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Case Reports
. 2014 Jun;20(6):1016-8.
doi: 10.3201/eid2006.131627.

Sequential gastroenteritis episodes caused by 2 norovirus genotypes

Gabriel I Parra, Kim Y Green
Case Reports

Sequential gastroenteritis episodes caused by 2 norovirus genotypes

Gabriel I Parra et al. Emerg Infect Dis. 2014 Jun.

Abstract

We investigated sequential episodes of acute norovirus gastroenteritis in a young child within an 11-month period. The infections were caused by 2 distinct genotypes (GII.4 and GII.6). Failure to achieve cross-protective immunity was linked to absence of an enduring and cross-reactive mucosal immune response, a critical consideration for vaccine design.

Keywords: Norovirus; diarrhea; genotype; immunity; viruses.

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Figures

Figure 1
Figure 1
Characterization of norovirus detected in stool samples and levels of local IgA responses for each infection. A) Phylogenetic tree of the major capsid protein (VP1) region from representative norovirus strains from each of the 22 genotypes within strain GII. Representative strains from each GII.4 and GII.6 cluster were compared with the strains reported in this article (boxed). For each strain, the name/year/country of isolation are shown. B) Levels of IgA in feces collected during the first (G11.4) and (G11.6) second infections. ELISA plates were coated with 1 μg/mL of each virus-like particle (VLP). Fecal samples were collected daily (D) and weekly (W), diluted to 1:500 in phosphate-buffered saline (pH 7.4), and tested for the presence of IgA with a polyclonal anti-human IgA conjugate. The experiment was performed twice in duplicate wells. Bars represent mean; error bars represent the standard errors of the mean. OD, optical density.
Figure 2,
Figure 2,
Appendix. Differences in the major capsid protein (VP1) between norovirus strains GII.4 and GII.6. A) Amino acid sequence alignment of the VP1 sequences. The shell (S) domain is highlighted with a dark line, and the protruding (P) domain is highlighted with a gray line. The color code for each of the epitopes and insertions is indicated. Residue numbers are based on norovirus strain GII.4. B) Top and side views of the P domain of GII.4 norovirus showing the location of the epitopes and the carbohydrate (represented as sticks and highlighted in green) binding sites.
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