII.6, GII.12, GII.16 and GII.17 were identified, with GII.17 accounting for 76% (16/21) of the typed strains. The NoV GII.17 predominance differs to other studies in Africa and further surveillance of NoVs in clinical and environmental settings is required to clarify/elucidate this observation. As information regarding NoVs in Kenyan water sources is limited this report provides valuable new data on NoV genotypes circulating in environmental water sources and the surrounding communities in Kenya.

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Section: Discussionmentioning

confidence: 99%

Norovirus GII.17 Predominates in Selected Surface Water Sources in Kenya

et al. 2014

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“…This complex pattern of strain coexistence again contrasts with the case for the noroviruses, for which individual genotypes predominate in any given season. Most notably, genotype II.4 has comprised 44% of 773 norovirus outbreaks in the United States over a 12-year period (1994 to 2006), with 51 to 85% of recent outbreaks being associated with GII.4 (46,48,53). The national and international epidemiological dominance of genotype II.4 has been attributed to a higher error rate of its viral RNA polymerase and an associated higher rate of evolution within the virus capsid (2).…”

Section: Discussionmentioning

confidence: 99%

Large-Scale Spatial and Temporal Genetic Diversity of Feline Calicivirus

Coyne

Christley

Pybus

et al. 2012

J Virol

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Feline calicivirus (FCV) is an important pathogen of domestic cats and a frequently used model of human caliciviruses. Here we use an epidemiologically rigorous sampling framework to describe for the first time the phylodynamics of a calicivirus at regional and national scales. A large number of FCV strains cocirculated in the United Kingdom at the national and community levels, with no strain comprising more than 5% and 14% of these populations, respectively. The majority of strains exhibited a relatively restricted geographical range, with only two strains (one field virus and one vaccine virus) spreading further than 100 km. None of the field strains were identified outside the United Kingdom. Temporally, while some strains persisted locally for the majority of the study, others may have become locally extinct. Evolutionary analysis revealed a radial phylogeny with little bootstrap support for nodes above the strain level. In most cases, spatially and temporally diverse strains intermingled in the phylogeny. Together, these data suggest that current FCV evolution is not associated with selective competition among strains. Rather, the genetic and antigenic landscape in each geographical location is highly complex, with many strains cocirculating. These variants likely exist at the community level by a combination of de novo evolution and occasional gene flow from the wider national population. This complexity provides a benchmark, for the first time, against which vaccine cross-protection at both local and national levels can be judged.

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“…Furthermore, we did not address undiagnosed NoV infections among hospital personnel, although recent studies have indicated that infected personnel can play an important role in the NoV transmission chain (16). Hence, appropriate collection and testing in both patients and personnel will be required for developing new evidence-based strategies to prevent the introduction and spread of NoV (20).…”

Section: Discussionmentioning

confidence: 99%

“…cDNA was amplified by a seminested PCR, and subsequently, region A of the polymerase gene was sequenced using the ABI-Prism BigDye Terminator v3.0 ready reaction cycle kit (ABI Prism 7700 sequence detection system; Applied Biosystems, Foster City, CA) as described previously (20). Sequences were assembled in BioNumerics (Applied Maths, Sint-Martens-Latem, Belgium, software package 6.6.4), evaluated manually for their quality by looking for the number of ambiguities, errors, mismatches, and deletions, and genotyped with an NoV-genotyping tool (http://www.rivm.nl/mpf/norovirus /typingtool) (13).…”

Section: Methodsmentioning

confidence: 99%

Unrecognized Norovirus Infections in Health Care Institutions and Their Clinical Impact

Beersma

Sukhrie²,

Bogerman³

et al. 2012

J Clin Microbiol

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e Noroviruses (NoVs) have emerged as the leading cause of acute viral gastroenteritis (GE) in humans. Although diagnostic facilities have greatly improved, significant underdiagnosis of NoV in hospitals may still occur, thereby increasing clinical burden and nosocomial spread. We evaluated the underdiagnosis of sporadic NoV infections in a tertiary care hospital and estimated its clinical impact. From December 2008 until July 2009, fecal samples specifically referred for bacterial but not viral examination were retrospectively tested for NoV by real-time PCR. The clinical and virological data from patients with undiagnosed NoV infection (missed patients) were evaluated and compared with those from patients with recognized NoV. During the study period, 45 patients with undiagnosed NoV were detected, whereas 50 patients were regularly diagnosed. The missed NoV cases were more frequently adults than children (80% versus 46%; P < 0.001). The viral load levels did not differ between the diagnosed and missed patients, but missed patients more frequently presented without diarrhea (20% versus 4%; P < 0.07). The newly admitted missed NoV cases with GE underwent more diagnostic imaging (24% versus 4%; P < 0.01) and tended to be hospitalized longer. When missed-NoV patients were included, the number of nosocomial clusters doubled and missed patients were index cases in 5 of the 6 clusters. These data indicate that NoV infections are frequently missed despite routine laboratory testing and demonstrate that underdiagnosis of NoV patients is associated with costly abdominal imaging and nosocomial clustering. Awareness of NoV infection in adult patients and education about the importance of viral GE should be increased. N oroviruses (NoVs) have emerged as the one of the most important pathogens causing acute gastroenteritis (GE) in children and adults (8,12). Nursing homes and hospitals are widely confronted with NoV outbreaks. Additionally, isolated (sporadic) cases of NoV frequently occur, but their incidence and clinical impact in hospitals have not been studied systematically (2, 17). Sporadic cases of NoV may result both from community-acquired infections in newly admitted patients and from nosocomial transmissions between patients, personnel, or visitors (9). Although sensitive commercial and homemade diagnostic assays for NoV have become widely available, sporadic NoV infections in hospitalized patients remain underdiagnosed, increasing the clinical burden and potential for nosocomial spread (1, 3, 21). Underrecognition of NoV may result in the individual patient undergoing more diagnostic procedures and may increase the influx of infectious patients into hospital wards, where they may trigger outbreaks (5, 14). Underdiagnosis of NoV may result from a referral bias, as well as from suboptimal laboratory facilities and inadequate specimen collection. This bias may occur when physicians selectively refer GE patients for bacteriological or parasitological testing but not virological testing. In the present study, we prosp...

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Using Molecular Epidemiology To Trace Transmission of Nosocomial Norovirus Infection

Cited by 49 publications

References 26 publications

Norovirus GII.17 Predominates in Selected Surface Water Sources in Kenya

Norovirus GII.17 Predominates in Selected Surface Water Sources in Kenya

Large-Scale Spatial and Temporal Genetic Diversity of Feline Calicivirus

Unrecognized Norovirus Infections in Health Care Institutions and Their Clinical Impact

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