Case Report
Detection of human norovirus GIV.1 in China: A case report

https://doi.org/10.1016/j.jcv.2014.08.002Get rights and content

Highlights

  • We report the first identification of human norovirus strain GIV.1 in China.

  • The full-length genome of human norovirus strain GIV.1 was determined and submitted to GenBank.

  • The local prevalence and clinical characteristics of human norovirus GIV.1 are explored.

Abstract

Noroviruses (NoVs) are a common cause of acute gastroenteritis (AGE) around the world; however, reports of genogroup IV (GIV) NoVs are rare. Here we report a human GIV genotype 1 (GIV.1) NoV strain (named CHNNGIV2011) identified by 454 high-throughput sequencing from stool samples of children with diarrhea. This is the first documented human GIV.1 NoVs infection in China. The complete genome of the virus is 7525 nucleotides in length. Sequencing and phylogenetic analyses showed that CHNNGIV2011 shared high sequence similarity to other GIV.1 NoVs from all over the world, especially to the recently reported NoV GIV.1 strain Lake Macquarie genome (99.0%). By seminested PCR and real-time PCR, a total of 2 out of 466 samples were positive for GIV.1 CHNNGIV2011 in Lulong County, Hebei Province, China, which supported a low prevalence of GIV.1 NoVs. The positive samples contained 7.2 × 107 and 2.6 × 108 copies/g in feces. In addition, one positive sample was found coinfection with strains NoV GII and salivirus. These findings suggest more study is needed to address the worldwide prevalence and role of GIV NoVs in AGE.

Section snippets

Why this case is important

Noroviruses (NoVs) are the major cause of acute gastroenteritis globally. The NoV genome is composed of three open reading frames (ORFs): a large non-structural protein, a major capsid protein (VP1), and a small basic structural protein (VP2). Based on VP1, NoVs have been divided into six genogroups (GI–GVI) [1]. GIV NoVs are further classified into genotype 1 and 2 (GIV.1 and GIV.2). Only GI, GII, and GIV.1 NoVs have been identified in humans [2], among which GI and GII cause most human

Case description

A total of 466 fecal samples from 466 children under the age of 5 years hospitalized with gastroenteritis were collected at Lulong County People's Hospital in Lulong County, Hebei Province, China, between April of 2011 and April of 2013.

Five fecal samples from children with gastroenteritis were pooled and sequenced by Roche Genome Sequencer FLX Titanium pyrosequencing technology. A customized informatics pipeline [8] with minor modifications identified 599 unique reads that shared sequence

Similar and contrasting cases in the literature and discussion

To date, GIV NoVs are rarely reported in humans. Human GIV.1 NoVs were first identified from sporadic cases of gastroenteritis [21]. From then on, they were occasionally detected in NoVs routine screenings of clinical and environmental samples [4], [5], [6], [7], [22]. Interestingly, in animals, GIV.2 NoVs were also detected [9], [23], [24]. Data on the clinical role of GIV NoVs are also limited. In the present study, two patients with gastroenteritis were found to be positive for NoV GIV.1 in

Authors’ contribution

Acquisition of data, data analysis, data interpretation and drafting the manuscript (Yuan-yun Ao). Involved in laboratory work (Yuan-yun Ao, Jie-mei Yu and Li-li Li). The conception and design of the study, and revising the manuscript critically for important intellectual content (Zhao-jun Duan, Jie-mei Yu, and Miao Jin). Final approval of the version to be submitted (Zhao-jun Duan, Jie-mei Yu).

Funding

This work was partly supported by the Gates Foundation (grant no. OPP1016839), and the National Natural Science Foundation of China (grant no. 81290345).

Competing interests

None of the authors has a conflict of interest to report.

Ethical approval

Consent to participate in this study was obtained from the parents of the children. The study protocol was approved by the National Institute for Viral Diseases Control and Prevention (Beijing, China) and the ethics committee of Lulong County People's Hospital (Hebei Province, China).

Acknowledgments

We thank David Wang and Guoyan Zhao from the Department of Pathology and Immunology, Washington University School of Medicine (St. Louis, MO, USA), for their help with the bioinformatics analyses.

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