title: Prevalence of norovirus among visitors from the United States to Mexico and Guatemala who experience traveler's diarrhea.
abstract: Traveler's diarrhea (TD) is the most common infectious illness acquired by visitors to developing nations. The purpose of this study was to utilize molecular diagnostic techniques to determine the prevalence of norovirus (NoV) in TD occurring among visitors from the United States to Guatemala and Mexico. Stool samples (n = 54) were collected from 34 TD cases and analyzed for NoV by reverse transcription-PCR and oligoprobe confirmation. The overall prevalence of NoV was 65%. Interestingly, all NoV-positive stool samples were identified as genogroup I NoVs, and time spent at travel destinations was found to be an important factor in determining the frequency of infection (P = 0.003). Eleven NoV-positive stool samples also tested positive for enterotoxigenic Escherichia coli, indicating that dual infections with this leading bacterial cause of TD were very common. Results of this study suggest that NoV infection is a frequent occurrence among travelers to Mexico and Guatemala who experience episodes of TD. In addition, the simple molecular detection method utilized here will serve to facilitate more in-depth epidemiological studies of this emergent viral pathogen in travelers and other at-risk populations.
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Chapin
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Carpenter
authors.forename: William C
authors.initials: WC
authors.lastname: Dudley
authors.forename: Lucy C
authors.initials: LC
authors.lastname: Gibson
authors.forename: Rafael
authors.initials: R
authors.lastname: Pratdesaba
authors.forename: Olga
authors.initials: O
authors.lastname: Torres
authors.forename: Domingo
authors.initials: D
authors.lastname: Sanchez
authors.forename: Jaime
authors.initials: J
authors.lastname: Belkind-Gerson
authors.forename: Irene
authors.initials: I
authors.lastname: Nyquist
authors.forename: Anders
authors.initials: A
authors.lastname: Kärnell
authors.forename: Bjorn
authors.initials: B
authors.lastname: Gustafsson
authors.forename: Jane L
authors.initials: JL
authors.lastname: Halpern
authors.forename: A Louis
authors.initials: AL
authors.lastname: Bourgeois
authors.forename: Kellogg J
authors.initials: KJ
authors.lastname: Schwab
mesh_terms: D015139:Blotting, Southern; D003967:Diarrhea / Q000821:virology*; D005838:Genotype; D006166:Guatemala; D006801:Humans; D008800:Mexico; D029322:Norovirus / Q000145:classification / Q000302:isolation & purification*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013997:Time Factors; D014195:Travel; D014481:United States