Clinical and Epidemiologic Characteristics of Norovirus GII.4 Sydney during Winter 2012–13 in Beijing, China following Its Global Emergence

Mai, Huan; Jin, Miao; Guo, Xiao; Liu, Jian; Liu, Ning; Xu, Cong; Gao, Yan; Wei, Lai

doi:10.1371/journal.pone.0071483

Cited by 23 publications

(22 citation statements)

References 20 publications

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“…Globally, GII.4 Sydney was first reported in Australia in March 2012; in China, it was first reported in Guangdong province in July 2012 (2) and then spread to many other provinces in China (8)(9)(10)(11). Data from August 2012-April 2013 monitored by the U.S. Centers for Disease Control and Prevention indicated that compared with other norovirus strains, GII.4 Sydney outbreaks disproportionally affected older persons, consistent with the observed predilection toward long-term care facilities (12).…”

Section: Discussionmentioning

confidence: 99%

“…Patients affected by GII.4 Sydney were more likely to have diarrheal illness and less likely to have vomiting, fever, and abdominal cramps. The surveillance data for diarrhea from October 2012 to March 2013 monitored by Peking University People's Hospital, a teaching hospital affiliated with Beijing University, showed that GII.4 Sydney caused severe fever, abdominal pain, and a higher frequency of diarrhea clinically compared with other norovirus infections (11). In the Shenzhen outbreak, the attack rates in the elderly and the staff were 15.9z and 23.2z, respectively, and the occurrence rates of bellyache and diarrhea were 86.5z and 67.6z, respectively; however, the occurrence rate of fever was only 2.7z.…”

Section: Discussionmentioning

confidence: 99%

“…Data from these countries indicated that this increase was associated with the emergence of a new variant of GII.4 named GII.4 Sydney (4-7). The surveillance data for diarrhea in China have shown that since late 2012, GII.4 Sydney gradually became the predominant strain and induced outbreaks in many provinces (2,(8)(9)(10)(11). In December 2012, an outbreak induced by GII.…”

Section: Introductionmentioning

confidence: 99%

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Epidemiological Investigation of a Norovirus GII.4 Sydney Outbreak in a China Elder Care Facility

et al. 2015

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SUMMARY: An outbreak of norovirus GII.4/Sydney_2012 affected a China elder care facility in December 2012. A total of 39 elderly people and staff met the outbreak case definition. The attack rates in the elderly and the staff were 15.9z (31/195) and 23.2z (19/82), respectively, including 13 asymptomatic cases in the staff. The result of gene sequencing revealed that the outbreak was caused by norovirus GII.4 Sydney. The mode of transmission of this outbreak was proven to be person-to-person. The first case (a self-cared elder) was affected outside the elder care facility and was not isolated after returning. Norovirus was transmitted via close contact among the self-cared elderly. Then, through servicerelated close contact, the attendants promoted the cross-transmission between the self-cared elderly and the nursed elderly. The virus was also spread among the staff via daily contact. In the elder care facility, the asymptomatic cases in the attendants played an important role in the transmission of norovirus, which deserves high attention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Epidemiological Investigation of a Norovirus GII.4 Sydney Outbreak in a China Elder Care Facility

et al. 2015

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“…A norovirus GI.1 monovalent VLP vaccine protected against illness and infection following challenge with homologous GI.1 Norwalk virus [11], prompting development of a bivalent GI.1/GII.4 VLP vaccine [12], as these 2 genogroups account for the majority of norovirus outbreaks [13–17]. The GII.4 component is a consensus VLP derived from 3 naturally occurring GII.4 variants that induced broadly reactive antibody responses in animal studies and may induce a multivalent response against different genotypes [12].…”

mentioning

confidence: 99%

Norovirus Vaccine Against Experimental Human GII.4 Virus Illness: A Challenge Study in Healthy Adults

Bernstein

Atmar

Lyon

et al. 2014

Journal of Infectious Diseases

234

186

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Background Vaccines against norovirus, the leading cause of acute gastroenteritis, should protect against medically significant illness and reduce transmission. Methods In this randomized, double-blind, placebo-controlled trial, 18- to 50-year-olds received 2 injections of placebo or norovirus GI.1/GII.4 bivalent vaccine-like particle (VLP) vaccine with 3-O-desacyl-4′-monophosphoryl lipid A (MPL) and alum. Participants were challenged as inpatients with GII.4 virus (4400 reverse transcription polymerase chain reaction [RT-PCR] units), and monitored for illness and infection. Results Per protocol, 27 of 50 (54.0%) vaccinees and 30 of 48 (62.5%) controls were infected. Using predefined illness and infection definitions, vaccination did not meet the primary endpoint, but self-reported cases of severe (0% vaccinees vs 8.3% controls; P = .054), moderate or greater (6.0% vs 18.8%; P = .068), and mild or greater severity of vomiting and/or diarrhea (20.0% vs 37.5%; P = .074) were less frequent. Vaccination also reduced the modified Vesikari score from 7.3 to 4.5 (P = .002). Difficulties encountered were low norovirus disease rate, and inability to define illness by quantitative RT-PCR or further antibody rise in vaccinees due to high vaccine-induced titers. By day 10, 11 of 49 (22.4%) vaccinees were shedding virus compared with 17 of 47 (36.2%) placebo recipients (P = .179). Conclusions Bivalent norovirus VLP vaccine reduced norovirus-related vomiting and/or diarrhea; field efficacy studies are planned. Clinical Trials Registration NCT01609257.

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“…The most prevalent genotypes detected were still norovirus GII, accounting for 89.9% of identified strains [18] . Twenty-two of the 26 (84.6%) identified NoV strains clustered into GII.4 Sydney [19] , which causes severe fever, abdominal pain and higher diarrhea frequency clinically compared to other NoV infections, following its global emer--gency.…”

Section: Introductionmentioning

confidence: 99%

Norovirus, the Next Target for Vaccine Development in China

Du¹,

Guo²

2017

J. Appl. Virol.

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Enteric virus-induced disease, even death, greatly affects the life quality of children <5 years of age in China, and imposes a heavy sociometric burden on family and government. The infectious diarrhea diseases and hand-foot-mouth disease (HFMD) have been enrolled in the list of notifiable infectious diseases in China. Fortunately, the highly valued rotavirus-induced diarrhea and enterovirus 71-induced HFMD can be prevented by the commercial vaccines. However, the underrated norovirus vaccine is still in progress, even norovirus was considered as the leading cause of acute gastroenteritis in children <5 years of age in the world, partially due to the inability to cultivate norovirus. Besides, the broad genetic and serotypic diversity of norovirus also complicates selection of candidate vaccine strain(s). Therefore, the primary objective of this article is to review norovirus epidemics in China recur to the data published in recent five years.

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Clinical and Epidemiologic Characteristics of Norovirus GII.4 Sydney during Winter 2012–13 in Beijing, China following Its Global Emergence

Cited by 23 publications

References 20 publications

Epidemiological Investigation of a Norovirus GII.4 Sydney Outbreak in a China Elder Care Facility

Epidemiological Investigation of a Norovirus GII.4 Sydney Outbreak in a China Elder Care Facility

Norovirus Vaccine Against Experimental Human GII.4 Virus Illness: A Challenge Study in Healthy Adults

Norovirus, the Next Target for Vaccine Development in China

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