湖州市非细菌性急性胃肠炎暴发中诺如病毒的分子生物学特点初步研究

本文初步研究了湖州市非细菌性急性胃肠炎暴发中检出的诺如病毒的分子生物学特征。收集湖州市2008年和2009年2起非细菌性急性胃肠炎暴发疫情中采集的患者粪便标本,采用荧光定量RT-PCR方法对其进行诺如病毒核酸检测,并对核酸阳性标本进行RNA多聚酶部分区域的RT-PCR扩增。选取阳性扩增产物进行纯化及序列测定,结合诺如病毒GI、GII各基因型参考株进行核苷酸序列遗传进化分析。结果2起疫情均同时检出了GI和GII型诺如病毒。随后对其中4份RNA多聚酶区扩增阳性的标本进行测序及序列分析,结果发现2008年检出的2株GI型诺如病毒均为GI/2基因型;而2009年检出的1株GI型诺如病毒为GI/3基因型,另一株GII型诺如病毒则与近些年欧洲和亚洲相继出现的遗传组GII的新基因型GIIb的各代表株同源性最高,为GIIb基因型。这说明湖州地区流行的诺如病毒存在很高的遗传多样性,并且不同时间流行的基因型也存在一定差异。这也是国内首次在急性病毒性胃肠炎暴发中检出诺如病毒GIIb变异株。     

2010年深圳地区诺如病毒的基因分型

了解2010年深圳地区诺如病毒的基因型别及分子流行病学特点。 用诺如病毒特异性引物（GI-SKF/GI-SKR、COG2F/G2-SKR）,通过逆转录-聚合酶链反应（RT-PCR）方法进行诺如病毒核酸扩增,阳性产物回收纯化并测序,用Clustal W和MEGA4.0生物软件对诺如病毒序列进行序列比对和系统进化分析。 85份阳性标本中有79株诺如GⅡ型和6株诺如GⅠ型,其中55株为GⅡ/4(2006b)型,16株为GⅡ/4(2008variant)型,2株为GⅡ/1型,4株为GⅡ/5型,2株为GⅡ/11型,1株为GI/4型,2株为GI/5型,3株为GI/6型。 2010年深圳地区诺如病毒的主要型别是GI和GⅡ,并且以GⅡ/4型为主,流行优势株为GⅡ/4（2006b）。     

贵州省2011年急性胃肠炎诺如病毒的哨点监测及其基因特征分析

为了解贵州省2011年诺如病毒的基因型,监测了2011年5月至12月于贵州省人民医院就诊的急性胃肠炎病例,收集粪便标本,采用荧光定量逆转录-聚合酶链反应(Real-time RT-PCR)初步鉴定,并对阳性株的VP1基因区克隆及测序。检测标本70份,GⅠ型诺如病毒阳性1株,阳性率1.43%,GⅡ型诺如病毒阳性34株,阳性率48.57%,获得7份GⅡ型诺如病毒VP1基因序列,3株为GⅡ.4亚型,为新型变异株(GⅡ4 2011),与GⅡ4 2006b变异株的亲缘关系最近,有1个氨基酸位发生了回复突变;4株为GⅡ.3亚型,分为2个基因簇,1簇与2008～2009年韩国株(HM635118)及上海株(GU991355)的亲缘关系最近,1簇与2010年日本株(AB629943)及2007年印度株(EU921389)等的亲缘关系最近,有4个氨基酸位点易发生回复突变。     

GⅡ.4型诺如病毒的进化及疫苗研究进展

人诺如病毒(Noroviruses,No Vs)是杯状病毒科(Caliciviridae)的一种单链正股RNA病毒,是引起急性胃肠炎的主要病因,以GⅡ.4基因型最为流行.GⅡ.4型诺如病毒极易发生变异,每隔2~3年便可形成新的变异株,引起胃肠炎大范围流行,这与甲型流感病毒的流行特点相似.GⅡ.4型诺如病毒的进化机制涉及受体-组织血型抗原(HBGAs)、基因组空间、群体免疫、复制保真度等因素,这些因素共同影响GⅡ.4型的进化率.诺如病毒变异较快,使得诺如病毒疫苗的研发较为困难.但令人欣慰的是,目前基于GⅡ.4病毒样颗粒(VLPs)的疫苗研制进展顺利,有望在短期内面世;此外,诺如病毒体外感染模型的建立,使得减毒活疫苗与灭活疫苗的研发成为可能.     

2019-2022年南京市急性胃肠炎暴发疫情中诺如病毒分子流行病学分析

诺如病毒是引起急性胃肠炎的主要病原体之一，本研究通过分析2019-2022年南京市诺如病毒急性胃肠炎暴发的流行特征和主要基因型变化，为疫情防控提供依据。收集2019年9月至2022年8月南京市疑似诺如病毒急性胃肠炎暴发样本，通过荧光定量PCR和一步法RT-PCR检测，对阳性样本进行序列测定并分型，挑选48株南京代表株与国内外参考株进行同源性分析。2019-2022年南京市诺如病毒急性胃肠炎暴发的高峰为冬春季，场所主要分布在小学和幼儿园，暴发以诺如病毒GII为主，共检测到11种基因型，包括4种GI和7种GII。主要流行株在三个流行季间有所变化，GII.2[P16]为2019-2021年的优势流行株，2021/2022流行季中GII.4 Sydney 2012[P16]亚型、GII.17[P17]亚型占比最大，多种亚型毒株共存。同源分析发现，2021年2株GII.6[P7]南京株分属于两类不同来源的GII.6衣壳基因型，2019-2022年的GII.2[P16]和GII.4 Sydney 2012[P16]南京株的部分聚合酶区序列变化较衣壳蛋白区大。2019-2022年间南京市诺如病毒急性...     

急性胃肠炎暴发中GⅠ.5[P4]型诺如病毒的遗传进化分析

近年来,南京市急性胃肠炎暴发呈上升趋势,主要是由GⅡ型诺如病毒(norovirus,NoV)引起,GⅠ型较为少见.本研究通过对南京市输入性病例和本地性暴发急性胃肠炎疫情中GⅠ.5[P4]型NoV进行遗传进化分析,为本地疫情控制和处置提供科学依据.对两起暴发疫情采集的18份样本进行荧光定量RT-PCR检测,并对NoV阳性样本部分聚合酶区和衣壳蛋白区进行一步法RT-PCR扩增、测序,结合参考株进行序列比对和进化树分析.18份样本中,GⅠ型NoV阳性5份,其中4份扩增出条带,其N/S区域序列与2016-2018年已公布的GⅠ.5[P4]同源性高达99.0％以上.其部分聚合酶区同1987年之后检出的GⅠ.P4进化距离较近,变异不大.部分衣壳蛋白区在2003-2013年发生较为明显的进化,形成新的簇,期间在2008年又继续进化,慢慢趋于稳定.这是南京市首次在输入性病例和本地暴发疫情中均检出同源性极高的GⅠ.5[P4],该NoV虽然在聚合酶区和衣壳蛋白区并没有发生较大进化,但是通过重组已在亚洲地区人群特别是中国多个城市导致了急性胃肠炎流行.因此,该型病毒株将是本市今后监测的重点.     

诺如病毒新型GII.4流行株Sydney2012在上海地区的检出和鉴定

为了解上海地区诺如病毒相关急性胃肠炎疫情的流行病学特点及流行株基因型的演化情况,2012年3月至2013年2月,收集上海市两处哨点医院成人急性胃肠炎粪便样本进行诺如病毒的分子检测并对其基因特征进行系统分析。在502份样本中,GI群共检出19例,检出率3.78%,呈现低位流行、全年散发的状态,无明显的季节分布;GII群检出86例,检出率17.13%,在10¹2月出现高位流行,并发现中老年人群GII群诺如病毒检出率显著高于青年个体（P<0.05）。同时首次于2012年9月在上海地区检出新型GII.4变异株Sydney₂012,证实是该变异株引发了2012年秋冬季诺如病毒急性胃肠炎的高位流行。序列分析表明该变异株为GII.e型开放阅读框（Open reading frame,ORF）1与GII.4型ORF2的重组体,目前已成为本地区的优势流行株。研究发现,2012年上海地区出现GII.4新型变异株Sydney₂012,并引发秋冬季诺如病毒急性胃肠炎的高位流行。     

2015年大连市急性胃肠炎病例中诺如病毒感染状况

摘要：目的 了解2015年大连市急性胃肠炎病例中诺如病毒的感染情况,及时掌握诺如病毒的流行趋势,提高防控能力。方法 对2015年大连市10家哨点医院采集的1 247份标本进行诺如病毒荧光定量RT-PCR检测。结果 诺如病毒核酸检测总阳性率为1.92%,其中GⅡ型 性率1.60%,GⅠ型阳性率0.32%。结论 大连市首次在急性胃肠炎病例中监测到GⅠ型诺如病毒,2015年大连市急性胃肠炎病例中诺如病毒感染以GⅡ型为主。     

一起旅游团中急性胃肠炎的暴发与GII. 17型诺如病毒相关

为了解2016年夏季一起发生在某赴内蒙古旅游团游客中的急性胃肠炎暴发流行的病毒病原。分别采集此次胃肠炎暴发流行中两名患病游客腹泻症状发生后第3天、5天和7天的粪便标本,提取核酸后首先用荧光定量PCR扩增诺如病毒核酸进行检测,阳性标本分别用RT-PCR扩增病毒VP1基因和RdRp区域基因,通过基因测序和序列比对进行基因分型,构建进化树确定进化同源性。通过荧光定量PCR法检测到两名患者的粪便标本均为诺如病毒阳性,提示此次胃肠炎暴发流行的病原为诺如病毒,进一步的RT-PCR扩增病毒基因分析显示检测到的诺如病毒为GII.P17-GII.G17型;构建系统进化树分析显示本次与2014~2015年度广州、中国香港、中国台湾和日本等地的病毒亲缘关系更为接近;氨基酸序列分析显示该基因型与2014年以来流行的毒株同源性较近,与2014年之前流行的毒株相比变异较大,氨基酸变异主要出现在主要衣壳蛋白的P结构域。提示GII.P17-GII.G17型诺如病毒也是引起内蒙地区急性胃肠炎暴发流行的病毒病原。     

西安市4起急性胃肠炎疫情中诺如病毒的分子特征分析

诺如病毒（Norovirus,NoV）属于杯状病毒科诺如病毒属,能造成急性肠胃炎暴发,在全球流行广泛,但其在西安市的流行情况不明。为明确2018年10月西安市4起幼儿园急性肠胃炎疫情的病原及其基因特征,本研究采集了患者肛拭子,用实时定量PCR检出诺如病毒阳性核酸,对其扩增部分多聚酶区和衣壳区基因并测序。将所得序列上传分型网站以明确基因型,并用软件分析系统进化、重组位点和正选择位点。共检出GII组阳性核酸31份,测序成功25份。4起疫情均由GII.2[P16]型诺如病毒引起。疫情株扩增序列全长、部分多聚酶区和衣壳区的序列与2018年美国流行株（MK773571）的核苷酸同源性分别为99.8%、99.5%和100%。疫情株与GII.2[P16]型中国参考序列（KY421122、KY806296和MG763377）的核苷酸同源性为99.6%,氨基酸同源性为100%。重组位点约在基因组的5 075bp。疫情株基因组的1 613～1 790aa没有正选择位点。及时的流行病学、分子流行病学研究和全基因组测序对控制诺如病毒相关疫情是必要的。     

Early Detection of Epidemic GII-4 Norovirus Strains in UK and Malawi: Role of Surveillance of Sporadic Acute Gastroenteritis in Anticipating Global Epidemics

Noroviruses are endemic in the human population, and are recognised as a leading cause of acute gastroenteritis worldwide. Although they are a highly diverse group of viruses, genogroup-II genotype-4 (GII-4) noroviruses are the most frequently identified strains worldwide. The predominance of GII-4 norovirus strains is driven by the periodic emergence of antigenic variants capable of evading herd protection. The global molecular epidemiology of emerging GII-4 strains is largely based on data from outbreak surveillance programmes, but the epidemiology of GII-4 strains among sporadic or community cases is far less well studied. To understand the distribution of GII-4 norovirus strains associated with gastroenteritis in the wider population, we characterised the GII-4 norovirus strains detected during studies of sporadic cases of infectious gastroenteritis collected in the UK and Malawi between 1993 and 2009. Our data shows that GII-4 norovirus strains that have emerged as strains of global epidemic importance have circulated in the community up to 18 years before their recognition as pandemic strains associated with increases in outbreaks. These data may suggest that more comprehensive surveillance programmes that incorporate strains associated with sporadic cases may provide a way for early detection of emerging strains with pandemic potential. This may be of particular relevance as vaccines become available.     

Molecular epidemiology of norovirus in asymptomatic food handlers in Busan,Korea, and emergence of genotype GII.17

The molecular epidemiology of norovirus infections was studied in food handlers without any symptoms from January to December 2015 in Busan city, Korea. A total of 2,174 fecal specimens from asymptomatic food handlers were analyzed, and 2.3% (49/2,174) were norovirus-positive. Fourteen of 335 samples (4.2%) were positive in January; fifteen of 299 samples (5.0%) in February, and seven of 189 samples (3.7%) in December. However, norovirus was rarely detected in other months. From sequencing analysis, 11 genotypes (five GI and six GII genotypes) were detected. Among the 42 capid gene sequences identified, 14 were from the GI genogroup, while 28 were from the GII genogroup. The most commonly detected genotype was GII.17, comprising 15 (35.7%) of positive samples. From January 2012 to December 2015, 5,138 samples were collected from gastroenteritis patients and outbreaks in Busan. The most detected genotype in 2012, 2013, and 2014 was GII.4 (121, 24, and 12 cases, respectively), but in 2015, GII.17 (25 cases) was the most common. The GII.4 genotype was the major cause of acute gastroenteritis from 2012 to 2014, but the GII.17 genotype became the most prevalent cause in 2015. Continued epidemiological surveillance of GII.17 is needed, together with assessment of the risk of norovirus infection.     

Norovirus Recombinant Strains Isolated from Gastroenteritis Outbreaks in Southern Brazil, 2004–2011

Noroviruses are recognized as one of the leading causes of viral acute gastroenteritis, responsible for almost 50% of acute gastroenteritis outbreaks worldwide. The positive single-strand RNA genome of noroviruses presents a high mutation rate and these viruses are constantly evolving by nucleotide mutation and genome recombination. Norovirus recombinant strains have been detected as causing acute gastroenteritis outbreaks in several countries. However, in Brazil, only one report of a norovirus recombinant strain (GII.P7/GII.20) has been described in the northern region so far. For this study, 38 norovirus strains representative of outbreaks, 11 GII.4 and 27 non-GII.4, were randomly selected and amplified at the ORF1/ORF2 junction. Genetic recombination was identified by constructing phylogenetic trees of the polymerase and capsid genes, and further SimPlot and Bootscan analysis of the ORF1/ORF2 overlap. Sequence analysis revealed that 23 out of 27 (85%) non-GII.4 noroviruses were recombinant strains, characterized as: GII.P7/GII.6 (n = 9); GIIP.g/GII.12 (n = 4); GII.P16/GII.3 (n = 4); GII.Pe/GII.17 (n = 2); GII.P7/GII.14 (n = 1); GII.P13/GII.17 (n = 1); GII.P21/GII.3 (n = 1); and GII.P21/GII.13 (n = 1). On the other hand, among the GII.4 variants analyzed (Den Haag_2006b and New Orleans_2009) no recombination was observed. These data revealed the great diversity of norovirus recombinant strains associated with outbreaks, and describe for the first time these recombinant types circulating in Brazil. Our results obtained in southern Brazil corroborate the previous report for the northern region, demonstrating that norovirus recombinant strains are circulating more frequently than we expected. In addition, these results emphasize the relevance of including ORF1/ORF2-based analysis in surveillance studies as well as the importance of characterizing strains from other Brazilian regions to obtain epidemiological data for norovirus recombinant strains circulating in the country.     

A homozygous nonsense mutation (428G-->A) in the human secretor (FUT2) gene provides resistance to symptomatic norovirus (GGII) infections

Noroviruses (formerly Norwalk-like viruses) are a major cause of acute gastroenteritis worldwide and are associated with a significant number of nosocomial and food-borne outbreaks. In this study we show that the human secretor FUT2 gene, which codes for an alpha(1,2)-fucosyltransferase synthesizing the H-type 1 antigen in saliva and mucosa, is associated with susceptibility to norovirus infections. Allelic polymorphism characterization at nucleotide 428 for symptomatic (n = 53) and asymptomatic (n = 62) individuals associated with nosocomial and sporadic norovirus outbreaks revealed that homozygous nonsense mutation (428G-->A) in FUT2 segregated with complete resistance for the disease. Of all symptomatic individuals, 49% were homozygous (SeSe) and 51% heterozygous (Sese428) secretors, and none were secretor negative (se428se428), in contrast to 20% nonsecretors (se428se428) among Swedish blood donors (n = 104) (P < 0.0002) and 29% for asymptomatic individuals associated with nosocomial outbreaks (P < 0.00001). Furthermore, saliva from secretor-positive and symptomatic patients but not from secretor-negative and asymptomatic individuals bound the norovirus strain responsible for that particular outbreak. This is the first report showing that the FUT2 nonsecretor (se428se428) genotype is associated with resistance to nosocomial and sporadic outbreaks with norovirus.     

Year-round prevalence of norovirus in the environment of catering companies without a recently reported outbreak of gastroenteritis

Food handlers play an important role in the transmission of norovirus (NoV) in food-borne outbreaks of gastroenteritis (GE). In a year-round prevalence study, the prevalence of NoV in catering companies without recently reported outbreaks of GE was investigated and compared to the observed prevalence in catering companies with recently reported outbreaks. Swab samples were collected from surfaces in the kitchens and (staff) bathrooms in 832 randomly chosen companies and analyzed for the presence of NoV RNA. In total, 42 (1.7%) out of 2,496 environmental swabs from 35 (4.2%) catering companies tested positive. In contrast, NoV was detected in 147 (39.7%) of the 370 samples for 44 (61.1%) of the 72 establishments associated with outbreaks of gastroenteritis. NoV-positive swabs were more frequently found in winter, in specific types of companies (elderly homes and lunchrooms), and in establishments with separate bathrooms for staff. We found a borderline association with population density but no relation to the number of employees. Sequence analysis showed that environmental strains were interspersed with strains found in outbreaks of illness in humans. Thus, the presence of NoV in catering companies seemed to mirror the presence in the population but was strongly increased when associated with food-borne GE. Swabs may therefore serve as a valuable tool in outbreak investigations for the identification of the causative agent, although results should be interpreted with care, taking into account all other epidemiological data.     

Norovirus disease: changing epidemiology and host susceptibility factors

Noroviruses cause the majority of acute viral gastroenteritis cases that occur worldwide. The increased recognition of noroviruses as the cause of outbreaks and sporadic disease is due to the recent availability of improved norovirus-specific diagnostics. Transmission of these viruses is facilitated by their high prevalence in the community, shedding of infectious virus particles from asymptomatic individuals and the high stability of the virus in the environment. Currently, the spectrum of clinical disease and the understanding of host susceptibility factors are changing. Cases of chronic norovirus gastroenteritis have been observed in transplant recipients and unusual clinical presentations have been recognized in otherwise healthy adults that are under physical stress. Recently, noroviruses were found to bind to gut-expressed carbohydrates, leading to a correlation between a person's genetically determined carbohydrate expression and their susceptibility to Norwalk virus infection. Greater community surveillance and further investigation of carbohydrate receptor-binding properties could provide further insights into norovirus transmission, susceptibility and pathogenesis, and should aid in developing vaccines and antiviral therapies for this common viral disease.     

Norovirus RNA-dependent RNA polymerase is phosphorylated by an important survival kinase, Akt

Viruses commonly use host cell survival mechanisms to their own advantage. We show that Akt, an important signaling kinase involved in cell survival, phosphorylates the RNA-dependent RNA polymerase (RdRp) from norovirus, the major cause of gastroenteritis outbreaks worldwide. The Akt phosphorylation of RdRp appears to be a feature unique to the more prevalent norovirus genotypes such as GII.4 and GII.b. This phosphorylation event occurs at a residue (Thr33) located at the interface where the RdRp finger and thumb domains interact and decreases de novo activity of the polymerase. This finding provides fresh insights into virus-host cell interactions.     

Norovirus‐binding proteins recovered from activated sludge micro‐organisms with an affinity to a noroviral capsid peptide

Aims: Transmission routes of noroviruses, leading aetiological agents of acute gastroenteritis, are rarely verified when outbreaks occur. Because the destination of norovirus particles being firmly captured by micro‐organisms could be totally different from that of those particles moving freely, micro‐organisms with natural affinity ligands such as virus‐binding proteins would affect the fate of viruses in environment, if such microbial affinity ligands exist. The aim of this study is to identify norovirus‐binding proteins (NoVBPs) that are presumably working as natural ligands for norovirus particles in water environments. Methods and Results: NoVBPs were recovered from activated sludge micro‐organisms by an affinity chromatography technique in which a capsid peptide of norovirus genogroup II (GII) was immobilized. The recovered NoVBPs bind to norovirus‐like particles (NoVLPs) of norovirus GII, and this adsorption was stronger than that to NoVLPs of norovirus genogroup I. The profile of two‐dimensional electrophoresis of NoVBPs showed that the recovered NoVBPs included at least seven spots of protein. The determination of N‐terminal amino acid sequences of these NoVBPs revealed that hydrophobic interactions could contribute to the adsorption between NoVBPs and norovirus particles. Conclusions: NoVBPs conferring a high affinity to norovirus GII were successfully isolated from activated sludge micro‐organisms. Significance and Impact of the Study: NoVBPs could be natural viral ligands and play an important role in the NoV transmission.