Epidemiology of Norovirus Outbreaks Reported to the Public Health Emergency Event Surveillance System, China, 2014–2017

Lian, Yiyao; Wu, Shuyu; Luo, Li; Lv, Bin; Liao, Qiaohong; Li, Zhongjie; Rainey, Jeanette J.; Hall, Aron J.; Lu, Ran

doi:10.3390/v11040342

Cited by 44 publications

(63 citation statements)

References 36 publications

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“…Hospital-based prospective, community-based retrospective and population-based prospective AGE surveillance found that the incidence of NoVAGE decreased with age from 3 to 24 years. The majority (~80%) of NoVs outbreaks reported to the Chinese Public Health Emergency Event Surveillance System (PHEESS) occurred in older children attending kindergartens, primary schools, and secondary schools [20]. The character of the immunity acquired after NoVs infections remains incompletely understood.…”

Section: Population At Riskmentioning

confidence: 99%

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The epidemiology of norovirus gastroenteritis in China: disease burden and distribution of genotypes

et al. 2019

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With the improvements of sanitation and nationwide safe water supply the occurrence of bacterial diarrhea declined remarkably, while viruses became the leading causes of acute gastroenteritis (AGE). Of these viruses, noroviruses (NoVs) are responsible for a considerable burden of gastroenteritis, especially in children < 2 years and elderly ≥ 65 years. NoVs circulating in the Chinese population are antigenically highly diverse with the genotype GII.4 being the dominant strain followed by GII.3. Given the widespread contamination in environmental sources, and highly infectious nature of NoVs, vaccination would be the desirable strategy for the control of NoV infections. However, a better understanding of acquired immunity after infection, and a reliable immunological surrogate marker are urgently needed, since two vaccine candidates based on virus-like particles (VLPs) are currently moving into clinical evaluations in China.

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Section: Population At Riskmentioning

confidence: 99%

“…The incidence of NoVs infection is remarkably low in the Qinghai-Tibet Plateau located in south-west of China [19], probably related to the low humidity in the region. Similar to sporadic NoV AGE, the majority of outbreaks have occurred in the colder season [8,19,20,23,35].…”

Section: Seasonalitymentioning

confidence: 99%

The epidemiology of norovirus gastroenteritis in China: disease burden and distribution of genotypes

et al. 2019

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“…Since 2004, provincial and local Centers for Disease Control and Prevention (CDCs) in China have been required to report all acute gastroenteritis outbreaks of >20 cases, including those caused by noroviruses, to a passive national outbreak surveillance system called Public Health Emergency Event Surveillance System (PHEESS) (12). Although PHEESS provides useful information, detailed epidemiologic and molecular data from norovirus outbreaks are typically not included.…”

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confidence: 99%

Norovirus Outbreak Surveillance, China, 2016–2018

Jin¹,

Wu²,

Kong³

et al. 2020

Emerg. Infect. Dis.

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H uman noroviruses are the leading cause of outbreaks of acute gastroenteritis, associated with ≈50% of all outbreaks worldwide (1). Norovirus outbreaks are frequently reported in semiclosed institutions, such as hospitals, nursing homes, schools, and childcare centers (2). The virus is primarily transmitted directly from person to person or indirectly through contaminated surfaces, food, or water (1). The relative stability of noroviruses on environmental surfaces makes infection control challenging (3). Several candidate norovirus vaccines are in clinical trials (4). Noroviruses are single-stranded RNA viruses that belong to the genus Norovirus, family Caliciviridae. The genome is organized into 3 open reading frames (ORFs): ORF1 encodes polyprotein, ORF2 encodes the major capsid protein (VP1), and ORF3 encodes the minor (VP2) capsid protein. The viruses are classified into at least 7 genogroups (G), of which viruses from GI, GII, and GIV infect humans (5,6). On the basis of the diversity of VP1, these genogroups can be further divided into at least 33 genotypes: 9 GI, 22 GII, and 2 GIV (7). In addition, on the basis of the diversity of the polymerase region of ORF1, >14 GI polymerase (GI.P) types and 27 GII.P types have been described (7). Because of the frequent recombination at the ORF1/ORF2 junction region, a dual-typing system has been proposed for GI and GII noroviruses (7). Since 2002, genogroup II, genotype 4 (GII.4), noroviruses have been associated with most norovirus outbreaks globally, and new GII.4 variants have emerged every 2-3 years (8). Monitoring the trends in the distribution of the various genotypes and possible association of certain strains with a more severe disease outcome is important for understanding and controlling norovirus epidemics (9). Several norovirus outbreak surveillance networks, including NoroNet (10) and CaliciNet (7,11), have been developed during the past decade. NoroNet captures molecular and epidemiologic data on norovirus outbreaks and sporadic cases submitted by 19 participating countries across Europe and Asia and by Australia. CaliciNet is a norovirus outbreak surveillance network in the United States in which state and local public health laboratories electronically submit laboratory data, including sequences from norovirus outbreaks, to a central database (https://www. cdc.gov/norovirus/reporting/calicinet/data.html). CaliciNet data are integrated with epidemiologic data

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“…GI and GII noroviruses are the most important viral cause of non-bacterial gastroenteritis in humans globally. A large proportion of the population is infected with noroviruses via contact with contaminated food, water, and environment every year [17,18,26] 13[P13] genotypes are still evolving and spreading at a lower rate. Although these genotypes might infect humans only sporadically, it is still useful to study the genetic diversity of these norovirus genotypes.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the high frequency of genetic recombination at the ORF1 and ORF2 junction, a number of recombinant strains have emerged under natural selection [1,17,18]. The emerging virus can replace the old ones and cause new infections and outbreaks every two to four years, as has been observed with GII.…”

Section: Introductionmentioning

confidence: 99%

Full-genome sequences of GII.13[P21] recombinant norovirus strains from an outbreak in Changsha, China

et al. 2020

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On 31 March 2019, 68 school students suffered from vomiting, diarrhea, and abdominal pain after participating in a group activity at a commercial park. In this outbreak, multiple norovirus genotypes were observed, including GII.2[P16], GII.17[P17], and GII.13[P21]. Further, we determined the full-genome sequences of two strains of GII.13[P21] recombinant noroviruses, which were 7434 nt long. Phylogenetic analysis based on open reading frames (ORFs) 1 and 2 revealed that these recombinants were related to stains of different genotypes from different countries. The full genome nucleotide sequences of the two isolates were 97.0% and 98.0% identical to those of strains from London and Thailand, respectively. Simplot analysis revealed the presence of a break point at nt 5059 in the ORF1 region. The histo-blood group antigen binding sites were conserved in both recombinant viruses. Our findings not only provide valuable genetic information about a recombinant norovirus but also contribute to our general understanding of the evolution, genetic diversity, and distribution of noroviruses.

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Epidemiology of Norovirus Outbreaks Reported to the Public Health Emergency Event Surveillance System, China, 2014–2017

Cited by 44 publications

References 36 publications

The epidemiology of norovirus gastroenteritis in China: disease burden and distribution of genotypes

The epidemiology of norovirus gastroenteritis in China: disease burden and distribution of genotypes

Norovirus Outbreak Surveillance, China, 2016–2018

Full-genome sequences of GII.13[P21] recombinant norovirus strains from an outbreak in Changsha, China

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