title: A predominant role for Norwalk-like viruses as agents of epidemic gastroenteritis in Maryland nursing homes for the elderly.
abstract: Stool specimens from 156 Maryland nursing home residents, who became ill during 20 outbreaks of gastroenteritis from November 1987 through February 1988, were analyzed. All tested negative for astroviruses, enteroviruses, Group A rotaviruses, Sapporo-like caliciviruses, and enteric bacteria (i.e., Salmonella, Clostridium, and Shigella species). Eighty-two (52%) were positive for Norwalk-like viruses (NLVs), members of the family Caliciviridae. Six distinct genetic clusters within genogroups I and II of the NLVs were detected; a genogroup II (GII) virus closely related to the Camberwell virus in the NLV GII/4 genetic cluster was the predominant strain. Serologic evidence of infection with > or = 1 NLV was detected in 61 (56%) of 109 patients tested against 3 NLV antigens (i.e., Norwalk, Hawaii, and Toronto viruses). Sixteen (80%) outbreaks met the definition for an NLV outbreak. Taken together with a retrospective analysis of bacterial gastroenteritis in this same setting, these data support a major role for NLVs as etiologic agents of gastroenteritis in elderly persons.
authors.affiliation: Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA. kgreen@niaid.nih.gov
authors.forename: Kim Y
authors.initials: KY
authors.lastname: Green
authors.forename: Gaël
authors.initials: G
authors.lastname: Belliot
authors.forename: Jean Lin
authors.initials: JL
authors.lastname: Taylor
authors.forename: José
authors.initials: J
authors.lastname: Valdesuso
authors.forename: Judy F
authors.initials: JF
authors.lastname: Lew
authors.forename: Albert Z
authors.initials: AZ
authors.lastname: Kapikian
authors.forename: Feng-Ying C
authors.initials: FY
authors.lastname: Lin
mesh_terms: D000368:Aged; D000595:Amino Acid Sequence; D000914:Antibodies, Viral / Q000097:blood; D002213:Capsid / Q000235:genetics; D004797:Enzyme-Linked Immunosorbent Assay; D005759:Gastroenteritis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008396:Maryland / Q000453:epidemiology; D008969:Molecular Sequence Data; D005810:Multigene Family; D029322:Norovirus / Q000235:genetics / Q000302:isolation & purification*; D009735:Nursing Homes; D016366:Open Reading Frames; D012621:Seasons
chemical_list: D000914:Antibodies, Viral