title: Norovirus and Sapovirus Epidemiology and Strain Characteristics among Navajo and Apache Infants.
abstract: Norovirus and sapovirus are important causes of acute gastroenteritis (AGE) among American Indian infants. We investigated the prevalence and molecular epidemiology of norovirus and sapovirus in American Indian infants who have historically experienced a high burden of AGE compared to other US populations. Stool samples were collected from 241 children with AGE (cases) and from 343 infants without AGE (controls) ≤9 months of age from 2002-2004. Cases experienced forceful vomiting and/or 3 or more watery or looser-than-normal stools in 24 hours. Stools were tested by real-time RT-PCR for norovirus GI, GII and GIV and sapovirus GI, GII, GIV and GV. Positive samples were genotyped after sequencing conventional RT-PCR products. Norovirus was identified in 76 (31.5%) of the cases and 70 (20.4%) of the controls (p<0.001). GII.3 and GII.4 Farmington Hills were the most frequently identified genotypes in 14.5% and 30.3% of cases and 17.1% and 27.1% of controls, respectively. Sapovirus GI and GII genotypes were identified in 8 (3.3%) of cases and 8 (2.3%) of controls and a single GIV virus was detected in a control. The same norovirus and sapovirus genotypes were circulating in the general U.S. population in the same time period. The high detection rate of norovirus in healthy controls suggests significant asymptomatic transmission in young infants in these communities.
authors.affiliation: Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Lindsay R
authors.identifier: http://orcid.org/0000-0002-4538-6424
authors.initials: LR
authors.lastname: Grant
authors.affiliation: Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: O'Brien
authors.affiliation: Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Weatherholtz
authors.affiliation: Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Raymond
authors.initials: R
authors.lastname: Reid
authors.affiliation: Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Novalene
authors.initials: N
authors.lastname: Goklish
authors.affiliation: Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Mathuram
authors.initials: M
authors.lastname: Santosham
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Umesh
authors.initials: U
authors.lastname: Parashar
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Jan
authors.initials: J
authors.lastname: Vinjé
mesh_terms: D017250:Caliciviridae Infections / Q000208:ethnology* / Q000821:virology; D016022:Case-Control Studies; D003967:Diarrhea / Q000208:ethnology* / Q000821:virology; D005243:Feces / Q000821:virology; D005759:Gastroenteritis / Q000208:ethnology* / Q000821:virology; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D007198:Indians, North American; D007223:Infant; D007231:Infant, Newborn; D017720:Molecular Epidemiology; D029322:Norovirus / Q000235:genetics*; D010802:Phylogeny; D015995:Prevalence; D060888:Real-Time Polymerase Chain Reaction; D029341:Sapovirus / Q000235:genetics*; D014481:United States / Q000453:epidemiology; D014839:Vomiting