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Seroepidemiology of norovirus-associated travelers' diarrhea.
J Travel Med. 2014 Jan-Feb; 21(1):6-11.JT

Abstract

BACKGROUND

Noroviruses (NoVs) are the most common cause of epidemic gastroenteritis, responsible for at least 50% of all gastroenteritis outbreaks worldwide and were recently identified as a leading cause of travelers' diarrhea (TD) in US and European travelers to Mexico, Guatemala, and India.

METHODS

Serum and diarrheic stool samples were collected from 75 US student travelers to Cuernavaca, Mexico, who developed TD. NoV RNA was detected in acute diarrheic stool samples using reverse transcription-polymerase chain reaction (RT-PCR). Serology assays were performed using GI.1 Norwalk virus (NV) and GII.4 Houston virus (HOV) virus-like particles (VLPs) to measure serum levels of immunoglobulin A (IgA) and IgG by dissociation-enhanced lanthanide fluorescent immunoassay (DELFIA); serum IgM was measured by capture enzyme-linked immunosorbent assay (ELISA), and the 50% antibody-blocking titer (BT50) was determined by a carbohydrate-blocking assay.

RESULTS

NoV infection was identified in 12 (16%; 9 GI-NoV and 3 GII-NoV) of 75 travelers by either RT-PCR or fourfold or more rise in antibody titer. Significantly more individuals had detectable preexisting IgA antibodies against HOV (62/75, 83%) than against NV (49/75, 65%) (p = 0.025) VLPs. A significant difference was observed between NV- and HOV-specific preexisting IgA antibody levels (p = 0.0037), IgG (p = 0.003), and BT50 (p = <0.0001). None of the NoV-infected TD travelers had BT50 > 200, a level that has been described previously as a possible correlate of protection.

CONCLUSIONS

We found that GI-NoVs are commonly associated with TD cases identified in US adults traveling to Mexico, and seroprevalence rates and geometric mean antibody levels to a GI-NoV were lower than to a GII-NoV strain.

Authors+Show Affiliations

Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA; School of Public Health, Center for Infectious Diseases, Houston, TX, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

24383649

Citation

Ajami, Nadim J., et al. "Seroepidemiology of Norovirus-associated Travelers' Diarrhea." Journal of Travel Medicine, vol. 21, no. 1, 2014, pp. 6-11.
Ajami NJ, Kavanagh OV, Ramani S, et al. Seroepidemiology of norovirus-associated travelers' diarrhea. J Travel Med. 2014;21(1):6-11.
Ajami, N. J., Kavanagh, O. V., Ramani, S., Crawford, S. E., Atmar, R. L., Jiang, Z. D., Okhuysen, P. C., Estes, M. K., & DuPont, H. L. (2014). Seroepidemiology of norovirus-associated travelers' diarrhea. Journal of Travel Medicine, 21(1), 6-11. https://doi.org/10.1111/jtm.12092
Ajami NJ, et al. Seroepidemiology of Norovirus-associated Travelers' Diarrhea. J Travel Med. 2014 Jan-Feb;21(1):6-11. PubMed PMID: 24383649.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Seroepidemiology of norovirus-associated travelers' diarrhea. AU - Ajami,Nadim J, AU - Kavanagh,Owen V, AU - Ramani,Sasirekha, AU - Crawford,Sue E, AU - Atmar,Robert L, AU - Jiang,Zhi-Dong, AU - Okhuysen,Pablo C, AU - Estes,Mary K, AU - DuPont,Herbert L, PY - 2013/02/11/received PY - 2013/06/06/revised PY - 2013/07/15/accepted PY - 2014/1/4/entrez PY - 2014/1/5/pubmed PY - 2014/9/5/medline SP - 6 EP - 11 JF - Journal of travel medicine JO - J Travel Med VL - 21 IS - 1 N2 - BACKGROUND: Noroviruses (NoVs) are the most common cause of epidemic gastroenteritis, responsible for at least 50% of all gastroenteritis outbreaks worldwide and were recently identified as a leading cause of travelers' diarrhea (TD) in US and European travelers to Mexico, Guatemala, and India. METHODS: Serum and diarrheic stool samples were collected from 75 US student travelers to Cuernavaca, Mexico, who developed TD. NoV RNA was detected in acute diarrheic stool samples using reverse transcription-polymerase chain reaction (RT-PCR). Serology assays were performed using GI.1 Norwalk virus (NV) and GII.4 Houston virus (HOV) virus-like particles (VLPs) to measure serum levels of immunoglobulin A (IgA) and IgG by dissociation-enhanced lanthanide fluorescent immunoassay (DELFIA); serum IgM was measured by capture enzyme-linked immunosorbent assay (ELISA), and the 50% antibody-blocking titer (BT50) was determined by a carbohydrate-blocking assay. RESULTS: NoV infection was identified in 12 (16%; 9 GI-NoV and 3 GII-NoV) of 75 travelers by either RT-PCR or fourfold or more rise in antibody titer. Significantly more individuals had detectable preexisting IgA antibodies against HOV (62/75, 83%) than against NV (49/75, 65%) (p = 0.025) VLPs. A significant difference was observed between NV- and HOV-specific preexisting IgA antibody levels (p = 0.0037), IgG (p = 0.003), and BT50 (p = <0.0001). None of the NoV-infected TD travelers had BT50 > 200, a level that has been described previously as a possible correlate of protection. CONCLUSIONS: We found that GI-NoVs are commonly associated with TD cases identified in US adults traveling to Mexico, and seroprevalence rates and geometric mean antibody levels to a GI-NoV were lower than to a GII-NoV strain. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/24383649/full_citation L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1111/jtm.12092 DB - PRIME DP - Unbound Medicine ER -