Faculty of Science, School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW, 2052, Australia.
Institute of Environmental Science and Research, Kenepuru Science Centre, Porirua, 5022, New Zealand.
Emerg Microbes Infect. 2018 Mar 29;7(1):50. doi: 10.1038/s41426-018-0047-8.
Norovirus is estimated to cause 677 million annual cases of gastroenteritis worldwide, resulting in 210,000 deaths. As viral gastroenteritis is generally self-limiting, clinical samples for epidemiological studies only partially represent circulating noroviruses in the population and is biased towards severe symptomatic cases. As infected individuals from both symptomatic and asymptomatic cases shed viruses into the sewerage system at a high concentration, waste water samples are useful for the molecular epidemiological analysis of norovirus genotypes at a population level. Using Illumina MiSeq and Sanger sequencing, we surveyed circulating norovirus within Australia and New Zealand, from July 2014 to December 2016. Importantly, norovirus genomic diversity during 2016 was compared between clinical and waste water samples to identify potential pandemic variants, novel recombinant viruses and the timing of their emergence. Although the GII.4 Sydney 2012 variant was prominent in 2014 and 2015, its prevalence significantly decreased in both clinical and waste water samples over 2016. This was concomitant with the emergence of multiple norovirus strains, including twoGII.4 Sydney 2012 recombinant viruses, GII.P4 New Orleans 2009/GII.4 Sydney 2012 and GII.P16/GII.4 Sydney 2012, along with three other emerging strains GII.17, GII.P12/GII.3 and GII.P16/GII.2. This is unusual, as a single GII.4 pandemic variant is generally responsible for 65-80% of all human norovirus infections at any one time and predominates until it is replaced by a new pandemic variant. In sumary, this study demonstrates the combined use of clinical and wastewater samples provides a more complete picture of norovirus circulating within the population.
诺如病毒估计在全球范围内每年导致 6.77 亿例肠胃炎,导致 21 万人死亡。由于病毒性肠胃炎通常是自限性的,因此仅对临床样本进行流行病学研究并不能完全代表人群中循环的诺如病毒,而且偏向于严重症状性病例。由于有症状和无症状感染者都会以高浓度将病毒排入下水道系统,因此污水样本可用于在人群水平上对诺如病毒基因型进行分子流行病学分析。我们使用 Illumina MiSeq 和 Sanger 测序,于 2014 年 7 月至 2016 年 12 月调查了澳大利亚和新西兰的循环诺如病毒。重要的是,我们比较了 2016 年临床和污水样本中诺如病毒的基因组多样性,以鉴定潜在的大流行变异株、新型重组病毒及其出现时间。虽然 2014 年和 2015 年 GII.4 悉尼 2012 变异株较为突出,但 2016 年其在临床和污水样本中的流行率均显著下降。这与多种诺如病毒株的出现同时发生,包括两种 GII.4 悉尼 2012 重组病毒、GII.P4 新奥尔良 2009/GII.4 悉尼 2012 和 GII.P16/GII.4 悉尼 2012,以及另外三种新出现的株系 GII.17、GII.P12/GII.3 和 GII.P16/GII.2。这种情况不常见,因为单一的 GII.4 大流行变异株通常会导致同一时间内 65-80%的人类诺如病毒感染,并且在被新的大流行变异株取代之前一直占主导地位。总之,本研究表明,综合使用临床和污水样本可以更全面地了解人群中循环的诺如病毒。