Abstract

Sapovirus enteric disease affects people of all ages across the globe, in both sporadic cases and outbreak settings. Sapovirus is seldom assessed in Germany and its epidemiology in the country is essentially unknown. Thus, sapovirus occurrence and genetic diversity were studied by real-time reverse transcription polymerase chain reaction (RT-PCR) and partial sequencing of major viral structural protein (VP1) gene in two different sets of stool samples: (1) a selection of 342 diarrheal stools collected from inpatient children during 2008−2009, and (2) 5555 stool samples collected during 2010–2018 from inpatients of all age groups with gastrointestinal complaints. Results showed year-round circulation of sapoviruses, with peaks during cooler months. In total, 30 samples (8.8%) of the first and 112 samples of the second set of samples (2.0%) were sapovirus positive. Capsid gene sequencing was successful in 134/142 samples (94.4%) and showed circulation of all known human pathogenic genogroups. Genotype GI.1 predominated (31.8%), followed by GII.1 (16.7%), GII.3 (14.5%), GI.2 (13.8%) and GV.1 (12.3%). Additionally, minor circulation of GI.3, GI.6, GII.2, GII.4, GII.6 and GIV.1 was shown. Consequently, sapovirus diagnostics need broadly reactive RT-PCR protocols and should particularly be considered in infants and young children. Further studies from other sampling sites are essential to extend our knowledge on sapovirus epidemiology in Germany.

Highlights

  • Throughout the world and among all age groups, human sapovirus infections are associated with acute gastroenteritis, in both sporadic cases and outbreak settings [1,2]

  • The presence of sapovirus RNA was assessed in two different sets of stool samples, which had been collected at Leipzig University Hospital, Germany

  • In none of the phylogenetic sub-clusters more than two nosocomial cases grouped. This is the first report to provide comprehensive data on molecular epidemiology of human sapoviruses circulating at a sampling site in Germany

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Summary

Introduction

Throughout the world and among all age groups, human sapovirus infections are associated with acute gastroenteritis, in both sporadic cases and outbreak settings [1,2]. Among patients with sporadic gastroenteritis, sapoviruses were shown to rank second to fourth as the major viral pathogens [2]. Though tending to be somewhat milder, the clinical symptoms of sapovirus gastroenteritis are indistinguishable from those caused by noroviruses [4]. Sapoviruses were first described in 1976 [5] and their name refers to an outbreak in an orphanage in the city of Sapporo in Japan [6]. Sapoviruses are classified in the Caliciviridae family [7]. The human sapovirus genome is a 7.4–7.5 kb single-stranded, positive-sense RNA molecule with a 3’-end poly(A) tail.

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