[First gastroenteritis outbreak caused by sapovirus (GI2) in Hungary - part of an international epidemic?].
Sapovirus belonging to Caliciviridae is one of the known pathogen of sporadic gastroenteritis infections in infants, children and rarely in elderly. Since the beginning of molecular monitoring of caliciviruses (mid 1990's) sapovirus was described rarely, once in approx. 5 years, as source of an outbreak. Circulation of caliciviruses has been monitored with molecular epidemiological methods by authors for 10 years in Hungary. Sapovirus has not been detected yet in the approximately 800 examined non-bacterial gastroenteritis outbreak. Based on the informal data supported by the international calicivirus surveillance study group, the number of outbreaks caused by sapovirus was increasing in Europe in 2008. Supposedly these outbreaks can be linked to genotype GI2 sapovirus.


OBJECTIVE
To describe the first verified detection and molecular epidemiological description of a gastroenteritis outbreak caused by sapovirus in Hungary.


METHODS
Stool samples originated from Bács-Kiskun County, from a mental deficiency day care center, where a gastroenteritis outbreak occurred in September, 2008. Amplification of the RNA polymerase gene of sapovirus was performed by RT-PCR method and the product was directly sequenced and phylogenetically analyzed. Clinical and epidemiological data were collected by epidemiological investigation.


RESULTS
17 of the 135 exposed people (12.6%) had gastroenteritis with vomiting and diarrhea in the period of September 11-22, 2008. Bacterial pathogens, rotavirus, adenovirus and norovirus were not detected, but sapovirus could be identified in 1 out of the 4 (25%) stool samples. The source of the outbreak was presumably the ill nurse and the virus spread with direct contact among the mentally deficient patients. Based on the RNA polymerase gene region the virus belongs to genotype GI2 sapovirus.


CONCLUSIONS
This study reports on the first detection of sapovirus from gastroenteritis outbreak in Hungary. Epidemiologic and clinical characteristics of the outbreak in the mental deficiency day care center are described in details to prove that not every case is "calicivirus" infection and epidemic is caused by the norovirus, which is another calicivirus examined by diagnostic methods. The outbreak caused by genotype GI2 sapovirus might be the part of an international epidemic, extended into a larger geographic area.
Pankovics
Péter
P
Allami Népegészségügyi és Tisztiorvosi Szolgálat, Dél-dunántúli Regionális Intézete, Regionális Virológiai Laboratórium, Pécs. pankovics.peter@baranya.antsz.hu
Kugler
Zoltán
Z
Kátai
Andrea
A
Reuter
Gábor
G
D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000821:virology*; D003967:Diarrhea / Q000821:virology; D004196:Disease Outbreaks; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D005838:Genotype; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007391:International Cooperation; D008297:Male; D009325:Nausea / Q000821:virology; D012367:RNA, Viral / Q000302:isolation & purification; D020133:Reverse Transcriptase Polymerase Chain Reaction; D029341:Sapovirus / Q000235:genetics / Q000302:isolation & purification*; D014839:Vomiting / Q000821:virology
D012367:RNA, Viral