Abstract
Norovirus is the commonest cause of acute gastrointestinal disease and is the main aetiological agent of outbreaks of gastroenteritis, particularly in semi-closed environments. Norovirus infections in England typically peak between December and March each year. The most commonly detected norovirus strains belong to the genetically diverse genogroup-II genotype-4 (GII-4) genocluster and in the previous two norovirus winter seasons the majority of GII-4 strains in circulation worldwide have been genetically similar to the GII-4 strain New Orleans 1805/2009/USA. At the beginning of the 2012/13 season a genetically distinct GII-4 strain (Sydney 2012/NSW0514/2012/AU) was described which emerged worldwide during the winter of 2012/13. Here we describe the emergence of norovirus strains genetically related to Sydney2012 in England during the 2012/13 season to replace NewOrleans2009 strains as the most commonly detected variant of GII-4 norovirus in England. Furthermore, we demonstrate that whilst the emergence of Sydney2012 coincided with an early peak in the number of norovirus outbreaks, there was not an overall increase in norovirus activity compared to the previous season. Finally, we show that the Sydney2012 strain is associated with distinct genetic changes compared to the NewOrleans2009 strain, and these changes may have contributed to the emergence of the Sydney2012 strain.
Highlights
Noroviruses are the commonest cause of acute gastrointestinal disease in England and Wales [1,2] and is recognised as the main aetiological agent of outbreaks of infectious intestinal disease (IID)
In the early part of the 2012/13 norovirus season, between July and December 2012 there were 480 laboratory-confirmed outbreaks reported to Hospital Norovirus Outbreak Reporting System (HNORS)
The biological and epidemiological success of these strains is, at least in part, influenced by the fixation of mutations in the hypervariable P2 domain that affect the antigenic profile of the virus [23,24,25], which can lead to worldwide strain replacement events [26]
Summary
Noroviruses are the commonest cause of acute gastrointestinal disease in England and Wales [1,2] and is recognised as the main aetiological agent of outbreaks of infectious intestinal disease (IID). The 59-ORF (ORF1) encodes a large polyprotein that undergoes post-translational processing into the viral non-structural proteins; ORF2 encodes the major capsid protein, VP1; and ORF3 encodes a small basic protein (VP2) which is thought to be a minor structural protein
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