Lu Jing, Peng Jinju, Fang Ling, Zeng Lilian, Lin Huifang, Xiong Qianling, Liu Zhe, Jiang Huimin, Zhang Chaozheng, Yi Lina, Song Tie, Ke Changwen, Li Caixia, Ke Bixia, He Guanhao, Zhu Guanghu, He Jianfeng, Sun Limei, Li Hui, Zheng Huanying
Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; School of Public Health, Southern Medical University, Guangzhou, China.
School of Public Health, Southern Medical University, Guangzhou, China; Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
Water Res. 2021 May 15;196:116990. doi: 10.1016/j.watres.2021.116990. Epub 2021 Mar 1.
Noroviruses (NoVs) are the leading cause of acute gastroenteritis (AGE) outbreaks. Since 2014, novel genetic variants of NoV have been continuously identified and have caused a sharp increase in the number of AGE outbreaks. The specific geographical distribution and expanding genetic diversity of NoV has posed a challenge to conventional surveillance. Here, we describe the long-term dynamic correlation between NoV distribution in sewage and in the local population through the molecular surveillance of NoV in Guangdong, 2013-2018. The relative viral loads of the GI and GII genotypes in sewage were calculated through RT-PCR. A high-throughput sequencing method and operational taxonomic unit (OTU) clustering pipeline were developed to illustrate the abundances of different genotypes and genetic variants in sewage. Our results showed that the NoV viral loads and the emergence of new variants in sewage were closely associated with NoV outbreak risks in the population. Compared with the outbreaks surveillance, the dominance of the newly emerged variants, GII.P17-GII.17 and GII.P16-GII.2, could be detected one or two months ahead in sewage of a hub city. In addition, the dynamics of pre-epidemic variants, which were rarely detected in clinics, could be captured through sewage surveillance, thus improving our understanding of the origin and evolution of these novel epidemic variants. Our data highlight that sewage surveillance could provide nearly real-time and high-throughput data on NoV circulation in the community. With the advances in sequencing techniques, the sewage surveillance system could also be extended to other related infectious diseases.
诺如病毒（NoVs）是急性胃肠炎（AGE）暴发的主要病因。自2014年以来，不断发现诺如病毒的新型基因变体，导致AGE暴发数量急剧增加。诺如病毒特定的地理分布和不断扩大的基因多样性对传统监测构成了挑战。在此，我们通过对2013 - 2018年广东诺如病毒的分子监测，描述了污水中诺如病毒分布与当地人群中诺如病毒分布之间的长期动态相关性。通过逆转录聚合酶链反应（RT-PCR）计算污水中GI和GII基因型的相对病毒载量。开发了一种高通量测序方法和操作分类单元（OTU）聚类流程，以阐明污水中不同基因型和基因变体的丰度。我们的结果表明，污水中的诺如病毒载量和新变体的出现与人群中的诺如病毒暴发风险密切相关。与暴发监测相比，在一个枢纽城市的污水中可以提前一到两个月检测到新出现的变体GII.P17 - GII.17和GII.P16 - GII.2的优势地位。此外，通过污水监测可以捕捉到临床中很少检测到的流行前变体的动态变化，从而增进我们对这些新型流行变体的起源和进化的理解。我们的数据强调，污水监测可以提供关于社区中诺如病毒传播的近乎实时和高通量的数据。随着测序技术的进步，污水监测系统也可以扩展到其他相关传染病。
