title: Clinical characteristics and molecular epidemiology of noroviruses in outpatient children with acute gastroenteritis in Huzhou of China.
abstract: BACKGROUND
  Noroviruses (NoVs) are considered major causative pathogens associated with the morbidity and mortality of young children with acute gastroenteritis. However, few studies have examined NoVs causing acute diarrhea among outpatient children worldwide. This study was conducted to investigate the clinical features and molecular epidemiology of NoVs in outpatient children with acute gastroenteritis in Huzhou, China, between April 2013 and April 2014.
  
  
  METHODS
  Stool specimens from 1346 outpatient children enrolled (under 5 years of age) with acute gastroenteritis were examined for NoVs by multiplex RT-PCR, and sequences of the partial capsids of NoVs were analyzed phylogenetically, while the relevant clinical data were analyzed statistically.
  
  
  RESULTS
  Of 1346 specimens, 383 (28.5%, 383/1346) were positive for NoVs. The proportion of GII genotypes (26.9%) was significantly higher than that of GI genotypes (1.6%). The GII.4 genotype was the most prevalent of GII genotypes and was clustered into GII.4/Sydney (37.8%) and GII.4/2006b (62.2%), whereas GI strains were clustered into GI.1. Additionally, the younger children (12 to <24 months of age) were more susceptible to NoVs than children in other age groups, and the highest percentage of NoV infections occurred in April 2013. The diarrheal frequency (times/d) and WBC counts of the infected outpatient group with NoVs were significantly higher than were those of the uninfected outpatient group.
  
  
  CONCLUSIONS
  NoVs were confirmed to be the major viral agents responsible for acute gastroenteritis in outpatient children in Huzhou, China, and GII.4/Sydney and GII.4/2006b variants were identified as the predominant strains in this study.
authors.affiliation: Department of Clinical Laboratory, Huzhou Central Hospital, Huzhou 313000, China.
authors.forename: Weihua
authors.initials: W
authors.lastname: Zou
authors.affiliation: Center of Clinical Laboratory, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.
authors.forename: Dawei
authors.initials: D
authors.lastname: Cui
authors.affiliation: Center of Clinical Laboratory, The First People's Hospital of Huzhou, Huzhou Teachers College, Huzhou, 313000, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Center of Clinical Laboratory, The First People's Hospital of Huzhou, Huzhou Teachers College, Huzhou, 313000, China.
authors.forename: Huihui
authors.initials: H
authors.lastname: Guo
authors.affiliation: Department of Clinical Laboratory, Huzhou Central Hospital, Huzhou 313000, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Yao
authors.affiliation: National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
authors.forename: Miao
authors.initials: M
authors.lastname: Jin
authors.affiliation: Department of Clinical Laboratory, Huzhou Central Hospital, Huzhou 313000, China.
authors.forename: Qiuling
authors.initials: Q
authors.lastname: Huang
authors.affiliation: Department of Clinical Laboratory, Huzhou Central Hospital, Huzhou 313000, China.
authors.forename: Min
authors.initials: M
authors.lastname: Gao
authors.affiliation: Center of Clinical Laboratory, The First People's Hospital of Huzhou, Huzhou Teachers College, Huzhou, 313000, China.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Wen
mesh_terms: D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000821:virology; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology; D014644:Genetic Variation; D006801:Humans; D007223:Infant; D008297:Male; D017720:Molecular Epidemiology; D029322:Norovirus / Q000235:genetics*; D010045:Outpatients; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics*
chemical_list: D012367:RNA, Viral