Norovirus Transmission Mediated by Asymptomatic Family Members in Households

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2020 Jul 24

PMID 32702014

Citations 13

Authors

Benjarat Phattanawiboon

Nutthawan Nonthabenjawan

Patcharaporn Boonyos

Chanya Jetsukontorn

Worakarn Towayunanta

Kobkool Chuntrakool

Karn Ngaopravet

Kriangsak Ruchusatsawat

Ballang Uppapong

Somchai Sangkitporn

Eisuke Mekada

Yoshiharu Matsuura

Masashi Tatsumi

Hiroto Mizushima

Affiliations

Soon will be listed here.

Abstract

The transmission of human norovirus excreted from infected persons occasionally causes sporadic infections and outbreaks. Both symptomatic patients and asymptomatic carriers have been reported to contribute to norovirus transmission, but little is known about the magnitude of the contribution of asymptomatic carriers. We carried out a 1-year survey of residents of a district of Bangkok, Thailand to determine the percentage of norovirus transmissions originating from asymptomatic individuals. We screened 38 individuals recruited from 16 families from May 2018 to April 2019 for GI and GII genotypes. Norovirus was detected every month, and 101 of 716 stool samples (14.1%) from individuals with no symptoms of acute gastroenteritis were norovirus-positive. The average infection frequency was 2.4 times per person per year. Fourteen genotypes were identified from the positive samples, with GII.4 being detected most frequently. Notably, 89.1% of the norovirus-positive samples were provided by individuals with no diarrhea episode. Similar to cases of symptomatic infections in Thailand, asymptomatic infections were observed most frequently in December. We detected 4 cases of NV infection caused by household transmission, and 3 of the 4 transmissions originated from asymptomatic individuals. We also identified a case in which norovirus derived from an asymptomatic individual caused diarrhea in a family member. These results suggest that asymptomatic individuals play a substantial role in both the maintenance and spreading of norovirus in a community through household transmission.

Citing Articles

Human norovirus in Brazil: an update of reports in different settings.

Oliveira J, Costa A, Ferreira I, Carvalho M, Siqueira J, Martins Aires C Braz J Microbiol. 2024; 55(3):2767-2782.

PMID: 39012425 PMC: 11405620. DOI: 10.1007/s42770-024-01444-5.

Noroviruses: Evolutionary Dynamics, Epidemiology, Pathogenesis, and Vaccine Advances-A Comprehensive Review.

Omatola C, Mshelbwala P, Okolo M, Onoja A, Abraham J, Adaji D Vaccines (Basel). 2024; 12(6).

PMID: 38932319 PMC: 11209302. DOI: 10.3390/vaccines12060590.

Measures for preventing norovirus outbreaks on campus in economically underdeveloped areas and countries: evidence from rural areas in Western China.

Xiong H, Ma F, Tang D, Liu D Front Public Health. 2024; 12:1406133.

PMID: 38894991 PMC: 11183813. DOI: 10.3389/fpubh.2024.1406133.

Epidemiology of norovirus infection in Nigeria: a systematic review and meta-analysis.

Chigor V, Digwo D, Adediji A, Chidebelu P, Chigor C, Ugwu K Arch Virol. 2024; 169(7):138.

PMID: 38847856 DOI: 10.1007/s00705-024-06056-w.

Global prevalence of asymptomatic norovirus infection in outbreaks: a systematic review and meta-analysis.

Wang J, Gao Z, Yang Z, Liu K, Zhang H BMC Infect Dis. 2023; 23(1):595.

PMID: 37700223 PMC: 10496210. DOI: 10.1186/s12879-023-08519-y.

References

White P . Evolution of norovirus. Clin Microbiol Infect. 2014; 20(8):741-5. DOI: 10.1111/1469-0691.12746. View

Saitou N, Nei M . The neighbor-joining method: a new method for reconstructing phylogenetic trees. Mol Biol Evol. 1987; 4(4):406-25. DOI: 10.1093/oxfordjournals.molbev.a040454. View

Chen M, Chen W, Chen P, Hsu S, Lo Y . An outbreak of norovirus gastroenteritis associated with asymptomatic food handlers in Kinmen, Taiwan. BMC Public Health. 2016; 16:372. PMC: 4855483. DOI: 10.1186/s12889-016-3046-5. View

Supadej K, Khamrin P, Kumthip K, Malasao R, Chaimongkol N, Saito M . Distribution of norovirus and sapovirus genotypes with emergence of NoV GII.P16/GII.2 recombinant strains in Chiang Mai, Thailand. J Med Virol. 2018; 91(2):215-224. DOI: 10.1002/jmv.25261. View

Mathijs E, Stals A, Baert L, Botteldoorn N, Denayer S, Mauroy A . A review of known and hypothetical transmission routes for noroviruses. Food Environ Virol. 2013; 4(4):131-52. DOI: 10.1007/s12560-012-9091-z. View

de Graaf M, van Beek J, Koopmans M . Human norovirus transmission and evolution in a changing world. Nat Rev Microbiol. 2016; 14(7):421-33. DOI: 10.1038/nrmicro.2016.48. View

Enserink R, Scholts R, Bruijning-Verhagen P, Duizer E, Vennema H, de Boer R . High detection rates of enteropathogens in asymptomatic children attending day care. PLoS One. 2014; 9(2):e89496. PMC: 3933542. DOI: 10.1371/journal.pone.0089496. View

Utsumi T, Lusida M, Dinana Z, Wahyuni R, Yamani L, Juniastuti . Occurrence of norovirus infection in an asymptomatic population in Indonesia. Infect Genet Evol. 2017; 55:1-7. DOI: 10.1016/j.meegid.2017.08.020. View

Carmona-Vicente N, Fernandez-Jimenez M, Vila-Vicent S, Rodriguez-Diaz J, Buesa J . Characterisation of a household norovirus outbreak occurred in Valencia (Spain). BMC Infect Dis. 2016; 16:124. PMC: 4788899. DOI: 10.1186/s12879-016-1455-9. View

10.

Partridge D, Evans C, Raza M, Kudesia G, Parsons H . Lessons from a large norovirus outbreak: impact of viral load, patient age and ward design on duration of symptoms and shedding and likelihood of transmission. J Hosp Infect. 2012; 81(1):25-30. DOI: 10.1016/j.jhin.2012.02.002. View

11.

Qi R, Huang Y, Liu J, Sun Y, Sun X, Han H . Global Prevalence of Asymptomatic Norovirus Infection: A Meta-analysis. EClinicalMedicine. 2019; 2-3:50-58. PMC: 6537540. DOI: 10.1016/j.eclinm.2018.09.001. View

12.

Robilotti E, Deresinski S, Pinsky B . Norovirus. Clin Microbiol Rev. 2015; 28(1):134-64. PMC: 4284304. DOI: 10.1128/CMR.00075-14. View

13.

Phillips G, Tam C, Rodrigues L, Lopman B . Prevalence and characteristics of asymptomatic norovirus infection in the community in England. Epidemiol Infect. 2010; 138(10):1454-8. DOI: 10.1017/S0950268810000439. View

14.

Kojima S, Kageyama T, Fukushi S, Hoshino F, Shinohara M, Uchida K . Genogroup-specific PCR primers for detection of Norwalk-like viruses. J Virol Methods. 2001; 100(1-2):107-14. DOI: 10.1016/s0166-0934(01)00404-9. View

15.

Hebbelstrup Jensen B, Jokelainen P, Yde Nielsen A, Franck K, Rejkjaer Holm D, Schonning K . Children Attending Day Care Centers are a Year-round Reservoir of Gastrointestinal Viruses. Sci Rep. 2019; 9(1):3286. PMC: 6397223. DOI: 10.1038/s41598-019-40077-9. View

16.

Atmar R, Opekun A, Gilger M, Estes M, Crawford S, Neill F . Norwalk virus shedding after experimental human infection. Emerg Infect Dis. 2008; 14(10):1553-7. PMC: 2609865. DOI: 10.3201/eid1410.080117. View

17.

Bruggink L, Dunbar N, Marshall J . Norovirus genotype diversity in community-based sporadic gastroenteritis incidents: a five-year study. J Med Virol. 2015; 87(6):961-9. DOI: 10.1002/jmv.24154. View

18.

Kageyama T, Shinohara M, Uchida K, Fukushi S, Hoshino F, Kojima S . Coexistence of multiple genotypes, including newly identified genotypes, in outbreaks of gastroenteritis due to Norovirus in Japan. J Clin Microbiol. 2004; 42(7):2988-95. PMC: 446284. DOI: 10.1128/JCM.42.7.2988-2995.2004. View

19.

Fan Y, Oikarinen S, Lehto K, Nurminen N, Juuti R, Mangani C . High prevalence of selected viruses and parasites and their predictors in Malawian children. Epidemiol Infect. 2019; 147:e90. PMC: 6521582. DOI: 10.1017/S0950268819000025. View

20.

Hall A . Noroviruses: the perfect human pathogens?. J Infect Dis. 2012; 205(11):1622-4. PMC: 4699433. DOI: 10.1093/infdis/jis251. View