title: Molecular epidemiology of norovirus gastroenteritis investigated using samples collected from children in Tunisia during a four-year period: detection of the norovirus variant GGII.4 Hunter as early as January 2003.
abstract: Human noroviruses (NoVs) cause epidemic and endemic acute gastroenteritis in children and adults. To study the prevalence and genetic diversity of NoV in children in Tunisia, a total of 788 fecal samples were collected during a 4-year period in the region of Monastir, from children 12 years of age or younger, hospitalized or presenting in dispensaries with symptoms of acute gastroenteritis. NoV was detected by reverse transcription-PCR and confirmed by sequence analysis. This is the first report that describes the molecular epidemiology of NoV in Tunisian children: NoVs were characterized as the causative agent in 128 (16.2%) of the samples. Fourteen samples contained a mixture of two NoVs, and 33 samples were coinfected with additional enteric viruses. Eight distinct NoV genotypes were detected (GGI.2, GGI.4, GGII.1, GGII.4, GGII.8, GGII.14, GGIIb/GGII.2, and GGIIb/GGII.3). GGII.4 was the most prevalent genotype, accounting for 83 (64.8%) cases. Interestingly the GGII.4 variant Hunter, described as spreading all over the world in 2004, was found in Tunisia as early as January 2003. The delay of 1 year between the isolation in Tunisia and the worldwide emergence is somewhat surprising, considering the importance of the contacts between North Africa and Europe particularly. Nevertheless, this illustrates the idea that sporadic gastroenteritis cases may be a reservoir for emerging epidemic NoV strains.
authors.affiliation: Laboratory of Infectious Diseases and Biological Agents, Faculty of Pharmacy, Monastir, Tunisia.
authors.forename: Khira
authors.initials: K
authors.lastname: Sdiri-Loulizi
authors.forename: Katia
authors.initials: K
authors.lastname: Ambert-Balay
authors.forename: Hakima
authors.initials: H
authors.lastname: Gharbi-Khelifi
authors.forename: Nabil
authors.initials: N
authors.lastname: Sakly
authors.forename: Mouna
authors.initials: M
authors.lastname: Hassine
authors.forename: Slaheddine
authors.initials: S
authors.lastname: Chouchane
authors.forename: Mohamed Neji
authors.initials: MN
authors.lastname: Guediche
authors.forename: Pierre
authors.initials: P
authors.lastname: Pothier
authors.forename: Mahjoub
authors.initials: M
authors.lastname: Aouni
mesh_terms: D000328:Adult; D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D005243:Feces / Q000821:virology; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D014644:Genetic Variation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D029322:Norovirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D017422:Sequence Analysis, DNA; D014416:Tunisia / Q000453:epidemiology
chemical_list: D012367:RNA, Viral