Multiple Outbreaks of Gastroenteritis Due to a Single Strain of Genotype GII/4 Norovirus in Kobe, Japan, 2006: Risk Factors for Norovirus Spread in Health Care Settings

Iijima, Yoshio; Tanaka, Shinobu; Ohishi, Hideaki

doi:10.7883/yoken.jjid.2008.419

Jpn J Infect Dis

2008

DOI: 10.7883/yoken.jjid.2008.419

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Multiple Outbreaks of Gastroenteritis Due to a Single Strain of Genotype GII/4 Norovirus in Kobe, Japan, 2006: Risk Factors for Norovirus Spread in Health Care Settings

Yoshio Iijima¹,

Shinobu Tanaka²,

Hideaki Ohishi³

Abstract: A large number of gastroenteritis outbreaks due to a norovirus GII/4 strain and its variants occurred during November and December 2006 in Kobe, Japan. Of the 118 outbreaks, 6 were foodborne and 112 were caused by person-to-person transmission in healthcare settings such as nursing homes and hospitals. The distribution of norovirus outbreaks in healthcare settings was skewed, particularly in the south coastal area. Moreover, several outbreaks occurred within 1 km 2 in various areas. Outbreaks in neighboring se… Show more

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Cited by 10 publications

References 21 publications

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Isolated norovirus GII.7 strain within an extended GII.4 outbreak

Hoffmann

Seebach

Foley³

et al. 2010

Journal of Medical Virology

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Noroviruses are a major cause of viral gastroenteritis and have been detected with increasing prevalence in recent years. Currently, two main genogroups GI and GII with an increasing number of subtypes are differentiated. Because of a high genetic variability new variants emerge constantly allowing epidemiological tracing of viruses from year to year and location to location. A 282 bp sequence at the 5'end of the capsid gene was analyzed in isolates originating from the University hospital, Technische Universität München. Phylogenetic analysis was based on 20 GII positive samples from an outbreak in March/April 2006 and 8 samples from the following winter season 2006-2008. In the initial outbreak two distinct genotypes were identified. The GII.4 strain 2006a found in the majority of outbreaks in 2006 worldwide was isolated from all but two patients. These two individuals were infected with a GII.7 strain clustering mainly with isolates from Asia. Of note, they excreted noroviral RNA for 81 and 27 days, respectively. Longitudinal analysis of an extended 1381 bp sequence revealed positive selection in the P2 domain. The variant was very similar to GII.7 strains isolated in 1990 and 1994 suggesting slow evolution with evidence of recombination according to the SimPlot analysis. Strains found in the following years 2006-2008 clustered around the isolate GII.4 2006b, characterized in the spring of 2006 and reaching a high prevalence in 2006-2007. The results provide an insight into norovirus evolution at a University hospital over 3 years and describe intraindividual evolution within a patient infected chronically.

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Isolated norovirus GII.7 strain within an extended GII.4 outbreak

Hoffmann

Seebach

Foley³

et al. 2010

Journal of Medical Virology

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Epidemiology of gastroenteritis viruses in Japan: Prevalence, seasonality, and outbreak

Thongprachum

Khamrin

Maneekarn

et al. 2015

Journal of Medical Virology

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Acute gastroenteritis has been recognized as one of the most common diseases in humans and continues to be a major public health problem worldwide. Several groups of viruses have been reported as the causative agents of acute gastroenteritis, including rotavirus, norovirus, sapovirus, human astrovirus, adenovirus, and an increasing number of others which have been reported more recently. The epidemiology, prevalence, seasonality, and outbreaks of these viruses have been reviewed in a number of studies conducted in Japan over three decades. Rotavirus and norovirus were the two most common viruses detected almost equally in children under 5 years of age who were suffering from acute gastroenteritis. Like many other countries, the main rotavirus strains circulating in pediatric patients in Japan are G1P[8], G2P[4], G3P[8], and G9P[8]. Norovirus GII.4 was involved in most outbreaks in Japan and found to be associated with the emergence of new variants Sydney_2012. The classic human astrovirus, MLB, and VA clades astroviruses were also commonly found in pediatric patients with acute diarrhea. The sapovirus and adenovirus have been identified as the minor viral causative agents for acute gastroenteritis in Japan.

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Genetic analysis of norovirus GII.4 variants circulating in Korea in 2008

Park¹,

Jeong

Baek³

et al. 2010

Arch Virol

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Noroviruses are the enteric pathogens most commonly responsible for infectious gastroenteritis and outbreaks of foodborne illness. The GII.4 norovirus, in particular, is responsible for the majority of epidemics. Here, we present data on the distribution of norovirus genotypes in Chungnam, Korea, in 2008, measure genetic variation among GII.4 strains, and compare Korean GII.4 variants with reference strains based on the 237-bp junction of ORF1 and ORF2. We detected 139 different strains, which formed two distinct genetic clusters with significant sequence diversity. One Korean cluster (2008-Korea_a) showed high similarity to the Sakai cluster that appeared in Japan and Europe in 2006. The other cluster (2008-Korea_b) was unique and unrelated to previously reported clusters. Genotype GII.4 was confirmed as the predominant cause of norovirus epidemics in Korea. Foodborne norovirus infections, on the other hand, were generally caused by emerging GII.4 genetic variants similar to those responsible for global epidemics.

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Multiple Outbreaks of Gastroenteritis Due to a Single Strain of Genotype GII/4 Norovirus in Kobe, Japan, 2006: Risk Factors for Norovirus Spread in Health Care Settings

Cited by 10 publications

References 21 publications

Isolated norovirus GII.7 strain within an extended GII.4 outbreak

Isolated norovirus GII.7 strain within an extended GII.4 outbreak

Epidemiology of gastroenteritis viruses in Japan: Prevalence, seasonality, and outbreak

Genetic analysis of norovirus GII.4 variants circulating in Korea in 2008

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