Evidence of the etiological predominance of norovirus in gastroenteritis outbreaks--emerging new-variant and recombinant noroviruses in Hungary.
Between January 2001 and December 2003, stool specimens from 262 (45%) of 581 reported outbreaks of gastroenteritis were investigated for noroviruses in Hungary. Specimens collected from outbreaks of non-bacterial gastroenteritis were examined by reverse-transcription polymerase chain reaction and enzyme immunoassay. In 253 (97%) of 262 outbreaks, norovirus was detected and confirmed by sequencing in 211 (81%). Hospitals (35%), day care centers (30%), and elderly homes (27%) were the most common settings. Diversity and frequency of the genotypes changed over time but with predominance (95%) of genogroup (GG) II strains. Strains grouped into 11 genotypes including an epidemic spread of new-variant GGII4 (Lordsdale virus) and a recently emerged group of natural recombinant strains (GGIIb/Hilversum polymerase) with four capsid types (Hawaii, Mexico, Snow Mountain, and Lordsdale). Clusters of epidemics including food-borne outbreaks were detected. According to this study, noroviruses are the predominant etiological agents causing gastroenteritis outbreaks in Hungary.
Regional Laboratory of Virology, ANTSZ Baranya County Institute of State Public Health Service, Pécs, Hungary. reuter@baranya.anstz.hu
Gábor
G
Reuter
Katalin
K
Krisztalovics
Harry
H
Vennema
Marion
M
Koopmans
György
G
Szucs
D017250:Caliciviridae Infections / Q000453:epidemiology / Q000821:virology*; D002213:Capsid; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000821:virology; D003428:Cross Infection / Q000453:epidemiology / Q000821:virology; D004196:Disease Outbreaks; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000821:virology; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D005838:Genotype; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008969:Molecular Sequence Data; D029322:Norovirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D010802:Phylogeny; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics; D011995:Recombination, Genetic; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017385:Sequence Homology
D012367:RNA, Viral