Effects and Clinical Significance of GII.4 Sydney Norovirus, United States, 2012–2013

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Abstract

During 2012, global detection of a new norovirus (NoV) strain, GII.4 Sydney, raised concerns about its potential effect in the United States. We analyzed data from NoV outbreaks in 5 states and emergency department visits for gastrointestinal illness in 1 state during the 2012–13 season and compared the data with those of previous seasons. During August 2012–April 2013, a total of 637 NoV outbreaks were reported compared with 536 and 432 in 2011–2012 and 2010–2011 during the same period. The proportion of outbreaks attributed to GII.4 Sydney increased from 8% in September 2012 to 82% in March 2013. The increase in emergency department visits for gastrointestinal illness during the 2012–13 season was similar to that of previous seasons. GII.4 Sydney has become the predominant US NoV outbreak strain during the 2012–13 season, but its emergence did not cause outbreak activity to substantially increase from that of previous seasons.

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Most cited references 15

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Norovirus gastroenteritis.

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Norovirus illness is a global problem: emergence and spread of norovirus GII.4 variants, 2001-2007.

J Joukje Siebenga, Harry Vennema, Du-Ping Zheng … (2009)

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.

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Author and article information

Journal

Journal ID (nlm-ta): Emerg Infect Dis

Journal ID (iso-abbrev): Emerging Infect. Dis

Journal ID (publisher-id): EID

Title: Emerging Infectious Diseases

Publisher: Centers for Disease Control and Prevention

ISSN (Print): 1080-6040

ISSN (Electronic): 1080-6059

Publication date (Print): August 2013

Volume: 19

Issue: 8

Pages: 1231-1238

Affiliations

[1]Centers for Disease Control and Prevention, Atlanta, Georgia, USA (E. Leshem, M. Wikswo, L. Barclay, U.D. Parashar, J. Vinjé, A.J. Hall);

[2]Ohio Department of Health, Columbus, Ohio, USA (E. Brandt, W. Storm, E. Salehi);

[3]Wisconsin Department of Health Services, Madison, Wisconsin, USA (T. DeSalvo);

[4]Wisconsin State Laboratory of Hygiene, Madison (T. Davis);

[5]Minnesota Department of Health, St. Paul, Minnesota, USA (A. Saupe, G. Dobbins);

[6]Oregon Public Health Division, Portland, Oregon, USA (H.A. Booth, C. Biggs);

[7]Tennessee Department of Health, Nashville, Tennessee, USA (K. Garman, A.M. Woron)

Author notes

Address for correspondence: Eyal Leshem, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop A34, Atlanta, GA 30333, USA; email: eleshem@ 123456cdc.gov

Article

Publisher ID: 13-0458

DOI: 10.3201/eid1908.130458

PMC ID: 3739516

PubMed ID: 23886013

SO-VID: 9e27c5c6-2a85-47cb-b876-a4bbcfde063d

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