Abstract
Since early November 2016, the number of laboratory-confirmed norovirus infections reported in Germany has been increasing steeply. Here, we report the detection and genetic characterisation of an emerging norovirus recombinant, GII.P16-GII.2. This strain was frequently identified as the cause of sporadic cases as well as outbreaks in nine federal states of Germany. Our findings suggest that the emergence of GII.P16-GII.2 contributed to rising case numbers of norovirus gastroenteritis in Germany.
Highlights
The Consultant Laboratories (CL) and National Reference centre (NRC) are officially appointed and funded by the German Federal Ministry of Health and play a central role in detection and prevention of infection disease in Germany
175 samples were associated with 69 outbreaks, mainly in childcare facilities (n = 39 outbreaks) and nursing homes (n = 12 outbreaks) in 11 of 16 federal states (Baden-Wuerttemberg, Bavaria, Berlin, Hesse, Lower Saxony, Mecklenburg-Western Pomerania, North Rhine-Westphalia, RhinelandPalatinate, Saxony, Schleswig-Holstein and Thuringia)
65 samples were from sporadic AGE and were sent by hospitals and diagnostics laboratories from six federal states (Baden-Wuerttemberg, Berlin, Brandenburg, Hamburg, Lower Saxony and North Rhine-Westphalia)
Summary
Steep rise in norovirus cases and emergence of a new recombinant strain GII.P16-GII., Germany, winter 2016. We report the detection and genetic characterisation of an emerging norovirus recombinant, GII.P16-GII.2 This strain was frequently identified as the cause of sporadic cases as well as outbreaks in nine federal states of Germany. In November 2016, 14,872 laboratory-confirmed cases were reported to the national public health authority compared with a median of 7,810 cases in the same month of the previous five years. This may be due to a new variant’s ability to escape herd immunity to the previously circulating strains. We conducted a phylogenetic analysis of the currently circulating norovirus strains in order to assess whether one or several new strains could be responsible for the current steep rise in norovirus cases
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