Abstract
BackgroundNorovirus is a leading cause of acute gastroenteritis worldwide. Routine norovirus diagnosis requires stool collection. The goal of this study was to develop and validate a noninvasive method to diagnose norovirus to complement stool diagnostics and to facilitate studies on transmission.MethodsA multiplex immunoassay to measure salivary immunoglobulin G (IgG) responses to 5 common norovirus genotypes (GI.1, GII.2, GII.4, GII.6, and GII.17) was developed. The assay was validated using acute and convalescent saliva samples collected from Peruvian children <5 years of age with polymerase chain reaction (PCR)–diagnosed norovirus infections (n = 175) and controls (n = 32). The assay sensitivity and specificity were calculated to determine infection status based on fold rise of salivary norovirus genotype-specific IgG using norovirus genotype from stool as reference.ResultsThe salivary assay detected recent norovirus infections and correctly assigned the infecting genotype. Sensitivity was 71% and specificity was 96% across the evaluated genotypes compared to PCR-diagnosed norovirus infection.ConclusionsThis saliva-based assay will be a useful tool to monitor norovirus transmission in high-risk settings such as daycare centers or hospitals. Cross-reactivity is limited between the tested genotypes, which represent the most commonly circulating genotypes.
Highlights
Norovirus is a leading cause of acute gastroenteritis worldwide
Sensitivity was 71% and specificity was 96% across the evaluated genotypes compared to polymerase chain reaction (PCR)-diagnosed norovirus infection
We aimed to (1) investigate the change in norovirus genotype-specific immunoglobulin G (IgG) in saliva between the acute and convalescent phase of norovirus infection and (2) determine the salivary norovirus IgG assay’s sensitivity and specificity to diagnose norovirus infection at the genotype level compared to molecular diagnosis by RT-PCR of the infecting genotype in stool in order to provide a practical tool for the evaluation of norovirus outbreaks and study of transmission
Summary
The goal of this study was to develop and validate a noninvasive method to diagnose norovirus to complement stool diagnostics and to facilitate studies on transmission. Our goal was to develop and validate a multiplex norovirus assay to measure antibody responses in saliva to 5 common norovirus genotypes (GI., GII., GII., GII., and GII.17) and to describe the salivary IgG response to those genotypes among children with stool-diagnosed norovirus infection and controls. We aimed to (1) investigate the change in norovirus genotype-specific IgG in saliva between the acute and convalescent phase of norovirus infection and (2) determine the salivary norovirus IgG assay’s sensitivity and specificity to diagnose norovirus infection at the genotype level compared to molecular diagnosis by RT-PCR of the infecting genotype in stool in order to provide a practical tool for the evaluation of norovirus outbreaks and study of transmission
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