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. 2010 Jun;48(6):2191-8.
doi: 10.1128/JCM.02427-09. Epub 2010 Apr 14.

Epidemiology and genotype analysis of emerging sapovirus-associated infections across Europe

Sanela Svraka  1 , Harry Vennema, Bas van der Veer, Kjell-Olof Hedlund, Margareta Thorhagen, Joukje Siebenga, Erwin Duizer, Marion Koopmans
Affiliations

Epidemiology and genotype analysis of emerging sapovirus-associated infections across Europe

Sanela Svraka et al. J Clin Microbiol. 2010 Jun.

Abstract

Sapoviruses (SaVs) belong to the Caliciviridae family and can cause gastroenteritis in humans and swine. Despite extensive testing, human sapoviruses have been found only in sporadic cases and in one mixed outbreak in children between 1994 and 2007 in the Netherlands. Here we describe a change in sapovirus epidemiology in the Netherlands resulting in sapovirus outbreaks and infections in adults. From November 2007 to January 2009, 478 outbreaks of acute gastroenteritis were reported to the National Institute for Public Health and the Environment in the Netherlands as a part of ongoing surveillance. Sapoviruses were found to be the most likely cause of 19 outbreaks (4%). During the same 2-year period, sapovirus infections were reported in Sweden, Slovenia, and Hungary. In the Netherlands, further characterization of outbreak strains showed that 12 (63%) sapovirus outbreaks were caused by genotype I.2 viruses. Most patients were adults older than 60 years (range, 1 to 100 years). Phylogenetic analysis using all presently available SaV sequences showed high homology between genotype I.2 strains detected in different geographical regions (Sweden, Slovenia, Taiwan, Japan, and Russia) since 2007. These first reported outbreaks of sapovirus infections in adults in the Netherlands were remarkable. Detection of identical genotypes in many samples might suggest that these viruses have the same origin, and since the infection is spreading fast, the prevalence of sapovirus infection may be increasing. The incidence of sapovirus infections in these countries suggests that a substantial part of Europe is affected by this virus.

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Figures

FIG. 1.
FIG. 1.
History of all reported gastroenteritis outbreaks and sapovirus outbreaks in the Netherlands.
FIG. 2.
FIG. 2.
Numbers of sapovirus cases and corresponding outbreaks (OB numbers). Sapovirus genotypes are indicated above the bars. The bars from OB2007323 to OB2008168 indicate single sapovirus infections in outbreaks, while bar OB2008000 indicates the sporadic cases. NT, not typed. In the key to bar patterns, “1” represents the number of positive samples and “0” represents the number of negative samples.
FIG. 3.
FIG. 3.
Age distribution (in years) of sapovirus patients involved in outbreaks and sporadic cases in the Netherlands, as detected through passive surveillance between 2007 and 2009. NK, not known.
FIG. 4.
FIG. 4.
Comparison analysis of SaV partial capsid nucleotide sequences using neighbor-joining tree analysis, showing different genogroups and clusters. The numbers at the branches indicate bootstrap values for the genotypes and isolates. Names of new sapovirus strains isolated in the Netherlands are red, sapovirus outbreaks from the Netherlands are marked with an asterisk, new strains from Slovenia are in blue, and new strains from Sweden are in green. GenBank accession numbers (in black) for the reference strains are as follows: U65427 (Hu/SaV/GI.1/Sapporo/1982/JP), U73124 (Hu/SaV/GI.2/Parkville/1994/US), AF194182 (Hu/SaV/GI.3/Stockholm318/1997/SE), AF435814 (Hu/SaV/GIV.1/Hou7-1181/1990/US), AY289803 (Hu/SaV/GV.1/Argentina39/AR), AY289804 (Hu/SaV/GII.3/cruise ship/2000/US), AF435812 (Hu/SaV/GII.2/Mex340/1990/MX), U95645 (Hu/SaV/GII.1/London/1992/UK), AF182760 (Sw/SaV/GIII.1/PEC-Cowden/1980/US), where JP stands for Japan, Hu for human, US for United States, SE for Sweden, AR for Argentina, MX for Mexico, UK for United Kingdom, Sw for swine, and PEC for porcine enteric calcivirus.
FIG. 5.
FIG. 5.
Evolutionary dynamics of sapovirus, based on partial capsid nucleotide sequences of GI.2 (top) and GIV.1 (bottom). The time scale is shown on the x axis, the tips are aligned with the dates of detection of samples, and node heights represent distances between the isolates.
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