Siebenga J Joukje, Vennema Harry, Zheng Du-Ping, Vinjé Jan, Lee Bonita E, Pang Xiao-Li, Ho Eric C M, Lim Wilina, Choudekar Avinash, Broor Shobha, Halperin Tamar, Rasool Nassar B G, Hewitt Joanne, Greening Gail E, Jin Miao, Duan Zhao-Jun, Lucero Yalda, O'Ryan Miguel, Hoehne Marina, Schreier Eckart, Ratcliff Rodney M, White Peter A, Iritani Nobuhiro, Reuter Gábor, Koopmans Marion
National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
J Infect Dis. 2009 Sep 1;200(5):802-12. doi: 10.1086/605127.
Noroviruses (NoVs) are the most common cause of viral gastroenteritis. Their high incidence and importance in health care facilities result in a great impact on public health. Studies from around the world describing increasing prevalence have been difficult to compare because of differing nomenclatures for variants of the dominant genotype, GII.4. We studied the global patterns of GII.4 epidemiology in relation to its genetic diversity.
Data from NoV outbreaks with dates of onset from January 2001 through March 2007 were collected from 15 institutions on 5 continents. Partial genome sequences (n=775) were collected, allowing phylogenetic comparison of data from different countries.
The 15 institutions reported 3098 GII.4 outbreaks, 62% of all reported NoV outbreaks. Eight GII.4 variants were identified. Four had a global distribution--the 1996, 2002, 2004, and 2006b variants. The 2003Asia and 2006a variants caused epidemics, but they were geographically limited. Finally, the 2001 Japan and 2001 Henry variants were found across the world but at low frequencies.
NoV epidemics resulted from the global spread of GII.4 strains that evolved under the influence of population immunity. Lineages show notable (and currently unexplained) differences in geographic prevalence. Establishing a global NoV network by which data on strains with the potential to cause pandemics can be rapidly exchanged may lead to improved prevention and intervention strategies.
诺如病毒（NoVs）是病毒性肠胃炎最常见的病因。它们在医疗机构中的高发病率及其重要性对公众健康产生了巨大影响。由于对主要基因型GII.4变体的命名不同，世界各地描述其患病率上升的研究难以进行比较。我们研究了GII.4流行病学的全球模式及其遗传多样性。
收集了来自五大洲15个机构的2001年1月至2007年3月发病日期的诺如病毒爆发数据。收集了部分基因组序列（n = 775），以便对来自不同国家的数据进行系统发育比较。
15个机构报告了3098起GII.4爆发，占所有报告的诺如病毒爆发的62%。鉴定出8种GII.4变体。其中4种具有全球分布——1996、2002、2004和2006b变体。2003Asia和2006a变体引发了疫情，但地域有限。最后，2001 Japan和2001 Henry变体在世界各地均有发现，但频率较低。
诺如病毒疫情是由在群体免疫影响下进化的GII.4毒株的全球传播引起的。谱系在地理患病率上存在显著（且目前无法解释）差异。建立一个全球诺如病毒网络，通过该网络可以快速交换有关可能引发大流行的毒株的数据，这可能会改进预防和干预策略。
