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. 2004 Jun;42(6):2668-74.
doi: 10.1128/JCM.42.6.2668-2674.2004.

Etiology of sporadic cases of pediatric acute gastroenteritis in asturias, Spain, and genotyping and characterization of norovirus strains involved

José Antonio Boga  1 , Santiago Melón, Inés Nicieza, Isabel De Diego, Mercedes Villar, Francisco Parra, María De Oña
Affiliations

Etiology of sporadic cases of pediatric acute gastroenteritis in asturias, Spain, and genotyping and characterization of norovirus strains involved

José Antonio Boga et al. J Clin Microbiol. 2004 Jun.

Abstract

From November 2000 to October 2001, a reverse transcription-PCR using primers directed to the norovirus RNA polymerase coding region was included in a viral and bacterial routine screening to diagnose sporadic cases of acute gastroenteritis among children in Asturias, Spain. The role of noroviruses (8.6% of the positively diagnosed cases) as the cause of sporadic pediatric gastroenteritis was evaluated with respect to the detection rates of other gastroenteritis-associated viruses and bacteria. The results indicated that noroviruses were less common than rotaviruses (36.9%), Campylobacter spp. (28.8%), and Salmonella spp. (18.4%) but more frequent than astroviruses (4.3%), adenoviruses (3.8%), and Yersinia spp. (2.2%). Mixed infections involving noroviruses were rarely observed (0.5%). The presence of a norovirus-associated pediatric gastroenteritis peak in summer, as well as the complete absence of norovirus-associated cases in colder months, challenges the view that norovirus infections exclusively have wintertime seasonality. On the other hand, phylogenetic analysis of the amplified fragments showed that the norovirus strains responsible were closely related. A further study using the full-length capsid region showed that these strains could be included into genogroup II, Bristol/Lorsdale cluster, and were closely related to the 1995 and 1996 U.S. subset of strains associated with outbreaks recorded worldwide between 1995 and 1996.

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Figures

FIG. 1.
FIG. 1.
Alignment of norovirus sequences within a conserved region of the RNA polymerase region, amplified using NV1 and NV2 primers. Nucleotide residue changes with respect to the consensus sequence are indicated. Numbers on the left correspond to the isolate name. The amplicon nucleotide residue numbers are indicated on the right. Primer sequences are excluded.
FIG. 2.
FIG. 2.
Phylogenetic analysis of the nine different norovirus isolates obtained in the present study. The nucleotide sequences of the 267-bp amplicons derived from the RNA polymerase coding regions were compared to representative genogroup I and II norovirus sequences. Abbreviations: NV, Norwalk virus, M87611; SoV, Southampton virus, L07418; DSV, Desert Shield virus, U04469; ChV, Chiba virus, AB042808; HssV, Hesse virus, AF093797; TV, Toronto virus, U02030; SMA, Snow Mountain Agent, L23831; HV, Hawaii virus, U07611; LV, Lorsdale virus, X86557.
FIG. 3.
FIG. 3.
Phylogenetic analysis of capsid amino acid sequences of Ast6139/2001/SP (underlined), two representative strains of the 95/96-US subset (asterisks), and representative norovirus strains of the genetic clusters proposed by Ando et al. (3).
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