Nosocomial outbreak of norovirus gastroenteritis and investigation of ABO histo-blood group type in infected staff and patients

Meyer, Emily Dorothee; Ebner, Winfried; Scholz, Robert; Dettenkofer, Markus; Daschner, F

doi:10.1016/s0195-6701(03)00296-2

Cited by 29 publications

(18 citation statements)

References 28 publications

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“…A similar observation was made by Hennessy et al (7) in investigating a norovirus outbreak at a British military field hospital, finding a reduced susceptibility of blood group B individuals to symptomatic norovirus infections. These observations are in contrast to those of Meyer et al (18), who reported that persons with the O phenotype were significant less affected than expected from the normal distribution. Furthermore, Rockx et al (22) recently reported that individuals secreting type B antigens in saliva were significantly protected against infection with genogroup I virus (2 of 22 individuals) and were also less likely to acquire norovirus-specific immunoglobulin G.…”

Section: Resultscontrasting

confidence: 99%

A Homozygous Nonsense Mutation (428G→A) in the Human Secretor ( FUT2 ) Gene Provides Resistance to Symptomatic Norovirus (GGII) Infections

Thorven¹,

Grahn

Hedlund

et al. 2005

J Virol

230

170

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Noroviruses (formerly Norwalk-like viruses) are a major cause of acute gastroenteritis worldwide and are associated with a significant number of nosocomial and food-borne outbreaks. In this study we show that the human secretor FUT2 gene, which codes for an ␣(1,2)-fucosyltransferase synthesizing the H-type 1 antigen in saliva and mucosa, is associated with susceptibility to norovirus infections. Allelic polymorphism characterization at nucleotide 428 for symptomatic (n ‫؍‬ 53) and asymptomatic (n ‫؍‬ 62) individuals associated with nosocomial and sporadic norovirus outbreaks revealed that homozygous nonsense mutation (428G3A) in FUT2 segregated with complete resistance for the disease. Of all symptomatic individuals, 49% were homozygous (SeSe) and 51% heterozygous (Sese 428 ) secretors, and none were secretor negative (se 428 se 428 ), in contrast to 20% nonsecretors (se 428 se 428 ) among Swedish blood donors (n ‫؍‬ 104) (P < 0.0002) and 29% for asymptomatic individuals associated with nosocomial outbreaks (P < 0.00001). Furthermore, saliva from secretorpositive and symptomatic patients but not from secretor-negative and asymptomatic individuals bound the norovirus strain responsible for that particular outbreak. This is the first report showing that the FUT2 nonsecretor (se 428 se 428 ) genotype is associated with resistance to nosocomial and sporadic outbreaks with norovirus.Noroviruses are the major cause of acute gastroenteritis worldwide among adults and are associated with the illness "winter vomiting disease," characterized by a short incubation period (24 to 48 h) and significant vomiting and diarrhea. While the viruses are highly contagious, with attack rates up to 70% (12), volunteer challenge studies have shown that a subset of individuals remain uninfected even after repeated challenges (2,20,26). At present, it is not clear why a fraction of individuals remain uninfected in norovirus outbreaks and why some volunteers are repeatedly resistant to experimental Norwalk virus inoculations. Recently, it was suggested that histo-blood group antigens and the secretor status might be associated with experimental Norwalk virus infections (4,10,11,16,17).The FUT2 gene, which is responsible for the secretor phenotype, encodes an ␣(1,2)-fucosyltransferase that regulates the expression of the ABH antigens in saliva and mucosal tissues and secretions. The FUT2 gene has a significant polymorphism with typical ethnic specificity (13). The nonsense mutation 428G3A (Trp1433stop) is characteristic for the dominating nonsecretor allele (se 428 ) in Europeans and appears in about 20% of the Caucasian population (13).The facts that about 20% of Europeans are nonsecretors and norovirus attack rates seldom exceeds 80% in a given outbreak led us to investigate, throughout a series of prospective studies, if the FUT2 secretor gene was associated with resistance to nosocomial and sporadic outbreaks caused by genogroup II (GGII) noroviruses, which dominate in all parts of the world (14). MATERIALS AND METHODSSubjects and sampl...

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Section: Resultscontrasting

confidence: 99%

A Homozygous Nonsense Mutation (428G→A) in the Human Secretor ( FUT2 ) Gene Provides Resistance to Symptomatic Norovirus (GGII) Infections

Thorven¹,

Grahn

Hedlund

et al. 2005

J Virol

230

170

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“…However some studies showed discrepant results concerning the effect of either the ABO or the secretor phenotype, raising questions about the importance of HBGAs in norovirus infections (10,12,31,32,37). These discrepancies could be due to several factors, including an ill-defined carbohydrate specificity of the causative strain and poor or incomplete phenotyping of the affected individuals.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive Analysis of a Norovirus-Associated Gastroenteritis Outbreak, from the Environment to the Consumer

et al. 2010

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Noroviruses have been recognized to be the predominant agents of nonbacterial gastroenteritis outbreaks in humans, and their transmission via contaminated shellfish consumption has been demonstrated. Norovirus laboratory experiments, volunteer challenge studies, and community gastroenteritis outbreak investigations have identified human genetic susceptibility factors related to histo-blood group antigen expression. Following a banquet in Brittany, France, in February 2008, gastroenteritis cases were linked to oyster consumption. This study identified an association of the norovirus illnesses with histo-blood group expression, and oyster contamination with norovirus was confirmed by qualitative and quantitative analyses. The secretor phenotype was associated with illness, especially for the non-A subgroup. The study showed that, in addition to accidental climatic events that may lead to oyster contamination, illegal shellfish collection and trading are also risk factors associated with outbreaks.

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“…A number of reports suggesting an association between ABO histo-blood group type and the risk of NV infection and symptomatic disease have been published [24,25]. Individuals with an O phenotype were more likely to be infected, whereas those with B histo-blood group antigens had a decreased risk of infection.…”

Section: Discussionmentioning

confidence: 99%

An Outbreak of Norovirus Gastroenteritis on an Israeli Military Base

et al. 2004

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Nosocomial outbreak of norovirus gastroenteritis and investigation of ABO histo-blood group type in infected staff and patients

Cited by 29 publications

References 28 publications

A Homozygous Nonsense Mutation (428G→A) in the Human Secretor ( FUT2 ) Gene Provides Resistance to Symptomatic Norovirus (GGII) Infections

A Homozygous Nonsense Mutation (428G→A) in the Human Secretor ( FUT2 ) Gene Provides Resistance to Symptomatic Norovirus (GGII) Infections

Comprehensive Analysis of a Norovirus-Associated Gastroenteritis Outbreak, from the Environment to the Consumer

An Outbreak of Norovirus Gastroenteritis on an Israeli Military Base

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