Abstract：Objective To investigate the molecular epidemiological characteristics of norovirus (NoV) among children with acute gastroenteritis in Tianjin in 2017. Methods A total of 758 stool specimens were collected from the children with acute gastroenteritis possibly caused by viral infection in Tianjin Children's Hospital between January and December, 2017. Quantitative real-time RT-PCR was used for primary screening of NoV, and conventional RTPCR was used for gene amplification, sequencing and genotype identification of the VP1 region of capsid protein in positive specimens. Results Among the 758 specimens, 241 (31.8%) were found to have GⅡ NoV. Sequencing of the VP1 region of capsid protein in positive specimens showed that among the 241 specimens with GⅡ NoV, 69 (28.6%) had GⅡ.4 subtype, 51 (21.2%) had GⅡ.3 subtype, 24 (10.0%) had GⅡ.2 subtype, and 18 (7.5%) had other subtypes. There was a significant difference in NoV detection rate between different age groups (P=0.018), and the 1- < 4 years group had the highest NoV detection rate (37.3%). There was also a significant difference in NoV detection rate across seasons (P < 0.001), and there was a highest NoV detection rate in winter (48.1%). Twenty-seven children (3.6%) had co-infections with NoV and rotavirus. Conclusions NoV is one of the major pathogens of the children with acute gastroenteritis from Tianjin in 2017. GⅡ genotype, especially GⅡ.4 subtype, is the prevalent strain. NoV infection is commonly seen in children less than 4 years and reaches the peak in winter. Some children are found to have co-infections with rotavirus.
FANG Yu-Lian,WANG Wei,WANG Ping et al. Molecular epidemiology of norovirus in children with acute gastroenteritis in Tianjin, China[J]. CJCP, 2019, 21(2): 139-143.
Ahmed SM, Hall AJ, Robinson AE, et al. Global prevalence of norovirus in cases of gastroenteritis:a systematic review and meta-analysis[J]. Lancet Infect Dis, 2014, 14(8):725-730.
[2]
Karst SM, Zhu S, Goodfellow IG. The molecular pathology of noroviruses[J]. J Pathol, 2015, 235(2):206-216.
[3]
Hernandez JM, Silva LD, Junior ECS, et al. Molecular epidemiology and temporal evolution of norovirus associated with acute gastroenteritis in Amazonas state, Brazil[J]. BMC Infect Dis, 2018, 18(1):147.
[4]
Hall AJ, Wikswo ME, Manikonda K, et al. Acute gastroenteritis surveillance through the National Outbreak Reporting System, United States[J]. Emerg Infect Dis, 2013, 19(8):1305-1309.
Kojima S, Kageyama T, Fukushi S, et al. Genogroup-specific PCR primers for detection of Norwalk-like viruses[J]. J Virol Methods, 2002, 100(1-2):107-114.
[7]
Jain S, Thakur N, Grover N, et al. Prevalence of rotavirus, norovirus and enterovirus in diarrheal diseases in Himachal Pradesh, India[J]. Virusdisease, 2016, 27(1):77-83.
[8]
Andrade JSR, Fumian TM, Leite JPG, et al. Detection and molecular characterization of emergent GⅡ.P17/GⅡ.17 Norovirus in Brazil, 2015[J]. Infect Genet Evol, 2017, 51:28-32.
[9]
Fu JG, Ai J, Zhang J, et al. Molecular epidemiology of genogroup Ⅱ norovirus infection among hospitalized children with acute gastroenteritis in Suzhou (Jiangsu, China) from 2010 to 2013[J]. J Med Virol, 2016, 88(6):954-960.
[10]
Yi J, Wahl K, Sederdahl BK, et al. Molecular epidemiology of norovirus in children and the elderly in Atlanta, Georgia, United States[J]. J Med Virol, 2016, 88(6):961-970.
[11]
Rahman M, Rahman R, Nahar S, et al. Norovirus diarrhea in Bangladesh, 2010-2014:prevalence, clinical features, and genotypes[J]. J Med Virol, 2016, 88(10):1742-1750.
[12]
Chan MC, Leung TF, Chung TW, et al. Virus genotype distribution and virus burden in children and adults hospitalized for norovirus gastroenteritis, 2012-2014, Hong Kong[J]. Sci Rep, 2015, 5:11507.
[13]
Yang SY, Hwang KP, Wu FT, et al. Epidemiology and clinical peculiarities of norovirus and rotavirus infection in hospitalized young children with acute diarrhea in Taiwan, 2009[J]. J Microbiol Immunol Infect, 2010, 43(6):506-514.
[14]
Park K, Yeo S, Jeong H, et a1. Updates on the genetic variations of norovirus in sporadic gastroenteritis in Chungnam Korea, 2009-2010[J]. Viro1 J, 2012, 9:29.
[15]
Lopman B, Armstrong B, Atchison C, et al. Host, weather and virological factors drive norovirus epidemiology:time-series analysis of laboratory surveillance data in England and Wales[J]. PLoS One, 2009, 4(8):e6671.
[16]
Rohayem J. Norovirus seasonality and the potential impact of climate change[J]. Clin Microbiol Infect, 2009, 15(6):524-527.
[17]
Patel MM, Widdowson MA, Glass RI, et al. Systematic literature review of role of noroviruses in sporadic gastroenteritis[J]. Emerg Infect Dis, 2008, 14(8):1224-1231.
[18]
Hoa Tran TN, Trainor E, Nakagomi T, et al. Molecular epidemiology of noroviruses associated with acute sporadic gastroenteritis in children:global distribution of genogroups, genotypes, and GⅡ.4 variants[J]. J Clin Virol, 2013, 56(3):185-193.
[19]
White PA. Evolution of norovirus[J]. Clin Microbiol Infect, 2014, 20(8):741-745.
[20]
Han J, Wu X, Chen L, et al. Emergence of norovirus GⅡ.P16-GⅡ.2 strains in patients with acute gastroenteritis in Huzhou, China, 2016-2017[J]. BMC Infect Dis, 2018, 18(1):342.
[21]
Nahar S, Afrad MH, Matthijnssens J, et al. Novel intergenotype human norovirus recombinant GⅡ.P16/GⅡ.3 in Bangladesh[J]. Infect Genet Evol, 2013, 20:325-329.
[22]
Fumian TM, da Silva Ribeiro de Andrade J, Leite JP, et al. Norovirus recombinant strains isolated from gastroenteritis outbreak in Southern Brazil, 2004-2011[J]. PLoS One, 2016, 11(4):e0145391.
[23]
Arana A, Cilla G, Montes M, et al. Genotypes, recombinant forms, and variants of norovirus GⅡ.4 in Gipuzkoa (Basque Country, Spain), 2009-2012[J]. PLoS One, 2014, 9(6):e98875.
[24]
Chen Y, Li Z, Han D, et al. Viral agents associated with acute diarrhea among outpatient children in southeastern China[J]. Pediatr Infect Dis J, 2013, 32(7):e285-e290.
[25]
Zou W, Cui D, Wang X, et al. Clinical characteristics and molecular epidemiology of noroviruses in outpatient children with acute gastroenteritis in Huzhou of China[J]. PLoS One, 2015, 10(5):e0127596.
