Abstract
BackgroundThe emergence of norovirus genotype GII.4 variants has been associated with gastroenteritis pandemics worldwide, prompting molecular surveillance for early detection of novel strains. In this study, we aimed to analyze the outbreak activity of norovirus and characterize the norovirus strains circulating in Alberta between July 2012 and February 2018.MethodsStool samples from gastroenteritis outbreaks in Alberta were tested for norovirus at the Provincial Laboratory for Public Health using a multiplex real time-RT PCR assay. The ORF1 and ORF2-genotypes of norovirus positive samples were assigned based on phylogenetic analyses of partial polymerase and capsid sequences, respectively.ResultsA total of 530 norovirus outbreaks were identified. During July 2012 and June 2017 there was a gradual decrease in the annual number of GII.4 outbreaks, however, outbreak numbers increased from June 2017–February 2018. Four novel strains emerged: GII.17 Kawasaki in July 2014–June 2015, GII.P16/GII.4 Sydney in July 2015–June 2016, GII.P16/GII.2 and GII.P4 New Orleans/GII.4 Sydney in July 2016–June 2017. GII.Pe/GII.4 Sydney was the single predominant strain responsible for the majority (over 50%) of all norovirus outbreaks up to June 2015. Between June 2017 and February 2018, GII.P16/GII.4 Sydney was the leading strain causing 63% of all norovirus outbreaks.ConclusionsGII.4 stands as the predominant capsid genotype causing a large majority of the norovirus outbreaks in early 2018. An increase in genotype diversity was observed in the last years, characterized by a high circulation of non-GII.4 strains and GII.4 recombinants.
Highlights
The emergence of norovirus genotype GII.4 variants has been associated with gastroenteritis pandemics worldwide, prompting molecular surveillance for early detection of novel strains
Norovirus outbreaks: Annual activity and circulating genotypes A total of 1572 gastroenteritis outbreak investigations were performed in Alberta between July 1st 2012 and February 30th 2018, of which 859 (54.6%) had specimens submitted to the Provincial Laboratory for Public Health (ProvLab) for laboratory testing
Strains carrying an ORF2 of variant Sydney were accountable for the majority of GII.4 outbreaks (297/319, 93.1%)
Summary
The emergence of norovirus genotype GII. variants has been associated with gastroenteritis pandemics worldwide, prompting molecular surveillance for early detection of novel strains. P2 forms the outermost part of the virion and contains binding sites for histo-blood group antigens (HBGAs), attachment factors for human NoV strains. Norovirus can evade host immune responses by antigenic drift, through a process similar to influenza’s epochal evolution [4]. Recombination is another mechanism of evolution for NoV that often occurs at the ORF1/ ORF2 junction, further increasing the genetic diversity of the virus [5]. Seven NoV genogroups (GI to GVII) have been described to date of which GI, GII and GIV can cause gastroenteritis in humans, with GIV being less common [6].
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