title: Molecular epidemiology of norovirus gastroenteritis outbreaks in North Carolina, United States: 1995-2000.
abstract: Noroviruses (NoVs) are the most common cause of acute non-bacterial gastroenteritis outbreaks in the US. We investigated 16 gastroenteritis outbreaks in North Carolina (NC), from 1995 to 2000, to further characterize the epidemiology of NoV using RT-PCR on stool and ELISA on sera. NoV were identified in 14 outbreaks by RT-PCR. Sequence analyses of the amplicons indicated the outbreak strains belonged to the following clusters: five GII/4, three GI/3, one GI/4, one GII/2, one GII/5, one GII/7, and one GII/13 (prototype strain). We detected NoV in stool samples from one outbreak but could not determine its specific cluster within the GII genogroup based on polymerase sequence analysis. The five GII/4 strains were classified as the "95/96 US common strain" and occurred throughout the 5-year period. In contrast to national trends, the majority (86%) of NoV outbreaks identified in North Carolina were foodborne. Of the 12 food-related NoV outbreaks, we were able to document transmission by food handlers in two outbreaks. Person-to-person transmission from primary cases was suggested in three outbreaks. Our results indicate that NoVs are important agents of viral gastroenteritis outbreaks in NC.
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: F C
authors.initials: FC
authors.lastname: Tseng
authors.forename: J S
authors.initials: JS
authors.lastname: Leon
authors.forename: J N
authors.initials: JN
authors.lastname: MacCormack
authors.forename: J-M
authors.initials: JM
authors.lastname: Maillard
authors.forename: C L
authors.initials: CL
authors.lastname: Moe
mesh_terms: D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000821:virology; D004196:Disease Outbreaks; D005243:Feces / Q000821:virology; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D029322:Norovirus / Q000145:classification* / Q000235:genetics*; D017422:Sequence Analysis, DNA; D014481:United States / Q000453:epidemiology