Characterization of the new GII.17 norovirus variant that emerged recently as the predominant strain in China.

Human noroviruses are the most important viral pathogens causing epidemic acute gastroenteritis, in which the GII.4 viruses have been predominant worldwide for the past decades. During 2014-2015 winter season, a new GII.17 variant emerged as the predominant virus in China surpassing the GII.4 virus in causing significantly increased acute gastroenteritis outbreaks. Genome sequences of the new GII.17 variant was determined and compared with other GII.17 noroviruses, revealing residue substitutions at specific locations, including the histo-blood group antigen-binding site and the putative antigenic epitopes. Further study of GII.17 outbreaks focusing on host susceptibility showed that the new GII.17 variant infected secretor individuals of A, B, O and Lewis types. Accordingly, the P particles of the new GII.17 variant bound secretor saliva samples of A, B, O and Lewis types with significantly higher binding signals than those of the P particles of the previous GII.17 variants. In addition, human sera collected from the outbreaks exhibited stronger blockade against the binding of the new GII.17 P particles to saliva samples than those against the binding between the P particles of previous GII.17 variants and saliva samples. Taken together, our data strongly suggested that the new GII.17 variant gained new histo-blood group antigen-binding ability and antigenic features, which may contribute to its predominance in causing human norovirus epidemics.

Molecular epidemiology of genogroup II norovirus infection among hospitalized children with acute gastroenteritis in Suzhou (Jiangsu, China) from 2010 to 2013.

Noroviruses (NoVs) are the most common cause of acute gastroenteritis in both sporadic and outbreak cases. Genotyping and recombination analyses were performed in order to help getting more knowledge of the distribution and genetic diversity of NoVs in Suzhou, located in Jiangsu province of China. All stool samples were collected from hospitalized children younger than 5 years old with acute gastroenteritis. For genotyping, the open reading frame (ORF) 1 and ORF2 were partially amplified and sequenced. 26.9% of stool samples were positive for genogroup II NoVs. The most common genotype was GII.4 and its variants included Den Haag-2006b, New Orleans-2009, and Sydney-2012. The Den Haag-2006b variants predominated during 2010-2012. In 2013, it was replaced by the Sydney-2012 variant. The second most common genotype was GII.12/GII.3. NoVs could be detected throughout the year, with GII.4 and GII.12/GII.3 coexisting during the cold months, and GII.4 was the main genotype during the warm months. The highest prevalence of NoV was detected in young children aged <24 months. Patients infected with GII.4 had a higher chance of getting moderate fever than other NoV-positive patients, while those infected with GII.12/GII.3 tended to have a mild degree of fever. NoV is an important pathogen responsible for viral gastroenteritis among children in Suzhou. Analyses of NoV circulating between 2010 and 2013 revealed a change of predominant variant of NoV GII.4 in each epidemic season and intergenotype recombinant strains represented an important part.

Emergence of two novel norovirus genotype II.4 variants associated with viral gastroenteritis in China.

Noroviruses (NoVs) are the principal cause of epidemic viral gastroenteritis worldwide, including industrialized and developing countries. Eight hundred and fifty sporadic specimens from hospitalized children with acute gastroenteritis and 131 specimens from seven gastroenteritis outbreaks were collected during 2011-2012 in Jiangsu, China. All specimens were tested for the presence of norovirus (NoV) by real time RT-PCR, and in these, 225/850 of sporadic specimens and 76/131 of outbreak specimens were positive. By sequencing, two novel variants termed JS2011/CHN variant and JS2012/CHN variant were found. By complete genome sequencing and phylogenetic analysis confirmed that both JS2011/CHN variant and JS2012/CHN variant shared more than 98% identity with GII.4 New Orleans/2009/USA strain and GII.4 Sydney/2012/AUS. Both of them had mutations in some key sites in nucleotide sequence and amino acid sequence of ORF1-ORF3. Whether two novel variants will cause epidemic of NoV outbreaks in China deserves further attention. A national surveillance network may be needed to identify trends in molecular evolution of NoVs for prevention of future epidemics.

Outbreaks of acute gastroenteritis associated with a re-emerging GII.P16-GII.2 norovirus in the spring of 2017 in Jiangsu, China.

A total of 64 acute gastroenteritis outbreaks with 2,953 patients starting in December of 2016 and occurring mostly in the late spring of 2017 were reported in Jiangsu, China. A recombinant GII.P16-GII.2 norovirus variant was associated with 47 outbreaks (73.4%) for the gastroenteritis epidemic, predominantly occurring in February and March of 2017. Sequence analysis of the RNA-dependent RNA polymerase (RdRp) and capsid protein of the viral isolates from these outbreaks confirmed that this GII.P16-GII.2 strain was the GII.P16-GII.2 variant with the intergenotypic recombination, identified in Taiwan, Hong Kong, and other cities in China in 2016. This GII.P16-GII.2 recombinant variant appeared to a re-emerging strain, firstly identified in 2011-2012 from Japan and USA but might be independently originated from other GII.P16-GII.2 variants for sporadic and outbreaks of gastroenteritis in Japan and China before 2016. Further identification of unique amino acid mutations in both VP1 and RdRp of NoV strain as shown in this report may provide insight in explaining its structural and antigenic changes, potentially critical for the variant recombinant to gain its predominance in causing regional and worldwide epidemics.

[Molecular characteristics of acute gastroenteritis outbreaks caused by norovirus, in Jiangsu province].

OBJECTIVE: To study both the epidemiologic and molecular characteristics of outbreaks caused by norovirus (NoV) with its variants, in Jiangsu. METHODS: 67 specimens from seven gastroenteritis outbreaks were collected from October 2012 to March 2013 in Jiangsu. NoV gene group was detected by Real-Time RT-PCR. NoV portions of RdRp gene and VP1 gene were amplified under RT-PCR. RESULTS: Seven gastroenteritis outbreaks were caused by NoV. Among all the fecal specimens,45 (67.2%) showed positive to NoV G II. Study on the genotype was conducted through analyzing the nucleotide sequence of RdRp gene. Based on the RdRp region, 7 strains appeared to be G II, with 3 and 38 strains belonged to G II.4--Sydney variants. Results from phylogenetic analysis confirmed that 38 variants shared 99% identity with G II.4--Sydney. We also amplified the VP1 genes from 6 variants and comparing with 9 epidemic strains on the sequence amino acid sequence. All the strains showed mutation in amino acid sequence at some key sites which were closely related to the forming of neutralizing epitopes. CONCLUSION: The short interval periods between all 7 NoV outbreaks with identical viral strain indicated the emergence of a new NoV variant in Jiangsu province,that had caused a number of epidemics abroad. Results from our study suggested that the development of monitoring programs on this novel G II.4--Sydney variant should be a part of the NoV surveillance in Jiangsu province or even in the country.

[Molecular features of human bocavirus from infantile diarrhea in Suzhou area, Jiangsu province in 2010-2011].

OBJECTIVE: To investigate the status of human bocavirus and to identify its epidemiological characteristics as well as genotype distribution in patients with infantile viral diarrhea in Suzhou, Jiangsu province. METHODS: 832 fecal specimens from patients with infantile virus diarrhea cases were collected from Suzhou Children's Hospital in 2010-2011. Human bocavirus were detected by Real-Time RT-PCR, and genotype were determined by sequence analysis. RESULTS: Among all the fecal specimens, 51 (6.1%) cases were positive for human bocavirus. The peak season of rotavirus infection was between July and September. Of all the episodes on rotavirus diarrhea, 96% occurred before 2 years of age, with peaks in children with 7-12 months of age. Data from Nucleotide Sequence analysis showed that among 28 samples that carrying HBoV-1, 5 strains belonged to HBoV-2, HBoV type 3 but type 4 were absent. CONCLUSION: Human bocavirus were detected from fecal specimens of infantile virus diarrhea in Suzhou, with genotype HBoV-1 as the major strain. HBoV-2 genotype was also found.

[Serologic survey on pandemic influenza A (H1N1) virus among aged ≥ 3 years population from Jiangsu province in 2009, China].

OBJECTIVE: To understand the antibody levels against pandemic influenza A (H1N1) virus (2009 H1N1) among aged ≥ 3 years population in 2009, from Jiangsu province, and to describe the distribution of 2009 H1N1. METHODS: Serum specimens were collected from natural populations at four different periods in Jiangsu, and tested with hemagglutination-inhibition (HI) assays. Rates of protective antibody against 2009 H1N1 and Geometric mean titers (GMTs) were estimated. RESULTS: The rates of protective antibody against 2009 H1N1 rose with the progress of epidemics in Jiangsu, which were 3.46%, 7.59%, 16.94%, respectively in July, August and November, 2009. There were no significant differences on the rates of protective antibody between males and females at four different cross-sectional periods (P > 0.05), and no significant differences on GMTs were observed at different periods except for November 2009. Significant differences on rates of protective antibody and GMTs among various age groups were observed at four different periods (P < 0.05), and similar results were observed among different periods in various age groups (P < 0.05). There were significant differences on rates of protective antibody and GMTs among different areas (P < 0.05). CONCLUSION: The 2009 H1N1 strain had been widely spread out in Jiangsu province since July 2009. People aged 12 - 17 years became the major victims after August. As of November 2009, the rate of protective antibody against 2009 H1N1 was still low, predicting that the epidemic might continue to exist for a certain period of time.