Human Sapovirus among Outpatients with Acute Gastroenteritis in Spain: A One-Year Study

Abstract

Viral agents of human gastroenteritis affect people of all ages across the globe. As a mainly self-limiting disease, it is difficult to evaluate the real prevalence of etiological agents circulating in each region. Many of the analyzed outbreaks are caused by viruses of the family Caliciviridae, especially the genus Norovirus (NoV). Most studies have focused on other enteric viruses, leaving sapovirus (SaV) underestimated as an important emerging human threat. This one-year study analyzed clinical samples from hospital outpatients with acute gastroenteritis in Spain, with the aim of revealing the importance of human SaV as an emerging viral pathogen. A total of 2667 stools were tested using reverse transcription (RT)-qPCR to detect and quantify SaV. Sapovirus was detected in all age groups, especially in infants, children, and the elderly. The prevalence was 15.64% (417/2667), and was slightly higher in 0–2- and 3–5-year-olds (19.53% and 17.95%, respectively) and much lower in 13–18-year-olds (9.86%). Positive samples were detected throughout the year, with peaks of detection during autumn and the late winter to early spring months. The mean value for the quantified samples was 6.5 × 105 genome copies per gram of stool (GC/g) (range 2.4 × 103–6.6 × 1011 GC/g). RT-nested PCR and sequencing were used for further genotyping. Genetic characterization showed a predominance of genogroup I (GI), followed by GII and GIV. The detection of multiple genotypes suggests the circulation of different strains without any clear tendency. The results obtained suggest SaV as the second major gastroenteritis agent after NoV in the region.

Genetic recombination and diversity of sapovirus in pediatric patients with acute gastroenteritis in Thailand, 2010–2018

“…The overall SaV-positive rate reported in the present study during the period 2010 to 2018 (1.6%, ranged from 0 to 2.8%) is more or less the same as other similar studies including Bangladesh (2.7%) (Dey et al, 2007), China (1.9%) (Ren et al, 2013), Vietnam (1.4%) (Trang et al, 2012), and Thailand (1.2 and 1.9%) (Khamrin et al, 2017;Supadej et al, 2019). However, when compared to the studies conducted in different geographical regions, the prevalence of SaV detected in this study was lower than those reported from Japan (4.8%), Philippines (7%), USA (5.4%), Italy (6%), Denmark (8.8%), Finland (9.3%), Spain (15.6%), and Nicaragua (17%) (Biscaro et al, 2018;Bucardo et al, 2014;Chhabra et al, 2013;Oka et al, 2015;Thongprachum et al, 2015;Varela et al, 2019). The variation of SaV prevalence in different studies could be explained, at least in part, by the difference in study locations, the detection methods, and the emergence of new epidemic strains.…”

“…Enteric caliciviruses including noroviruses and sapoviruses are the major causes of AGE of human in all age group worldwide (Khamrin et al, 2017;Lu et al, 2014;Neo et al, 2017;Sala et al, 2014). The detection rate of SaV infection in many countries around the world have been reported with a range from 0.2 to 39% in children and 2.2 to 15.6% in all age groups (Magwalivha et al, 2018;Oka et al, 2015;Varela et al, 2019). In Thailand, the prevalence of SaV was detected between 0% and 15.0% (Kumthip & Khamrin, 2018).…”

“…Sapovirus (SaV) is one of the important pathogens that cause outbreaks and sporadic cases of acute gastroenteritis (AGE) in people of all ages worldwide (Torner et al, 2016). Prevalences of SaV infection have been reported between 0.2% and 39% in children with AGE (Magwalivha et al, 2018) and between 2.2% and 15.6% in all age groups (Oka et al, 2015;Varela et al, 2019). SaV belongs to genus Sapovirus of the Caliciviridae family.…”

Prevalence and genetic diversity of human sapovirus associated with sporadic acute gastroenteritis in South China from 2013 to 2017

“…23 However, high rates of SaV infections more than 10% were reported in Latin America and Spain. 35 For example, SaV could be detected in 17.3% (57 of 330) of diarrheic children in Nicaragua between 2009 and 2010. 31 In Brazil, 18.6% of fecal samples and 36.3% of nasopharyngeal swab samples were detected SaV-positive from 102 hospitalized children with symptoms of acute gastroenteritis.…”

“…In Thailand, only six (0.7%) samples were detected SaV‐positive out of 889 fecal specimens from 2012 to 2014 . However, high rates of SaV infections more than 10% were reported in Latin America and Spain . For example, SaV could be detected in 17.3% (57 of 330) of diarrheic children in Nicaragua between 2009 and 2010 .…”