Food-Borne Outbreak of Gastroenteritis Associated with Genogroup I Calicivirus

Johansson, Peter; Torvén, Maria; Hammarlund, Ann-Christin; Björne, Ulla; Hedlund, Kjell‐Olof; Svensson, Lennart

doi:10.1128/jcm.40.3.794-798.2002

Cited by 49 publications

(36 citation statements)

References 40 publications

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“…In restaurant J, frozen imported bivalve shellfish was initially suspected as the cause of infection, but no NV was detected in either the shellfish or other food samples. In outbreaks originating from infected food handlers, specific food is not always identified as the main source of the infection (5,12,15). Lopman et al (19) have recently reported that specific vehicles were implicated in 39.1% of NV food-borne outbreaks and that multiple food vehicles contributed to some outbreaks.…”

Section: Discussionmentioning

confidence: 99%

Multiprefectural Spread of Gastroenteritis Outbreaks Attributable to a Single Genogroup II Norovirus Strain from a Tourist Restaurant in Nagasaki, Japan

et al. 2005

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A series of gastroenteritis outbreaks caused by noroviruses (NVs) among tourist groups from several prefectures was associated with eating a lunch prepared by a restaurant in Nagasaki City, Japan, on 18 and 19 November 2003. A retrospective cohort study was performed to estimate the magnitude of the outbreak and identify the source of infection. Epidemiological information was obtained through the local public health centers in the areas where the illness occurred. Stool and vomit specimens and food and environmental samples were analyzed by reverse transcription-PCR with genogroup-specific primers. Positive samples were sequenced and analyzed phylogenetically. Of 1,492 tourists who ate a lunch prepared by the restaurant during the 2-day period, 660 (44.2%) developed illness, with an average incubation time of 31.2 h. Whereas NVs were not detected in any food samples, identical sequences most closely related to the Mexico genotype of genogroup II NV were found in specimens from case patients, restaurant staff, and the kitchen table. Food handlers were concluded to be the source of the outbreak as a result of the contamination of several meals. The series of outbreaks described here exemplifies the role of tourism as a contemporary way to distribute a single infectious agent to multiple and geographically remote areas.

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Section: Discussionmentioning

confidence: 99%

Multiprefectural Spread of Gastroenteritis Outbreaks Attributable to a Single Genogroup II Norovirus Strain from a Tourist Restaurant in Nagasaki, Japan

et al. 2005

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“…This result suggests that the GII/4 strains are an important cause of both outbreaks and sporadic occurrences of gastroenteritis. Noroviruses can be transmitted by the fecal-oral route through person-to-person contact and by food-and waterborne infections (2,3,12). In Japan, oyster-associated gastroenteritis is a major problem, and it is not unusual to detect multiple norovirus genotypes in an oyster-associated outbreak (14).…”

Section: Discussionmentioning

confidence: 99%

“…The prototype strain of human norovirus is the Norwalk virus (NV/Human/US/1968), which was first discovered in an outbreak of gastroenteritis in an elementary school in Norwalk, OH, in 1968 (15). Noroviruses are the leading cause of outbreaks of gastroenteritis in the world; they cause outbreaks in various settings, including hospitals, cruise ships, schools, and restaurants (2,9,12,15,23,24,29). In addition, noroviruses have been detected in environmental samples (e.g., treated and untreated sewage) as well as in contaminated foods such as oysters, shellfish, sandwiches, salads, raspberries, and even ice (7,18,19,26).…”

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Norovirus Infections in Symptomatic and Asymptomatic Food Handlers in Japan

Ozawa¹,

et al. 2007

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Noroviruses are the leading cause of outbreaks of gastroenteritis in the world. At present, norovirus genogroup II, genotype 4 (GII/4), strains are the most prevalent in many countries. In this study we investigated 55 outbreaks and 35 sporadic cases of norovirus-associated gastroenteritis in food handlers in foodcatering settings between 10 November 2005 and 9 December 2006 in Japan. Stool specimens were collected from both symptomatic and asymptomatic individuals and were examined for norovirus by real-time reverse transcription-PCR; the results were then confirmed by sequence analysis. Norovirus was detected in 449 of 2,376 (19%) specimens. Four genogroup I (GI) genotypes and 12 GII genotypes, including one new GII genotype, were detected. The GII/4 sequences were predominant, accounting for 19 of 55 (35%) outbreaks and 16 of 35 (46%) sporadic cases. Our results also showed that a large number of asymptomatic food handlers were infected with norovirus GII/4 strains. Norovirus GII had a slightly higher mean viral load (1 log unit higher) than norovirus GI, i.e., 3.81 ؋ 10 8 versus 2.79 ؋ 10 7 copies/g of stool. Among norovirus GI strains, GI/4 had the highest mean viral load, whereas among GII strains, GII/4 had the highest mean viral load (2.02 ؋ 10 8 and 7.96 ؋ 10 9 copies/g of stool, respectively). Importantly, we found that asymptomatic individuals had mean viral loads similar to those of symptomatic individuals, which may account for the increased number of infections and the predominance of an asymptomatic transmission route.The positive-sense polyadenylated single-stranded RNA virus family Caliciviridae contains four genera: Norovirus, Sapovirus, Lagovirus, and Vesivirus (1). The prototype strain of human norovirus is the Norwalk virus (NV/Human/US/1968), which was first discovered in an outbreak of gastroenteritis in an elementary school in Norwalk, OH, in 1968 (15). Noroviruses are the leading cause of outbreaks of gastroenteritis in the world; they cause outbreaks in various settings, including hospitals, cruise ships, schools, and restaurants (2,9,12,15,23,24,29). In addition, noroviruses have been detected in environmental samples (e.g., treated and untreated sewage) as well as in contaminated foods such as oysters, shellfish, sandwiches, salads, raspberries, and even ice (7,18,19,26). Numerous molecular epidemiological studies have revealed a global distribution of these viruses (25,27,31).The most widely used method of detecting noroviruses is reverse transcription-PCR (RT-PCR), which has high sensitivity; also, the products can be used for further genetic analysis. Real-time RT-PCR assays have also been developed; they are sensitive, broadly reactive, and rapid for the detection of human noroviruses in clinical stool specimens and environmental samples (13,14,21).As the detection methods become more and more sensitive, the numbers of genogroups and genotypes are expected to increase. One emerging characteristic is that strains have been found to persist in one geographical region, only to disapp...

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“…In recent years, caliciviruses have emerged as an important cause of gastroenteritis in all age groups and are now recognized as the main cause of gastroenteritis in nursing homes and hospitals (3,8,12,14,15,27).…”

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Evolution of Human Calicivirus RNA In Vivo:Accumulation of Mutations in the Protruding P2 Domain of the CapsidLeads to Structural Changes and Possibly a NewPhenotype

Nilsson

Hedlund²,

Thorhagen³

et al. 2003

J Virol

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184

158

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In the present study we report on evolution of calicivirus RNA from a patient with chronic diarrhea (i.e., lasting >2 years) and viral shedding. Partial sequencing of open reading frame 1 (ORF1) from 12 consecutive isolates revealed shedding of a genogroup II virus with relatively few nucleotide changes during a 1-year period. The entire capsid gene (ORF2) was also sequenced from the same isolates and found to contain 1,647 nucleotides encoding a protein of 548 amino acids with similarities to the Arg320 and Mx strains. Comparative sequence analysis of ORF2 revealed 32 amino acid changes during the year. It was notable that the vast majority of the cumulative amino acid changes (8 of 11) appeared within residues 279 to 405 located within the hypervariable domain (P2) of the capsid protein and hence were subject to immune pressure. An interesting and novel observation was that the accumulated amino acid changes in the P2 domain resulted in predicted structural changes, including disappearance of a helix structure, and thus a possible emergence of a new phenotype. FUT2 gene polymorphism characterization revealed that the patient is heterozygous at nucleotide 428 and thus Secretor ؉ , a finding in accordance with the hypothesis of FUT2 gene polymorphism and calicivirus susceptibility. To our knowledge, this is the first report of RNA evolution of calicivirus in a single individual, and our data suggest an immunity-driven mechanism for viral evolution. We also report on chronic virus excretion, immunoglobulin treatment, and modification of clinical symptoms; our observations from these studies, together with the FUT2 gene characterization, may lead to a better understanding of calicivirus pathogenesis.Acute diarrheal diseases are common in humans and are associated with significant morbidity worldwide and substantial mortality in developing countries. In recent years, caliciviruses have emerged as an important cause of gastroenteritis in all age groups and are now recognized as the main cause of gastroenteritis in nursing homes and hospitals (3,8,12,14,15,27).Caliciviruses are classified into four genera: norovirus, sapovirus, vesivirus, and logovirus. Human caliciviruses are found within the norovirus and sapovirus genera, which contain a wide range of genetically distinct strains. The sequence heterogeneity of these strains may be a result of the high mutation rate caused by the lack of proofreading of the polymerase. However, the sequence variation has also raised the possibility that calicivirus RNA undergoes constant genetic drift through immune-response-driven mechanisms, leading to the emergence of new strains. However, at present there is no information on human calicivirus mutation rates over time, nor has the importance of immune-response-driven mutations been reported.The clinical features of a calicivirus infection includes an incubation period of 12 to 48 h characterized by acute onset of nausea, vomiting, abdominal cramps and diarrhea that generally lasts for about 48 h. Recent studies have shown, howe...

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Food-Borne Outbreak of Gastroenteritis Associated with Genogroup I Calicivirus

Cited by 49 publications

References 40 publications

Multiprefectural Spread of Gastroenteritis Outbreaks Attributable to a Single Genogroup II Norovirus Strain from a Tourist Restaurant in Nagasaki, Japan

Multiprefectural Spread of Gastroenteritis Outbreaks Attributable to a Single Genogroup II Norovirus Strain from a Tourist Restaurant in Nagasaki, Japan

Norovirus Infections in Symptomatic and Asymptomatic Food Handlers in Japan

Evolution of Human Calicivirus RNA In Vivo:Accumulation of Mutations in the Protruding P2 Domain of the CapsidLeads to Structural Changes and Possibly a NewPhenotype

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