Journal
EPIDEMIOLOGY AND INFECTION
Volume 142, Issue 11, Pages 2326-2335Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0950268813003373
Keywords
Gastroenteritis; GII.4 variant; norovirus; recombination
Funding
- Italian Ministry of Education, University and Research [20084F4P7X_004]
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During a 5-year (2007-2011) surveillance period a total of 435 (15.34%) of 2834 stool specimens from children aged <14 years with acute gastroenteritis tested positive for norovirus and 217 strains were characterized upon partial sequence analysis of the polymerase gene as either genogroup (G)I or GII. Of the noroviruses, 99.2% were GII with the GII.P4 genotype being predominant (80%). GII.P4 variants (Yerseke 2006a, Den Haag 2006b, Apeldoorn 2008, New Orleans 2009) emerged sequentially during the study period. Sequence analysis of the capsid gene of 57 noroviruses revealed that 7.8% were recombinant (ORF1/ORF2) viruses including GII.P7_GII.6, GII.P16_GII.3, GII.P16_GII.13, GII.Pe_GII.2, and GII.Pe_GII.4, never identified before in Italy. GII.P1_GII.1, GII.P2_GII.1, GII.P3_GII.3 and GII.P6_GII.6 strains were also detected. Starting in 2011 a novel GII. 4 norovirus with 3-4% nucleotide difference in the polymerase and capsid genes from variant GII. 4 New Orleans 2009 was monitored in the local population. Since the epidemiology of norovirus changes rapidly, continuous surveillance is necessary to promptly identify the onset of novel types/variants.
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