Grant Lindsay R, O'Brien Katherine L, Weatherholtz Robert C, Reid Raymond, Goklish Novalene, Santosham Mathuram, Parashar Umesh, Vinjé Jan
Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
PLoS One. 2017 Jan 3;12(1):e0169491. doi: 10.1371/journal.pone.0169491. eCollection 2017.
Norovirus and sapovirus are important causes of acute gastroenteritis (AGE) among American Indian infants. We investigated the prevalence and molecular epidemiology of norovirus and sapovirus in American Indian infants who have historically experienced a high burden of AGE compared to other US populations. Stool samples were collected from 241 children with AGE (cases) and from 343 infants without AGE (controls) ≤9 months of age from 2002-2004. Cases experienced forceful vomiting and/or 3 or more watery or looser-than-normal stools in 24 hours. Stools were tested by real-time RT-PCR for norovirus GI, GII and GIV and sapovirus GI, GII, GIV and GV. Positive samples were genotyped after sequencing conventional RT-PCR products. Norovirus was identified in 76 (31.5%) of the cases and 70 (20.4%) of the controls (p<0.001). GII.3 and GII.4 Farmington Hills were the most frequently identified genotypes in 14.5% and 30.3% of cases and 17.1% and 27.1% of controls, respectively. Sapovirus GI and GII genotypes were identified in 8 (3.3%) of cases and 8 (2.3%) of controls and a single GIV virus was detected in a control. The same norovirus and sapovirus genotypes were circulating in the general U.S. population in the same time period. The high detection rate of norovirus in healthy controls suggests significant asymptomatic transmission in young infants in these communities.
诺如病毒和札幌病毒是美国印第安婴儿急性胃肠炎（AGE）的重要病因。与其他美国人群相比，美国印第安婴儿历史上AGE负担较高，我们对这些婴儿中诺如病毒和札幌病毒的流行情况及分子流行病学进行了调查。2002年至2004年期间，从241名患AGE的儿童（病例组）和343名≤9个月未患AGE的婴儿（对照组）中采集粪便样本。病例组儿童在24小时内出现剧烈呕吐和/或3次或更多次水样便或比正常更稀的粪便。粪便样本通过实时逆转录聚合酶链反应检测诺如病毒GI、GII和GIV以及札幌病毒GI、GII、GIV和GV。对常规逆转录聚合酶链反应产物测序后，对阳性样本进行基因分型。病例组中76例（31.5%）检测出诺如病毒，对照组中70例（20.4%）检测出诺如病毒（p<0.001）。GII.3和GII.4法明顿希尔斯株分别是病例组中14.5%和30.3%以及对照组中17.1%和27.1%最常鉴定出的基因型。病例组中有8例（3.3%）和对照组中有8例（2.3%）鉴定出札幌病毒GI和GII基因型，在1例对照组中检测到1株GIV病毒。同一时期，相同的诺如病毒和札幌病毒基因型在美国普通人群中传播。健康对照组中诺如病毒的高检出率表明这些社区的幼儿中存在显著的无症状传播。
