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Sarmento SK, de Andrade JDSR, Malta FC, Fialho AM, Mello MDS, Burlandy FM, Fumian TM. Norovirus Epidemiology and Genotype Circulation during the COVID-19 Pandemic in Brazil, 2019-2022. Pathogens 2023; 13:3. [PMID: 38276149 PMCID: PMC10818385 DOI: 10.3390/pathogens13010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 01/27/2024] Open
Abstract
Norovirus stands out as a leading cause of acute gastroenteritis (AGE) worldwide, affecting all age groups. In the present study, we investigated fecal samples from medically attended AGE patients received from nine Brazilian states, from 2019 to 2022, including the COVID-19 pandemic period. Norovirus GI and GII were detected and quantified using RT-qPCR, and norovirus-positive samples underwent genotyping through sequencing the ORF1/2 junction region. During the four-year period, norovirus prevalence was 37.2%, varying from 20.1% in 2020 to 55.4% in 2021. GII genotypes dominated, being detected in 92.9% of samples. GII-infected patients had significantly higher viral concentrations compared to GI-infected patients (median of 3.8 × 107 GC/g and 6.7 × 105 GC/g, respectively); and patients aged >12-24 months showed a higher median viral load (8 × 107 GC/g) compared to other age groups. Norovirus sequencing revealed 20 genotypes by phylogenetic analysis of RdRp and VP1 partial regions. GII.4 Sydney[P16] was the dominant genotype (57.3%), especially in 2019 and 2021, followed by GII.2[P16] (14.8%) and GII.6[P7] (6.3%). The intergenogroup recombinant genotype, GIX.1[GII.P15], was detected in five samples. Our study is the first to explore norovirus epidemiology and genotype distribution in Brazil during COVID-19, and contributes to understanding the epidemiological dynamics of norovirus and highlighting the importance of continuing to follow norovirus surveillance programs in Brazil.
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Affiliation(s)
| | | | | | | | | | | | - Tulio Machado Fumian
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21045-900, RJ, Brazil (F.M.B.)
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Palit P, Das R, Haque MA, Hasan MM, Noor Z, Mahfuz M, Faruque ASG, Ahmed T. Risk Factors for Norovirus Infections and Their Association with Childhood Growth: Findings from a Multi-Country Birth Cohort Study. Viruses 2022; 14:v14030647. [PMID: 35337054 PMCID: PMC8954848 DOI: 10.3390/v14030647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/05/2022] [Accepted: 03/18/2022] [Indexed: 12/13/2022] Open
Abstract
The prevalence of norovirus infections in different geographical locations and their attribution to childhood diarrhea is well established. However, there are no reports showing possible relationships of different norovirus genogroups with subsequent childhood malnutrition. In this study, we attempted to establish a potential association between asymptomatic norovirus infections with childhood growth faltering during. Non-diarrheal stools were collected from 1715 children enrolled in locations in a multi-county birth cohort study across eight different geographical locations and were assessed for norovirus genogroup I (GI) and norovirus genogroup II (GII). Asymptomatic norovirus GI infections were negatively associated with monthly length-for-age Z score/LAZ (β = -0.53, 95% CI: -0.73, -0.50) and weight-for-age Z score/WAZ (β = -0.39, 95% CI: -0.49, -0.28), respectively. The burden of asymptomatic norovirus GI infections was negatively associated with LAZ (β = -0.46, 95% CI: -0.67, -0.41) and WAZ (β = -0.66, 95% CI: -0.86, -0.53) at 2 years of age, whilst the burden of asymptomatic norovirus GII infections was negatively associated with WAZ (β = -0.27, 95% CI: -0.45, -0.25) at 2 years of age. Our findings warrant acceleration in attempts to develop vaccines against norovirus GI and norovirus GII, with the aim of minimizing the long-term sequelae on childhood growth.
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Affiliation(s)
- Parag Palit
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (P.P.); (R.D.); (M.M.H.); (M.M.); (A.S.G.F.); (T.A.)
| | - Rina Das
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (P.P.); (R.D.); (M.M.H.); (M.M.); (A.S.G.F.); (T.A.)
| | - Md. Ahshanul Haque
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (P.P.); (R.D.); (M.M.H.); (M.M.); (A.S.G.F.); (T.A.)
- Correspondence:
| | - Md. Mehedi Hasan
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (P.P.); (R.D.); (M.M.H.); (M.M.); (A.S.G.F.); (T.A.)
| | - Zannatun Noor
- Emerging Infections and Parasitology Laboratory, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh;
| | - Mustafa Mahfuz
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (P.P.); (R.D.); (M.M.H.); (M.M.); (A.S.G.F.); (T.A.)
- Faculty of Medicine and Life Sciences, University of Tampere, 33100 Tampere, Finland
| | - Abu Syed Golam Faruque
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (P.P.); (R.D.); (M.M.H.); (M.M.); (A.S.G.F.); (T.A.)
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (P.P.); (R.D.); (M.M.H.); (M.M.); (A.S.G.F.); (T.A.)
- Department of Global Health, University of Washington, Seattle, WA 98195, USA
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Virological and Epidemiological Features of Norovirus Infections in Brazil, 2017-2018. Viruses 2021; 13:v13091724. [PMID: 34578304 PMCID: PMC8472875 DOI: 10.3390/v13091724] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/09/2021] [Accepted: 08/13/2021] [Indexed: 12/19/2022] Open
Abstract
Noroviruses are considered an important cause of acute gastroenteritis (AGE) across all age groups. Here, we investigated the incidence of norovirus, genotypes circulation, and norovirus shedding in AGE stool samples from outpatients in Brazil. During a two-year period, 1546 AGE stool samples from ten Brazilian states were analyzed by RT-qPCR to detect and quantify GI and GII noroviruses. Positive samples were genotyped by dual sequencing using the ORF1/2 junction region. Overall, we detected norovirus in 32.1% of samples, with a massive predominance of GII viruses (89.1%). We also observed a significant difference between the median viral load of norovirus GI (3.4×105 GC/g of stool) and GII (1.9×107 GC/g). The most affected age group was children aged between 6 and 24 m old, and norovirus infection was detected throughout the year without marked seasonality. Phylogenetic analysis of partial RdRp and VP1 regions identified six and 11 genotype combinations of GI and GII, respectively. GII.4 Sydney[P16] was by far the predominant genotype (47.6%), followed by GII.2[P16], GII.4 Sydney[P31], and GII.6[P7]. We detected, for the first time in Brazil, the intergenogroup recombinant genotype GIX.1[GII.P15]. Our study contributes to the knowledge of norovirus genotypes circulation at the national level, reinforcing the importance of molecular surveillance programs for future vaccine designs.
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Dey SK, Sharif N, Billah B, Siddique TTI, Islam T, Parvez AK, Talukder AA, Phan T, Ushijima H. Molecular epidemiology and genetic diversity of norovirus infection in children with acute gastroenteritis in Bangladesh, 2014-2019. J Med Virol 2021; 93:3564-3571. [PMID: 33386771 DOI: 10.1002/jmv.26772] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/21/2020] [Accepted: 12/30/2020] [Indexed: 01/28/2023]
Abstract
Acute gastroenteritis (AGE) is one of the most common diseases in children, and it continues to be a significant cause of morbidity and mortality worldwide. Norovirus is one of the major enteropathogens associated with both sporadic diarrhea and outbreaks of gastroenteritis. This study aims to investigate genotype diversity and molecular epidemiology of norovirus in Bangladesh. A total of 466 fecal specimens were collected from January 2014 to January 2019 from children below 5 years old with AGE in Bangladesh. All samples were analyzed by reverse transcriptase polymerase chain reaction to detect norovirus, and sequence analysis was conducted if found positive. Norovirus was detected in 5.1% (24 of 466) fecal specimens. Norovirus genotype GII.7 was predominant (62.5%, 15 of 24), followed by GII.3 (37.5%, 9 of 24). Coinfection between rotavirus and norovirus was found in 7 of 24 positive cases. Diarrhea (93.7%) and dehydration (89%) were the most common symptoms in children with AGE. About 80% of the positive cases were detected in children aged under 24 months. One seasonal peak (87.5% infection) was detected in the winter. This study suggests that norovirus continues to be one of the major etiologies of children AGE in Bangladesh. This study will provide a guideline to assess the burden of norovirus infection in Bangladesh, which will assist to combat against AGE.
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Affiliation(s)
- Shuvra Kanti Dey
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Nadim Sharif
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Baki Billah
- Department of Zoology, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | | | - Tarequl Islam
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | | | - Ali Azam Talukder
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Tung Phan
- Division of Clinical Microbiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Hiroshi Ushijima
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University, Tokyo, Japan
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Norovirus strains in patients with acute gastroenteritis in rural and low-income urban areas in northern Brazil. Arch Virol 2021; 166:905-913. [PMID: 33462673 DOI: 10.1007/s00705-020-04944-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 11/13/2020] [Indexed: 01/24/2023]
Abstract
From 2010-2016, a total of 251 stool samples were screened for norovirus using next-generation sequencing (NGS) followed by phylogenetic analysis to investigate the genotypic diversity of noroviruses in rural and low-income urban areas in northern Brazil. Norovirus infection was detected in 19.9% (50/251) of the samples. Eight different genotypes were identified: GII.4_Sydney[P31] (64%, 32/50), GII.6[P7] (14%, 7/50), GII.17[P17] (6%, 3/50), GII.1[P33] (6%, 3/50), GII.3[P16] (4%, 2/50), GII.2[P16] (2%, 1/50), GII.2[P2] (2%, 1/50), and GII.4_New Orleans[P4] (2%, 1/50). Distinct GII.6[P7] variants were recognized, indicating the presence of different co-circulating strains. Elucidating norovirus genetic diversity will improve our understanding of their potential health burden, in particular for the GII.4_Sydney[P31] variant.
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Pankov RC, Gondim RNDG, Prata MMG, Medeiros PHQS, Veras HN, Santos AKS, Havt A, da Silva MFM, Fumian TM, Miagostovich MP, Leite JPG, Lima AAM. Rotavirus A Infections in Community Childhood Diarrhea in the Brazilian Semiarid Region During Postvaccination Era. J Pediatr Gastroenterol Nutr 2019; 69:e91-e98. [PMID: 31568040 DOI: 10.1097/mpg.0000000000002416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND Rotavirus A (RVA) is one of the leading causes of acute gastroenteritis worldwide; however, few studies assessed RVA genetics with community surveillance. OBJECTIVES This study aimed to investigate clinical data, genetic diversity, and coinfection patterns of RVA infections in children from 2 to 36 months old with or without community childhood diarrhea in the Brazilian semiarid region during postvaccination era. METHODS We enrolled and collected socioeconomic/clinical information using a standardized questionnaire and fecal samples from 291 children. Viral RNA samples were extracted and analyzed using quantitative reverse transcription polymerase chain reaction to establish the diagnosis of RVA. Sequencing of VP7 and VP4 (VP8*) regions and phylogenetic analysis were performed. RESULTS RVA-negative diagnosis was associated with children 24 to 36 months old with complete vaccination schedule. Genotype G1P[8] was the most prevalent (57%), whereas unusual genotypes including G1P[4], G2P[8], and G3P[9] were also detected. G1- and P[8]-positive samples showed high degrees of similarity with the vaccine strain. RVA coinfections were frequently observed, and enteroaggregative Escherichia coli was the most prevalent copathogen. CONCLUSIONS These results demonstrate that genotype G1P[8] is the most prevalent strain. VP7 and/or VP8* gene segments arising from RV1 vaccine strain were documented in these children, suggesting shedding or herd vaccination. Moreover, our study indicates full vaccination is important for protection against RVA infections.
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Affiliation(s)
- Rafaela C Pankov
- Institute of Biomedicine and Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE
| | - Rafhaella N D G Gondim
- Institute of Biomedicine and Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE
| | - Mara M G Prata
- Institute of Biomedicine and Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE
| | - Pedro H Q S Medeiros
- Institute of Biomedicine and Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE
| | - Herlice N Veras
- Institute of Biomedicine and Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE
| | - Ana K S Santos
- Institute of Biomedicine and Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE
| | - Alexandre Havt
- Institute of Biomedicine and Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE
| | | | | | | | | | - Aldo A M Lima
- Institute of Biomedicine and Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE
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