Whole genomic analysis of human G8P[14] group A rotavirus detected from community gastroenteritis outbreak.

Several suspected cases of zoonotic transmission of group A rotavirus (RVA)-related gastroenteritis were reported previously. In August 2012, G8P[14] RVA was detected in fecal specimens from a community gastroenteritis outbreak occurring during a school trip. In this study, additional analyses were performed and it was found that this strain had the G8-P[14]-I2-R2-C2-M2-A3-N2-T6-E2-H3 sequence, similar to bovine-like RVA strains. Some contamination by emesis and diarrheic feces was observed near a rest room in the lodging area. Contact history with animals was unknown in members of this school trip, and this case implied that the strain may have acquired the ability for person-to-person transmission.

Detection of Enteric Viruses in Fecal Specimens from Nonbacterial Foodborne Gastroenteritis Outbreaks in Tokyo, Japan between 1966 and 1983.

We investigated the prevalence of 5 enteric viruses (norovirus [NoV], sapovirus, rotavirus, astrovirus, and adenovirus) in archived stool specimens collected from 70 foodborne gastroenteritis outbreaks in Tokyo, Japan, which occurred from 1966 to 1983, and genetically characterized these viruses. NoV was detected in 48 (68.6%) outbreaks, while SaV, group C rotavirus (RVC), and astrovirus were detected in 1 (1.4%) outbreak each. Based on the partial capsid sequences, the detected NoVs were classified into the following genotypes: 9 in genogroup I (GI; GI.1-6, GI.8, GI.9, and GI.NA), 13 GII (GII.1-9, GII.13, GII.16, GII.17, and GII.22), and one in GIV. The oldest NoV outbreaks occurred in 1966. No predominant genotype was found. One strain, classified as GI. NA based on the N/S region sequence, was subsequently classified as GI.8 based on the complete VP1 sequence. Nine types of recombinant NoV sequences, including 7 unreported combinations, were identified. Further genetic characterization of NoV GII.17 and GII.4 demonstrated that the NoV GII.17 strains detected from 1970 to 1982 clustered independently from previously reported NoV GII.17 strains. Phylogenetic analysis, using the complete VP1 region and the P2 domain, demonstrated that NoV GII.4 strains collected between 1975 and 1980 clustered with archival strains collected in the USA in the mid-1970s. In contrast, a NoV GII.4 strain collected in 1983 formed an independent branch from reference strains collected in the mid-1970s to 2012.

Feasibility of viral dust infection via air movement and dispersion of dried viral particles from the floor.

The contributions of splash from vomiting and the dispersion of dried-up virus from a contaminated floor surface to community gastroenteritis outbreaks caused by Norovirus (NoV) were evaluated, using Feline calicivirus (FCV) as an NoV surrogate. There was no difference in the size distribution of FCV-containing particles around 0.75 µm) collected from a virus-sprayed chamber 1 and 12 hr after nebulization. FCV clearly dispersed after hitting a floor surface contaminated with dried virus. These results suggest that NoV can likely form airborne droplet nuclei, and dust may be the main route of infection transmission. J. Med. Virol. 89:931-935, 2017. © 2016 Wiley Periodicals, Inc.

Shedding of Rubella Virus among Infants with Congenital Rubella Syndrome Born in Tokyo, Japan, 2013-2014.

Rubella is usually a mild illness, with febrile rash being its main symptom. However, serious consequences of rubella infection can result when the infection occurs during the early stages of pregnancy. After the occurrence of a rubella outbreak in Japan that was observed from 2012 to 2013, 45 infants were reportedly born with congenital rubella syndrome (CRS). We prospectively followed the 15 CRS cases reported in Tokyo to determine the virus shedding periods by using nested reverse transcriptase-polymerase chain reaction to detect rubella virus genes. Throast swabs were used for virus detection. The virus shedding period was measured from birth until the time when the sample last tested positive followed by 2 consecutive negative samples. Kaplan-Meier method was used to estimate the proportion of cases remaining positive for rubella virus genes over time. The proportion of CRS cases shedding virus dropped steadily after birth, dropping to 33.8% at 6 months and 16.9% at 12 months. Our findings also suggested that the earlier the mother's onset of rubella during pregnancy, the longer the infant remained positive. Based on our findings, we believe that infants with CRS should be monitored for rubella virus shedding until 1 year of age.

[An autochthonous outbreak of dengue type 1 in Tokyo, Japan 2014].

OBJECTIVES: An outbreak of autochthonous dengue fever was reported in August 2014, with cases suspected mainly from Yoyogi Park in Tokyo. This is the first epidemic of dengue fever in Japan since 1945. METHODS: From August to October 2014, the following measures were taken to control the outbreak: 1) risk communication and information sharing; 2) active case finding; 3) vector surveillance in affected sites; and 4) laboratory testing. We also reviewed the surveillance data as reported to the National Epidemiological Surveillance of Infectious Diseases during the 44 epidemiological weeks. results: An official dengue fever call center was set up temporarily for the general public and 3,005 calls were received. The Tokyo Metropolitan Government issued 39 press releases regarding patients and nine related to dengue virus (DENV) detection and vector control activities for the media. Confirmed autochthonous dengue fever cases were reported between the 35th and 44th epidemiological weeks. Out of 160 cases of outbreak, 108 (67.5%) confirmed cases were reported in Tokyo. The estimated illness onset dates were between August 9 and October 7, and estimated dates of infections were between August 3 and October 3, 2014. The data suggest that the infective mosquitoes had already been present in Yoyogi Park at the end of July 2014. During the weekly vector surveillance at Yoyogi Park, a total of 1,152 adult mosquitoes, of which 856 (73.3%) were Aedes mosquitoes, were collected over 11 weeks by a light trap with dry ice. DENV was detected from adult Aedes mosquito samples collected on the 2nd, 9th, and 16th of September, 2014. Serum samples from 240 suspected cases were examined at the Tokyo Metropolitan Institute of Public Health, and 78 were positive for the DENV NS1 antigen, DENV-specific IgM antibody, or DENV nucleic acid with reverse transcriptase polymerase chain reaction (RT-PCR) (NS1: 66 cases; IgM: 50 cases; PCR: 57 cases). Genetic analysis of DENV-positive serum and mosquito samples found all to be categorized as DENV-serotype 1 (gene type I). Phylogenetic analysis of the envelope protein genome sequence from patients and mosquitoes in Tokyo revealed more than 99% similarity with each other and with the strain from the first outbreak-associated patient in Saitama. CONCLUSION: Measures important for control of infectious disease epidemic were learned during this recent indigenous dengue outbreak in Tokyo. It also highlighted the importance of preparedness for epidemics of indigenous or imported infectious diseases, especially in light of the fact that Tokyo is in preparation for the Olympic and Paralympic Games in 2020.

The 2011 measles outbreak in Tokyo. An analysis of surveillance data.

OBJECTIVES: The study was conducted with the intention of establishing a strategy to eliminate measles on the basis of an analysis of the epidemiological profile of measles cases reported in Tokyo during the year 2011. METHODS: We investigated measles cases reported to the Tokyo Metropolitan Government in 2011, recorded as part of the National Epidemiological Surveillance of Infectious Diseases. Factors analyzed included age, vaccination status for each patient, cases for which records were discarded after laboratory confirmation, genotype of the measles virus and relationships between dates of specimen collection and results of polymerase chain reaction (PCR) and IgM antibody tests. RESULTS: A total of 178 measles cases were reported in Tokyo during 2011, and the majority of cases (128, 71.9%) were reported during the peak period from epiweeks 13 to 24. The largest age group reported was one to four years of age (40, 22.5%) followed by groups of 20-29 and 30-39 years of age (both 34, 19.1%). Most cases were sporadic, with only six outbreaks occurring. Even then, the numbers of cases for each outbreak was less than five. More than half of the patients in all age groups, except for the 1-4-year-old group, had not been vaccinated or did not have a record of vaccination. Genotypes D4 and D9 of measles virus were detected in most cases. However, genotype D5, which had been circulating in Japan before 2008, was not detected. CONCLUSION: Imported viruses were the cause of measles cases reported in Tokyo during 2011. The disease control was better than that in 2007 and 2008 because of the swift and appropriate responses to the occurrences. It is also possible that there has been an increase in the proportion of people with immunity to measles. Increasing the rate of immunization, performing effective surveillance, and confirming suspicious measles cases by using molecular methods are important for achieving the elimination of measles.

Multiplex real-time PCR assays for the detection of group C rotavirus, astrovirus, and Subgenus F adenovirus in stool specimens.

Group C rotavirus (GCRV), astrovirus (AstV), and adenovirus (subgenus F AdenoV) are etiologic agents of acute nonbacterial gastroenteritis, which often represents community outbreaks. For the efficient detection of GCRV, AstV, and subgenus F AdenoV in stool specimens, a multiplex real-time PCR assay was developed to detect these three viruses simultaneously, with high sensitivity and specificity. In total, 8404 clinical specimens were collected between April 2008 and March 2011 and tested for GCRV, AstV, and subgenus F AdenoV by the multiplex real-time PCR, as well as for norovirus (NoV), sapovirus (SaV), and group A rotavirus (GARV) by non-multiplex real-time PCR. Forty-one specimens were positive for GCRV, AstV, or subgenus F AdenoV, including 15 specimens that were also positive for NoV, SaV, or GARV. Multiple viruses were detected simultaneously in 29 out of 4596 (0.63%) specimens infected with at least one virus. The association rates of AstV and subgenus F AdenoV with other viruses were significantly higher than those of NoV, SaV, GARV, or GCRV.

[Detection of norovirus RNA in bivalve molluscs by using bacteria-culture-employed method (A3T method)].

Norovirus (NV) RNA has rarely been detected in foods despite the use of highly sensitive methods such as RT-PCR and real-time RT-PCR. In the modified method (A3T method) reported previously, a bacterial culture process was introduced into the standard protocol for NV detection to remove some inhibitor(s) present in food ingredients. To confirm the efficiency of the A3T method and to examine NV contamination in bivalve molluscs, we tried to detect NV RNA in bivalve molluscs on the market and in oyster samples associated with foodborne outbreaks by using the standard method and the A3T method. NV RNAs were detected in 20 samples (18.0%) of 111 bivalve molluscs, including oysters, on the market by use of the A3T method, while only one sample (0.9%) was positive according to the standard method. NV RNA was also detected in 10 of 35 oyster samples related to foodborne outbreaks by the A3T method. Those results show that the A3T method is suitable for the detection of NV in bivalve molluscs in general laboratories.

[Enhancement of norovirus detection rates in oysters and other food samples by using bacterial treatment].

Factors such as low recovery rate and food contaminants may be responsible for the difficulty of detecting Norovirus (NV) by PCR in foodborne outbreaks. To detect NV more efficiently, we introduced a bacterial treatment, in which concentrated samples were incubated overnight with Klebsiella oxytoca at 35 degrees C before RNA extraction using the standard protocol. Recovery rates of NVs (G I/8 or G II/13) added to food suspensions in the modified method were compared with those in the standard method by quantification of NV RNAs using real-time PCR. Recovery rates in the modified method were 8.6% for G I/8 and 11.6% for G II/13 in 18 oyster samples and 13.9% for G I/8 and 19.6% for G II/13 in 15 other food samples, while those in the standard method were 0.3% for G I/8 and 0.5% for G II/13 in the oyster samples and 1.9% for G I/8 and 7.9% for G II/13 in the other food samples. These results indicate that the bacterial treatment increase the recovery of NV from foods such as oysters, suggesting that the modified method will be useful for NV detection in food samples.

[Effects of hand hygiene on feline calicivirus inactivation and removal as norovirus surrogate treated with antiseptic hand rubbing, wet wipes, and functional water].

As a preventive action plan against gastroenteritis caused by the Norovirus (NV), we studied hand hygiene effects using with three hand rubbing products, four wet wipe products, and two functional water types using Feline Calicivirus as a Norovirus surrogate. After treatment using antiseptic hand rubbing products containing chlorhexidine, quaternary ammonium, and povidone-iodine, high inactivation detected by TCID50 was observed compared to products containing povidone-iodine, although no difference was seen in viral removal measured by the amount of viral genome copies in real-time-PCR. Among wet wipes soaked in chlorhexidine, quaternary ammonium, benzoic acid and PHMB, two groups showed viral inactivation and removal. Two products were more effective for functional water, viral decrease was seen in rinsing in running electrolyzed acid water and handwashing by soap. Results underscore the importance of selection in hand washing metheds (alternative soap and also) in preventing viral gastroenteritis.

[Effects of handwashing on Feline Calicivirus removal as Norovirus surrogate].

Viral gastroenteritis caused by Norovirus (NV) mainly appears during the winter season. In fact, outbreaks and patients with NV gastroenteritis are the major cause of community disease in the winter. Strategies to avoid gastroenteritis caused by NV are thus needed. No effective method for evaluating virus inactivation and removal exists for of NV, which cannot be cultured using cell-lines. Trials using Feline Calici Virus (FCV; a member of the calicivirus family) as a NV surrogate have been conducted by culturing FCV in CRFK cells. By washing one's hands, about 99% of the viruses can be removed, compared with simply rinsing one's hands in running water. Washing one's hands with alcohol, chlorhexidine, quaternary ammonium, or 3 other kinds of hand soaps (containing povidone-iodine, triclosan, and isopropylmethyl phenol, respectively), was also effective for removing viruses. These results suggest that washing one's hands may be an effective method of preventing viral gastroenteritis.

Multiple viral infections and genomic divergence among noroviruses during an outbreak of acute gastroenteritis.

An epidemic outbreak of both norovirus (NV) and astrovirus (ASV) occurred on a research ship surveying Tokyo Bay, causing acute gastroenteritis in 26 of its 37 crew members. The presence of viral pathogens in fecal specimens was analyzed, and noroviruses were identified by reverse transcription-PCR in 18 (48.6%) of these specimens. In addition, astroviruses were identified in 14 (37.8%) of the fecal samples from the affected crew members, and multiple viral infections of both NV and ASV were observed in 6 cases. The genogrouping of the NV-positive samples was then examined by dot blot hybridization, and it was determined that all of the isolates were from genogroup II (GII). No bacterial pathogens were subsequently isolated from fecal specimens. Furthermore, a variety of NV strains were identified by sequencing and single-stranded conformational polymorphism (SSCP) analyses of PCR products from the fecal samples. One recombinant NV isolate, Minato/14, was identified as a recombinant NV strain of GII/6 and GII/1. The other NV isolates from this outbreak were classified into three NV genotypes (GII/1 [Minato/10], GII/4 [Minato/33], and GII/5 [Minato/6]). Furthermore, ASVs in positive samples were determined to belong to serotypes 1 and 2 by sequencing analysis. Our findings thus indicate that coinfections with NV and ASV, including a number of NV genotypes, persisted during an outbreak of gastroenteritis in a closed environment.

[Comparison of the number of Norovirus genome copies in patients and healthy persons].

In viral gastroenteritis outbreaks occurred by Norovirus (NV), NV was detected not only from patients but also from healthy persons who have taken the same food, and also detected from healthy staff members working at community places such as hospital, school and nursing home. The number of fecal NV genome copies of patients, healthy persons and food handlers are examined by real-time PCR method, to investigate foodborne gastroenteritis and person to person transmission outbreaks. There is no significant difference on the number of NV genome copies in feces between patients, and NV-detected healthy persons. Those result indicate asymptomatic carrier of NV who were working as food handlers or staff members at community places will become an origin of food-borne gastroenteritis or person to person transmission outbreaks.

[Community gastroenteritis caused by adenovirus type 41].

Viral gastroenteritis is caused mainly by NV (Norovirus). Rotavirus, Astrovirus and Adenovirus are the major cause of gastroenteritis in humans although there are rare cases. From the end of June to the beginning of July 2002, we had an endemic of community gastroenteritis by Adenovirus. In our investigation, the patients were separated into 3 groups. On comparison of the viruses from each groups we observed that they had the same characteristics. In conclusion, we found that the infection was caused by person to person contact and not by food.