123 results on '"Stephan S. Monroe"'
Search Results
2. Norovirus Transmission on Cruise Ship
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Elmira T. Isakbaeva, Marc-Alain Widdowson, R. Suzanne Beard, Sandra N. Bulens, James Mullins, Stephan S. Monroe, Joseph S. Bresee, Patricia Sassano, Elaine H. Cramer, and Roger I. Glass
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viral gastroenteritis ,outbreak ,Norwalk ,cruise ship ,dispatch ,United States ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
We describe an investigation of a norovirus gastroenteritis outbreak aboard a cruise ship affecting 6 consecutive cruises and the use of sequence analysis to determine modes of virus transmission. Noroviruses (NoV), are the most common cause of infectious acute gastroenteritis and are transmitted feco-orally through food and water, directly from person to person and by environmental contamination (1). These viruses are often responsible for protracted outbreaks in closed settings, such as cruise ships, nursing homes, and hospitals (2,3).
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- 2005
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3. Norovirus and Foodborne Disease, United States, 1991–2000
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Marc-Alain Widdowson, Alana Sulka, Sandra N. Bulens, R. Suzanne Beard, Sandra S. Chaves, Roberta Hammond, Ellen D.P. Salehi, Ellen Swanson, Jessica Totaro, Ray Woron, Paul S. Mead, Joseph S. Bresee, Stephan S. Monroe, and Roger I. Glass
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research ,food ,norovirus ,disease outbreaks ,burden of illness ,United States ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
Efforts to prevent foodborne illness target bacterial pathogens, yet noroviruses (NoV) are suspected to be the most common cause of gastroenteritis. New molecular assays allow for better estimation of the role of NoV in foodborne illness. We analyzed 8,271 foodborne outbreaks reported to the Centers for Disease Control and Prevention from 1991 to 2000 and additional data from 6 states. The proportion of NoV-confirmed outbreaks increased from 1% in 1991 to 12% in 2000. However, from 1998 to 2000, 76% of NoV outbreaks were reported by only 11 states. In 2000, an estimated 50% of foodborne outbreaks in 6 states were attributable to NoV. NoV outbreaks were larger than bacterial outbreaks (median persons affected: 25 versus 15), and 10% of affected persons sought medical care; 1% were hospitalized. More widespread use of molecular assays will permit better estimates of the role of NoV illness and help direct efforts to control foodborne illness.
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- 2005
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4. SARS-associated Coronavirus Transmission, United States
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Elmira T. Isakbaeva, Nino Khetsuriani, R. Suzanne Beard, Angela Peck, Dean D. Erdman, Stephan S. Monroe, Suxiang Tong, Thomas G. Ksiazek, Sara Lowther, Indra Pandya Smith, Larry J. Anderson, Jairam Lingappa, and Marc-Alain Widdowson
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severe acute respiratory syndrome (SARS) ,outbreak ,SARS-associated coronavirus ,epidemiology ,transmission ,natural history ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
To better assess the risk for transmission of the severe acute respiratory syndrome–associated coronavirus (SARS-CoV), we obtained serial specimens and clinical and exposure data from seven confirmed U.S. SARS patients and their 10 household contacts. SARS-CoV was detected in a day-14 sputum specimen from one case-patient and in five stool specimens from two case-patients. In one case-patient, SARS-CoV persisted in stool for at least 26 days after symptom onset. The highest amounts of virus were in the day-14 sputum sample and a day-14 stool sample. Residual respiratory symptoms were still present in recovered SARS case-patients 2 months after illness onset. Possible transmission of SARS-CoV occurred in one household contact, but this person had also traveled to a SARS-affected area. The data suggest that SARS-CoV is not always transmitted efficiently. Laboratory diagnosis of SARS-CoV infection is difficult; thus, sputum and stool specimens should be included in the diagnostic work-up for SARS-CoV infection.
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- 2004
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5. Norwalk-Like Viral Gastroenteritis Outbreak in U.S. Army Trainees
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Mark K. Arness, Brian H. Feighner, Michelle L. Canham, David N. Taylor, Stephan S. Monroe, Theodore J. Cieslak, Edward L. Hoedebecke, Christina S. Polyak, Judy C. Cuthie, Rebecca L. Fankhauser, Charles D. Humphrey, Tamra L. Barker, Chris D. Jenkins, and Donald R. Skillman
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acute gastroenteritis ,Fort Bliss ,Norwalk-like virus ,United States ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
An outbreak of acute gastroenteritis hospitalized 99 (12%) of 835 U.S. Army trainees at Fort Bliss, El Paso, Texas, rom August 27 to September 1, 1998. Reverse transcriptase polymerase chain reaction tests for Norwalk-like virus were positive for genogroup 2. Gastroenteritis was associated with one post dining facility and with soft drinks.
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- 2000
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6. Are Noroviruses Emerging?
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Marc-Alain Widdowson, Stephan S. Monroe, and Roger I. Glass
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Epidemiology ,Norovirus ,Communicable Diseases ,Emerging ,United States ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Published
- 2005
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7. Control and Prevention of Viral Gastroenteritis
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Stephan S. Monroe
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norovirus ,rotavirus ,viruses ,foodborne illness ,viral gastroenteritis ,enteric infections ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
Diarrheal illness remains 1 of the top 5 causes of death in low-income and middle-income countries, especially for children
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- 2011
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8. Norovirus Detection and Genotyping for Children with Gastroenteritis, Brazil
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Caroline C. Soares, Norma Santos, Rachel Suzanne Beard, Maria Carolina M. Albuquerque, Adriana G. Maranhão, Ludmila N. Rocha, Maria Liz Ramírez, Stephan S. Monroe, Roger I. Glass, and Jon Gentsch
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Norovirus ,viral gastroenteritis ,viral diagnostics ,real-time RT-PCR ,dispatch ,Brazil ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
During 1998–2005, we analyzed stool samples from 289 children in Rio de Janeiro to detect and genotype norovirus strains. Previous tests showed all samples to be negative for rotavirus and adenovirus. Of 42 (14.5%) norovirus-positive specimens, 20 (47.6%) were identified as genogroup GI and 22 (52.3%) as GII.
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- 2007
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9. Complete Genome Sequences of Human Astrovirus Prototype Strains (Types 1 to 8)
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Stephan S. Monroe, Jan Vinjé, Emily Reynolds, Christina J. Castro, and Rachel L. Marine
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0301 basic medicine ,Genetics ,biology ,viruses ,030106 microbiology ,Genome Sequences ,virus diseases ,Human astrovirus ,biology.organism_classification ,Genome ,Astrovirus ,03 medical and health sciences ,Open reading frame ,030104 developmental biology ,fluids and secretions ,Immunology and Microbiology (miscellaneous) ,GenBank ,Identity (object-oriented programming) ,Molecular Biology ,Gene - Abstract
We report the complete genome sequences of the eight human astrovirus Oxford prototype strains. These sequences share 94.9% to 99.9% nucleotide identity with open reading frame 2 (ORF2) genes of astrovirus genomes previously deposited in GenBank and include the first complete genome of human astrovirus type 7.
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- 2019
10. Reduced evolutionary rate in reemerged Ebola virus transmission chains
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Ute Ströher, William Nwachukwu, Mariano Sanchez-Lockhart, A. Scott Laney, Moses Massaquoi, Michael R. Wiley, Tolbert Nyenswah, Christopher J. Gregory, Adolphus Yeiah, Karla Prieto, Joseph W. Diclaro, Stuart T. Nichol, Mosoka Fallah, Jason T. Ladner, Suzanne Mate, Jonathan D'ambrozio, Jens H. Kuhn, John Saindon, Meagan Wisniewski, Francis Kateh, Zephaniah Balogun, Stephan S. Monroe, Merle L. Gilbert, Athalia Christie, Jeffrey R. Kugelman, Peter Clement, Peter B. Jahrling, Gary P. Schroth, Terrence Lo, Stewart Coulter, Fatorma K. Bolay, Andrew Rambaut, Alex Gasasira, Gustavo Palacios, Fred Amegashie, Lawrence Fakoli, Lisa E. Hensley, Brian J. Kearney, and David J. Blackley
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0301 basic medicine ,Sexual transmission ,Epidemiology ,viruses ,flare-up ,reemerged ,Ebola virus disease ,Persistently infected ,Genome, Viral ,Biology ,medicine.disease_cause ,Disease Outbreaks ,law.invention ,reduced evolutionary rate ,Ebola virus ,03 medical and health sciences ,0302 clinical medicine ,Viral genetics ,law ,medicine ,Humans ,Research article ,030212 general & internal medicine ,Western Africa ,skin and connective tissue diseases ,Research Articles ,Ebolavirus ,persistent infection ,Multidisciplinary ,transmission chain ,virus diseases ,SciAdv r-articles ,Outbreak ,Hemorrhagic Fever, Ebola ,Liberia ,Virology ,030104 developmental biology ,Transmission (mechanics) ,Research Article - Abstract
Surveillance of Ebola virus disease flare-ups uncovers a reduced rate of Ebola virus evolution during persistent infections., On 29 June 2015, Liberia’s respite from Ebola virus disease (EVD) was interrupted for the second time by a renewed outbreak (“flare-up”) of seven confirmed cases. We demonstrate that, similar to the March 2015 flare-up associated with sexual transmission, this new flare-up was a reemergence of a Liberian transmission chain originating from a persistently infected source rather than a reintroduction from a reservoir or a neighboring country with active transmission. Although distinct, Ebola virus (EBOV) genomes from both flare-ups exhibit significantly low genetic divergence, indicating a reduced rate of EBOV evolution during persistent infection. Using this rate of change as a signature, we identified two additional EVD clusters that possibly arose from persistently infected sources. These findings highlight the risk of EVD flare-ups even after an outbreak is declared over.
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- 2016
11. Consumption of pesticide-treated wheat seed by a rural population in Malawi
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Joshua G. Schier, Yanique Redwood, Yelena D Karaseva, Eugenia Katsoudas, Emily Lutterloh, Stephan S. Monroe, Andrew Likaka, James J. Sejvar, and Beth A. Tippett Barr
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Rural Population ,Malawi ,Epidemiology ,Biology ,Toxicology ,Article ,chemistry.chemical_compound ,Carbaryl ,parasitic diseases ,medicine ,Pesticides ,United States Environmental Protection Agency ,Triticum ,Reference dose ,Public Health, Environmental and Occupational Health ,Environmental engineering ,Sowing ,Outbreak ,Pirimiphos-methyl ,Environmental Exposure ,Environmental exposure ,Pesticide ,Pollution ,United States ,chemistry ,Seeds ,Permethrin ,medicine.drug - Abstract
An outbreak of typhoid fever in rural Malawi triggered an investigation by the Malawi Ministry of Health and the Centers for Disease Control and Prevention in July 2009. During the investigation, villagers were directly consuming washed, donated, pesticide-treated wheat seed meant for planting. The objective of this study was to evaluate the potential for pesticide exposure and health risk in the outbreak community. A sample of unwashed (1430 g) and washed (759 g) wheat seed donated for planting, but which would have been directly consumed, was tested for 365 pesticides. Results were compared with each other (percentage change), the US Environmental Protection Agency's (EPA) health guidance values and estimated daily exposures were compared with their Reference dose (RfD). Unwashed and washed seed samples contained, respectively: carboxin, 244 and 57 p.p.m.; pirimiphos methyl, 8.18 and 8.56 p.p.m.; total permethrin, 3.62 and 3.27 p.p.m.; and carbaryl, 0.057 and 0.025 p.p.m.. Percentage change calculations (unwashed to washed) were as follows: carboxin, -76.6%; pirimiphos methyl, +4.6%; total permethrin, -9.7%; and carbaryl -56.1%. Only carboxin and total permethrin concentration among washed seed samples exceeded US EPA health guidance values (285 × and seven times, respectively). Adult estimated exposure scenarios (1 kg seed) exceeded the RfD for carboxin (8 × ) and pirimiphos methyl (12 × ). Adult villagers weighing 70 kg would have to consume 0.123, 0.082, 1.06, and 280 kg of washed seed daily to exceed the RfD for carboxin, pirimiphos methyl, permethrins, and carbaryl, respectively. Carboxin, pirimiphos methyl, permethrins, and carbaryl were detected in both unwashed and washed samples of seed. Carboxin, total permethrin, and carbaryl concentration were partially reduced by washing. Health risks from chronic exposure to carboxin and pirimiphos methyl in these amounts are unclear. The extent of this practice among food insecure communities receiving relief seeds and resultant health impact needs further study.
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- 2012
12. The Etiology of Severe Acute Gastroenteritis Among Adults Visiting Emergency Departments in the United States
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Joseph S, Bresee, Ruthanne, Marcus, Richard A, Venezia, William E, Keene, Dale, Morse, Mark, Thanassi, Patrick, Brunett, Sandra, Bulens, R Suzanne, Beard, Leslie A, Dauphin, Laurence, Slutsker, Cheryl, Bopp, Mark, Eberhard, Aron, Hall, Jan, Vinje, Stephan S, Monroe, Roger I, Glass, and John, Jui
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Adult ,Diarrhea ,Male ,medicine.medical_specialty ,Salmonella ,Adolescent ,medicine.disease_cause ,Specimen Handling ,Interviews as Topic ,Feces ,Young Adult ,fluids and secretions ,Surveys and Questionnaires ,Rotavirus ,Internal medicine ,Prevalence ,medicine ,Humans ,Immunology and Allergy ,Prospective Studies ,Aged ,Caliciviridae Infections ,Aged, 80 and over ,biology ,business.industry ,Emergency department ,Middle Aged ,biology.organism_classification ,United States ,Caliciviridae ,Gastroenteritis ,Hospitalization ,Infectious Diseases ,Acute Disease ,Salmonella Infections ,Immunology ,Etiology ,Norovirus ,Female ,medicine.symptom ,Emergency Service, Hospital ,business - Abstract
Background. Acute gastroenteritis (AGE) remains a common cause of clinic visits and hospitalizations in the United States, but the etiology is rarely determined. Methods. We performed a prospective, multicenter emergency department–based study of adults with AGE. Subjects were interviewed on presentation and 3–4 weeks later. Serum samples, rectal swab specimens, and/or whole stool specimens were collected at presentation, and serum was collected 3–4 weeks later. Fecal specimens were tested for a comprehensive panel of viral, bacterial, and parasitic pathogens; serum was tested for calicivirus antibodies. Results. Pathogens were detected in 25% of 364 subjects, including 49% who provided a whole stool specimen. The most commonly detected pathogens were norovirus (26%), rotavirus (18%), and Salmonella species (5.3%). Pathogens were detected significantly more often from whole stool samples versus a rectal swab specimen alone. Nine percent of subjects who provided whole stool samples had .1 pathogen identified. Conclusions. Viruses, especially noroviruses, play a major role as agents of severe diarrhea in adults. Further studies to confirm the unexpectedly high prevalence of rotaviruses and to explore the causes of illness among patients from whom a pathogen cannot be determined are needed. Studies of enteric pathogens should require the collection of whole stool samples.
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- 2012
13. Multidrug-Resistant Typhoid Fever With Neurologic Findings on the Malawi-Mozambique Border
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Abel Phiri, Jeremias Naiene, Kevin Joyce, Linda Capewell, James J. Sejvar, Stephan S. Monroe, Sam D. Kampondeni, Andrew Likaka, Benson Chilima, Emily Lutterloh, Kashmira Date, Deborah F. Talkington, Rudia Lungu, Benjamin Nygren, Robert Manda, Macpherson Mallewa, Eric D. Mintz, Yanique Redwood, David A. Townes, Joshua G. Schier, Beth A. Tippett Barr, Tadala Khaila, Sara A. Lowther, Lauren J. Stockman, James Kaphiyo, Gregory L. Armstrong, Michael S. Humphrys, and Austin Demby
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Microbiology (medical) ,medicine.medical_specialty ,Abdominal pain ,medicine.diagnostic_test ,business.industry ,Chloramphenicol ,Outbreak ,Drug resistance ,Salmonella typhi ,medicine.disease ,Typhoid fever ,Infectious Diseases ,Internal medicine ,Ampicillin ,medicine ,Blood culture ,medicine.symptom ,business ,medicine.drug - Abstract
Background Salmonella enterica serovar Typhi causes an estimated 22 million cases of typhoid fever and 216 000 deaths annually worldwide. We investigated an outbreak of unexplained febrile illnesses with neurologic findings, determined to be typhoid fever, along the Malawi-Mozambique border. Methods The investigation included active surveillance, interviews, examinations of ill and convalescent persons, medical chart reviews, and laboratory testing. Classification as a suspected case required fever and ≥1 other finding (eg, headache or abdominal pain); a probable case required fever and a positive rapid immunoglobulin M antibody test for typhoid (TUBEX TF); a confirmed case required isolation of Salmonella Typhi from blood or stool. Isolates underwent antimicrobial susceptibility testing and subtyping by pulsed-field gel electrophoresis (PFGE). Results We identified 303 cases from 18 villages with onset during March-November 2009; 214 were suspected, 43 were probable, and 46 were confirmed cases. Forty patients presented with focal neurologic abnormalities, including a constellation of upper motor neuron signs (n = 19), ataxia (n = 22), and parkinsonism (n = 8). Eleven patients died. All 42 isolates tested were resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole; 4 were also resistant to nalidixic acid. Thirty-five of 42 isolates were indistinguishable by PFGE. Conclusions The unusual neurologic manifestations posed a diagnostic challenge that was resolved through rapid typhoid antibody testing in the field and subsequent blood culture confirmation in the Malawi national reference laboratory. Extending laboratory diagnostic capacity, including blood culture, to populations at risk for typhoid fever in Africa will improve outbreak detection, response, and clinical treatment.
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- 2012
14. Enzootic Rabies Elimination from Dogs and Reemergence in Wild Terrestrial Carnivores, United States
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Stephan S. Monroe and Ermias D. Belay
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Microbiology (medical) ,medicine.medical_specialty ,Hemorrhagic Fevers, Viral ,filoviruses ,Rabies ,Epidemiology ,Population ,lcsh:Medicine ,Biology ,high mortality ,lcsh:Infectious and parasitic diseases ,Environmental health ,Pandemic ,medicine ,Infection control ,Humans ,viruses ,lcsh:RC109-216 ,education ,bacteria ,education.field_of_study ,Transmission (medicine) ,infectious disease pathology ,Mortality rate ,Public health ,Incidence (epidemiology) ,Incidence ,high-consequence pathogens ,lcsh:R ,anthrax ,United States ,zoonoses ,orthopoxviruses ,Vaccination ,hemorrhagic fevers ,Infectious Diseases ,Immunology ,Commentary ,monkeypox ,pathology ,Centers for Disease Control and Prevention, U.S ,Smallpox - Abstract
Infectious diseases that have epidemic or pandemic potential and spread rapidly through a population within a short time are an ongoing public health concern in industrialized and developing countries. Frequent exposure to infectious sources (e.g., food, infected animals, and vectors) or a high rate of person-to-person spread facilitates spread of these diseases. Foodborne illnesses and seasonal influenza are notable examples. These diseases typically are associated with high rates of illness and substantial societal and economic cost but relatively low rates of death in otherwise healthy persons. Other infectious diseases, in contrast, may occur infrequently but are associated with high rates of death. The low incidence of some of these diseases reflects effective public health prevention measures, such as vaccinations. For a select group of zoonotic infectious diseases with high death rates, the low incidence reflects infrequent spillover from an animal reservoir into humans. Often, humans represent a dead-end host for these pathogens, and person-to-person transmission is rare if appropriate infection control practices are followed. Many of the pathogens highlighted in the current issue of Emerging Infectious Diseases can collectively be described as low-incidence, high-consequence pathogens. Selected diseases caused by these pathogens are described below.
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- 2014
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15. Comparing Serologic Response against Enteric Pathogens with Reported Diarrhea to Assess the Impact of Improved Household Drinking Water Quality
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Leslie A. Dauphin, William F. Bibb, Stephan S. Monroe, Roger I. Glass, Stephen P. Luby, Eric D. Mintz, Carlos E. Mendoza, M. Beatriz Lopez, John A. Crump, Jeffrey W. Priest, and Maricruz Alvarez
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medicine.medical_specialty ,education.field_of_study ,biology ,business.industry ,Population ,Case-control study ,biology.organism_classification ,medicine.disease_cause ,Serology ,Diarrhea ,Infectious Diseases ,Cryptosporidium parvum ,Virology ,Internal medicine ,Enterotoxigenic Escherichia coli ,Cohort ,Immunology ,Norovirus ,Medicine ,Parasitology ,medicine.symptom ,business ,education - Abstract
We evaluated enteric infection serology as an alternative outcome measure to diarrhea prevalence in a randomized controlled trial of household-based drinking water treatment; 492 households were randomly assigned to 5 household-based water treatment interventions or control. Individuals were followed weekly over 52 weeks to measure diarrhea prevalence. Study subjects of age ≤ 6 months and < 24 months had blood drawn at entry and exit from the study or age cohort. Serologic assays for Cryptosporidium parvum, Giardia intestinalis, enterotoxigenic Escherichia coli (ETEC), and Norovirus were done. Of 343 subjects eligible for the study, the proportions of subjects experiencing serologic responses were 56% for Norovirus, 24% for C. parvum, 10% for ETEC, and 16% for G. intestinalis. Serologic response was associated with increased diarrhea prevalence only for G. intestinalis (P = 0.0134). Serologic response to the antigens tested for G. intestinalis but not for Norovirus, C. parvum, and ETEC may be a useful health-effect measure. Larger intervention studies that yield a more marked effect on diarrheal disease, use additional and improved serologic assays, and that collect serum samples at more frequent intervals are needed.
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- 2007
16. Outbreak of norovirus illness associated with a swimming pool
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Susan M. Adams, D. Itani, Marc-Alain Widdowson, C. Otto, Amanda M. Burns, L. Zanardi Blevins, L. J. Podewils, Lenee Blanton, M. Hagenbuch, Stephan S. Monroe, and Michael J. Beach
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Epidemiology ,medicine.disease_cause ,Maintenance system ,Disease Outbreaks ,Cohort Studies ,Swimming Pools ,Environmental health ,Humans ,Medicine ,Child ,Aged ,Retrospective Studies ,business.industry ,Norovirus ,Infant ,Outbreak ,Retrospective cohort study ,Middle Aged ,Gastroenteritis ,Surgery ,Disinfection ,Equipment failure ,Infectious Diseases ,Child, Preschool ,Acute Disease ,Vomiting ,Female ,Chlorine ,medicine.symptom ,Water Microbiology ,business ,Research Article ,Staff training ,Cohort study - Abstract
SUMMARYOn 3 February 2004, the Vermont Department of Health received reports of acute gastroenteritis in persons who had recently visited a swimming facility. A retrospective cohort study was conducted among persons attending the facility between 30 January and 2 February. Fifty-three of 189 (28%) persons interviewed developed vomiting or diarrhoea within 72 h after visiting the facility. Five specimens tested positive for norovirus and three specimen sequences were identical. Entering the smaller of the two pools at the facility was significantly associated with illness (RR 5·67, 95% CI 1·5–22·0,P=0·012). The investigation identified several maintenance system failures: chlorine equipment failure, poorly trained operators, inadequate maintenance checks, failure to alert management, and insufficient record keeping. This study demonstrates the vulnerability of recreational water to norovirus contamination, even in the absence of any obvious vomiting or faecal accident. Our findings also suggest that norovirus is not as resistant to chlorine as previously reported in experimental studies. Appropriate regulations and enforcement, with adequate staff training, are necessary to ensure recreational water safety.
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- 2006
17. Norovirus classification and proposed strain nomenclature
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Rebecca L. Fankhauser, Stephan S. Monroe, R. Suzanne Beard, Tamie Ando, Du-Ping Zheng, and Roger I. Glass
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Noroviruses ,Sequence alignment ,Computational biology ,Biology ,Genetic analysis ,Tree (descriptive set theory) ,Open Reading Frames ,Phylogenetics ,Terminology as Topic ,Virology ,Animals ,Humans ,Nomenclature ,Phylogeny ,Phylogenetic analysis ,Phylogenetic tree ,Sequence Homology, Amino Acid ,Strain (biology) ,Norovirus ,Classification ,Protein Structure, Tertiary ,Norwalk-like viruses ,Pairwise comparison ,Capsid Proteins ,Sequence Alignment - Abstract
Without a virus culture system, genetic analysis becomes the principal method to classify norovirus (NoV) strains. Currently, classification of NoV strains beneath the species level has been based on sequences from different regions of the viral genome. As a result, the phylogenetic insights of some virus were not appropriately interpreted, and no consensus has been reached to establish a uniform classification scheme. To provide a consistent and reliable scientific basis for classifying NoVs, we analyzed the amino acid sequences for the major capsid protein of 164 NoV strains by first using an alignment based on the predicted 3D structures. A Bayesian tree was generated, and the maximum likelihood pairwise distances of the aligned sequences were used to evaluate the results from the uncorrected pairwise distance method. Analyses of the pairwise distances demonstrated three clearly resolved peaks, suggesting that NoV strains beneath the species level can be classified at three levels: strain (S), cluster (C), and genogroup (G). The uncorrected pairwise distance ranges for S, C, and G were 0–14.1%, 14.3–43.8%, and 44.9–61.4%, respectively. A scheme with 29 genetic clusters [8 in genogroup 1 (G1), 17 in G2, 2 in G3, and 1 each in G4 and G5] was defined on the basis of the tree topology with the standards provided and was supported by the distance analysis. Of these, five clusters in G2 and one in G1 are newly described. This analysis can serve as the basis for a standardized nomenclature to genetically describe NoV strains.
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- 2006
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18. Norovirus Transmission on Cruise Ship
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Joseph S. Bresee, Elmira T. Isakbaeva, Stephan S. Monroe, Patricia Sassano, Sandra N. Bulens, Marc-Alain Widdowson, James A. Mullins, Elaine H. Cramer, Roger I. Glass, and R. Suzanne Beard
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Microbiology (medical) ,cruise ship ,Epidemiology ,Virus transmission ,viruses ,Cruise ,lcsh:Medicine ,medicine.disease_cause ,Disease Outbreaks ,lcsh:Infectious and parasitic diseases ,Environmental health ,Medicine ,Humans ,lcsh:RC109-216 ,Ships ,Caliciviridae Infections ,Travel ,viral gastroenteritis ,outbreak ,Transmission (medicine) ,business.industry ,Norovirus ,lcsh:R ,Outbreak ,dispatch ,Acute gastroenteritis ,Virology ,United States ,Gastroenteritis ,Norwalk ,Infectious Diseases ,Nursing homes ,business - Abstract
We documented transmission by food and person-to-person contact; persistence of virus despite sanitization onboard, including introductions of new strains; and seeding of an outbreak on land., We describe an investigation of a norovirus gastroenteritis outbreak aboard a cruise ship affecting 6 consecutive cruises and the use of sequence analysis to determine modes of virus transmission. Noroviruses (NoV), are the most common cause of infectious acute gastroenteritis and are transmitted feco-orally through food and water, directly from person to person and by environmental contamination (1). These viruses are often responsible for protracted outbreaks in closed settings, such as cruise ships, nursing homes, and hospitals (2,3).
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- 2005
19. Norovirus and Foodborne Disease, United States, 1991–2000
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Sandra N. Bulens, Marc-Alain Widdowson, Joseph S. Bresee, Stephan S. Monroe, Jessica Totaro, Alana Sulka, Ellen Swanson, Ray Woron, Paul S. Mead, Roger I. Glass, Roberta Hammond, R. Suzanne Beard, Sandra S. Chaves, and Ellen Salehi
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Microbiology (medical) ,Epidemiology ,viruses ,lcsh:Medicine ,Food Contamination ,Disease ,medicine.disease_cause ,Medical care ,lcsh:Infectious and parasitic diseases ,Disease Outbreaks ,Foodborne Diseases ,stomatognathic system ,Environmental health ,medicine ,Animals ,Humans ,lcsh:RC109-216 ,Caliciviridae Infections ,business.industry ,Research ,food ,lcsh:R ,Norovirus ,Foodborne outbreak ,Outbreak ,Disease control ,Virology ,United States ,Gastroenteritis ,Infectious Diseases ,burden of illness ,Centers for Disease Control and Prevention, U.S ,business ,Food contaminant - Abstract
Analysis of foodborne outbreaks shows how advances in viral diagnostics are clarifying the causes of foodborne outbreaks and determining the high impact of norovirus infections., Efforts to prevent foodborne illness target bacterial pathogens, yet noroviruses (NoV) are suspected to be the most common cause of gastroenteritis. New molecular assays allow for better estimation of the role of NoV in foodborne illness. We analyzed 8,271 foodborne outbreaks reported to the Centers for Disease Control and Prevention from 1991 to 2000 and additional data from 6 states. The proportion of NoV-confirmed outbreaks increased from 1% in 1991 to 12% in 2000. However, from 1998 to 2000, 76% of NoV outbreaks were reported by only 11 states. In 2000, an estimated 50% of foodborne outbreaks in 6 states were attributable to NoV. NoV outbreaks were larger than bacterial outbreaks (median persons affected: 25 versus 15), and 10% of affected persons sought medical care; 1% were hospitalized. More widespread use of molecular assays will permit better estimates of the role of NoV illness and help direct efforts to control foodborne illness.
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- 2005
20. Evaluation and Validation of Real-Time Reverse Transcription-PCR Assay Using the LightCycler System for Detection and Quantitation of Norovirus
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Xiao-Li Pang, Stephan S. Monroe, Linda Chui, Jutta K. Preiksaitis, and Bonita E. Lee
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Microbiology (medical) ,Hot Temperature ,Diamines ,medicine.disease_cause ,Sensitivity and Specificity ,Astrovirus ,Feces ,Virology ,Rotavirus ,medicine ,Humans ,Benzothiazoles ,Organic Chemicals ,Child ,Caliciviridae Infections ,Detection limit ,biology ,Reverse Transcriptase Polymerase Chain Reaction ,Norovirus ,Sapovirus ,biology.organism_classification ,Disease control ,Molecular biology ,Gastroenteritis ,Reverse transcription polymerase chain reaction ,Child, Preschool ,Clinical diagnosis ,Quinolines ,RNA, Viral - Abstract
We developed an assay for the detection and quantitation of norovirus with the LightCycler SYBR Green-based real-time reverse transcription-PCR (real-time LC RT-PCR) and previously published primers in the capsid and the polymerase gene. One hundred thirty-two stool specimens from the Provincial Laboratory for Public Health (Microbiology), Alberta, Canada, and the Centers for Disease Control and Prevention, Atlanta, Ga., were used to validate the new assay. The samples were collected from patients involved in outbreaks of acute gastroenteritis or children who presented with sporadic gastroenteritis. The real-time LC RT-PCR assay detected norovirus strains from three genogroup I (G-I) clusters (G-I/1, G-I/2, and G-I/3) and 10 genogroup II (G-II) clusters (G-II/1, G-II/2, G-II/3, G-II/4, G-II/6, G-II/7, G-II/10, G-II/12, G-II/15, and G-II/16). There was 100% concordance with the results from 58 stool specimens which tested positive by conventional RT-PCR assays. By dilution analysis, the real-time LC RT-PCR was 10,000 times more sensitive than the conventional RT-PCR. The new assay increased the number of samples in which noroviruses were detected by 19%. The real-time LC RT-PCR had a wide dynamic range, detecting from 5 to 5 × 10 6 copies of RNA per reaction, resulting in a theoretical lower limit of detection of 25,000 copies of RNA per g of stool. No cross-reactions were found with specimens containing sapovirus, rotavirus, astrovirus, and adenovirus. Because of the high sensitivity and specificity of the assay with a relatively rapid and simple procedure, the real-time LC RT-PCR will be useful as a routine assay for the clinical diagnosis of norovirus infection.
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- 2004
21. Direct Sequencing of SARS-Coronavirus S and N Genes from Clinical Specimens Shows Limited Variation
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Mai Le Quynh, Bo Shu, Qi Chen, Charryse Birge, Shur-Wern Wang Chern, Stephan S. Monroe, Dean D. Erdman, Jagdish Butany, Jairam R. Lingappa, Byron T. Cook, Renee L. Galloway, Paul A. Rota, Ashley C. LaMonte, Suzanne R. Beard, Suxiang Tong, Larry J. Anderson, Xin Liu, James A. Comer, Mark A. Pallansch, Thomas G. Ksiazek, Jyh-Yuan Yang, and Fu Ng Wai
- Subjects
viruses ,Mutation, Missense ,Genome, Viral ,Biology ,medicine.disease_cause ,Severe Acute Respiratory Syndrome ,Genome ,Virus ,Major Articles ,Major Articles and Brief Reports ,Viral Envelope Proteins ,medicine ,Immunology and Allergy ,Missense mutation ,Coronavirus Nucleocapsid Proteins ,Humans ,Point Mutation ,Gene ,Coronavirus ,Genetics ,Mutation ,Membrane Glycoproteins ,Polymorphism, Genetic ,Point mutation ,Nucleic acid sequence ,Nucleocapsid Proteins ,Virology ,Infectious Diseases ,Amino Acid Substitution ,Severe acute respiratory syndrome-related coronavirus ,Viruses ,Spike Glycoprotein, Coronavirus ,RNA, Viral - Abstract
Severe acute respiratory syndrome-associated coronavirus (SARS-CoV) emerged, in November 2002, as a novel agent causing severe respiratory illness. To study sequence variation in the SARS-CoV genome, we determined the nucleic acid sequence of the S and N genes directly from clinical specimens from 10 patients—1 specimen with no matched SARS-CoV isolate, from 2 patients; multiple specimens from 3 patients; and matched clinical-specimen/ cell-culture-isolate pairs from 6 patients. We identified 3 nucleotide substitutions that were most likely due to natural variation and 2 substitutions that arose after cell-culture passage of the virus. These data demonstrate the overall stability of the S and N genes of SARS-CoV over 3 months during which a minimum of 4 generations for transmission events occurred. These findings are a part of the expanding investigation of the evolution of how this virus adapts to a new host.
- Published
- 2004
22. Molecular Epidemiology of Outbreaks of Viral Gastroenteritis in New York State, 1998–1999
- Author
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Roger I. Glass, Dennison W. Moore, Stan F. Kondracki, Dale L. Morse, Nando K. Chatterjee, Michael Cambridge, and Stephan S. Monroe
- Subjects
Microbiology (medical) ,viruses ,Molecular Sequence Data ,New York ,Reoviridae ,Enzyme-Linked Immunosorbent Assay ,medicine.disease_cause ,Disease Outbreaks ,Microbiology ,Rotavirus ,medicine ,Humans ,Amino Acid Sequence ,Caliciviridae Infections ,Molecular Epidemiology ,Sequence Homology, Amino Acid ,Molecular epidemiology ,biology ,Reverse Transcriptase Polymerase Chain Reaction ,Norovirus ,Genetic Variation ,Outbreak ,biology.organism_classification ,Virology ,Gastroenteritis ,Diarrhea ,Infectious Diseases ,RNA, Viral ,Enterovirus ,Viral disease ,medicine.symptom - Abstract
This investigation evaluated the role of Norwalk-like virus (NLV) and other viruses (rotavirus, enteric adenovirus, and enterovirus) in 11 outbreaks of acute nonbacterial gastroenteritis that occurred in multiple settings in a span of 18 months in New York State. To determine the etiology of illness, patients' stool specimens were analyzed with a combination of reverse-transcription polymerase chain reaction (RT-PCR) and nucleotide sequencing, cell culture, and ELISA diagnostic techniques. NLV was detected from all of these outbreaks, with an overall detection rate of 64% (51 of 79) for all specimens tested. Repeated attempts to isolate other viral pathogens were unsuccessful. Phylogenetic analysis of a subset of 27 specimens from these outbreaks showed the presence of both genogroup I and genogroup II NLVs. A spectrum of different nucleotide sequences were detected, demonstrating interoutbreak sequence variation and unrelated infections. NLV is a significant causative agent of diarrhea outbreaks in New York State.
- Published
- 2004
23. Molecular characterization of noroviruses detected in diarrheic stools of Michigan and Wisconsin dairy calves: circulation of two distinct subgroups
- Author
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Stephan S. Monroe, Daniel L. Grooms, Roger K. Maes, Lora E Hanson, Annabel G. Wise, and Donald Sockett
- Subjects
Diarrhea ,Michigan ,Cancer Research ,animal diseases ,viruses ,Molecular Sequence Data ,RT-PCR ,Cattle Diseases ,NLV ,Biology ,medicine.disease_cause ,Article ,Microbiology ,Feces ,Open Reading Frames ,Wisconsin ,fluids and secretions ,Newbury agent-2 ,Virology ,medicine ,Animals ,Bovine enteric calicivirus ,Amino Acid Sequence ,Circoviridae Infections ,Conserved Sequence ,Phylogeny ,DNA Primers ,Jena ,Base Sequence ,Sequence Homology, Amino Acid ,Phylogenetic tree ,Reverse Transcriptase Polymerase Chain Reaction ,Norovirus ,virus diseases ,digestive system diseases ,Dairying ,Infectious Diseases ,Capsid ,Capsid Proteins ,Cattle ,Female ,Sequence Alignment - Abstract
Noroviruses have emerged as the leading worldwide cause of acute non-bacterial gastroenteritis in humans. The presence of noroviruses in diarrheic stool samples from calves on Michigan and Wisconsin dairy farms was investigated by RT-PCR. Norovirus-positive samples were found on all eight farms studied in Michigan and on 2 out of 14 farms in Wisconsin. Phylogenetic analyses of partial polymerase and capsid sequences, derived for a subset of these bovine noroviruses, showed that these strains formed a group which is genetically distinct from the human noroviruses, but more closely related to genogroup I than to genogroup II human noroviruses. Examination of 2 full and 10 additional partial capsid (ORF2) sequences of these bovine strains revealed the presence of two genetic subgroups or clusters of bovine noroviruses circulating on Michigan and Wisconsin farms. One subgroup is "Jena-like", the other "Newbury agent-2-like".
- Published
- 2004
24. PREVALENCE OF INFECTION WITH WATERBORNE PATHOGENS: A SEROEPIDEMIOLOGIC STUDY IN CHILDREN 6–36 MONTHS OLD IN SAN JUAN SACATEPEQUEZ, GUATEMALA
- Author
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Robert S. Klein, William F. Bibb, Ellen B. Steinberg, Maricruz Alvarez de Mejia, Byron Arana, Robert M. Hoekstra, Benjamin D. Gold, Carlos E. Mendoza, Beth P. Bell, Stephan S. Monroe, Stephen P. Luby, Eric D. Mintz, M. Beatriz Lopez, Jeffrey W. Priest, Roger I. Glass, and Caryn Bern
- Subjects
medicine.medical_specialty ,education.field_of_study ,biology ,business.industry ,media_common.quotation_subject ,Population ,Seroepidemiologic Studies ,biology.organism_classification ,Serology ,Infectious Diseases ,Hygiene ,Virology ,Environmental health ,Immunology ,Tropical medicine ,Epidemiology ,Medicine ,Infection control ,Parasitology ,business ,education ,Norwalk virus ,media_common - Abstract
Water and sanitation interventions in developing countries have historically been difficult to evaluate. We conducted a seroepidemiologic study with the following goals: 1) to determine the feasibility of using antibody markers as indicators of waterborne pathogen infection in the evaluation of water and sanitation intervention projects; 2) to characterize the epidemiology of waterborne diarrheal infections in rural Guatemala, and 3) to measure the age-specific prevalence of antibodies to waterborne pathogens. Between September and December 1999, all children 6-36 months of age in 10 study villages were invited to participate. We collected sufficient serum from 522 of 590 eligible children, and divided them into six-month age groups for analysis (6-12, 13-18, 19-24, 25-30, and 31-36 months). The prevalence of antibodies was lowest in children 6-12 months old compared with the four older age groups for the following pathogens: enterotoxigenic Escherichia coli (48%, 81%, 80%, 77%, and 83%), Norwalk virus (27%, 61%, 83%, 94%, and 94%), and Cryptosporidium parvum (27%, 53%, 70%, 67%, and 73%). The prevalence of total antibody to hepatitis A virus increased steadily in the three oldest age groups (40%, 28%, 46%, 60%, and 76%). In contrast, the prevalence of antibody to Helicobacter pylori was relatively constant in all five age groups (20%, 19%, 21%, 25%, and 25%). Serology appears to be an efficient and feasible approach for determining the prevalence of infection with selected waterborne pathogens in very young children. Such an approach may provide a suitable, sensitive, and economical alternative to the cumbersome stool collection methods that have previously been used for evaluation of water and sanitation projects.
- Published
- 2004
25. Characterization of a novel coronavirus associated with severe acute respiratory syndrome
- Author
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Pierre E. Rollin, W. Allan Nix, Dean D. Erdman, Luis Lowe, Paul A. Rota, Thomas G. Ksiazek, Silvia Peñaranda, Stephanie L. Liffick, Mellissa Olsen-Rasmussen, William J. Bellini, Christian Drosten, Suxiong Tong, Joseph L. DeRisi, Qi Chen, Min hsin Chen, Stephan Günther, Ray Campagnoli, Michael Frace, M. Steven Oberste, Brian P. Holloway, Larry J. Anderson, Stephan S. Monroe, Azaibi Tamin, Josef Limor, Karen A. McCaustland, Bettina Bankamp, Mark A. Pallansch, Joseph P. Icenogle, Anthony Sanchez, Albert Osterhaus, Ron A. M. Fouchier, Teresa C. T. Peret, David Wang, Kaija Maher, Cara C. Burns, and Virology
- Subjects
Human coronavirus NL63 ,DNA, Complementary ,Transcription, Genetic ,Sequence analysis ,Coronavirus M Proteins ,viruses ,Molecular Sequence Data ,Genome, Viral ,Regulatory Sequences, Nucleic Acid ,medicine.disease_cause ,Severe Acute Respiratory Syndrome ,Genome ,Viral Matrix Proteins ,Open Reading Frames ,Viral Proteins ,Viral Envelope Proteins ,Endopeptidases ,medicine ,Coronaviridae ,Coronavirus Nucleocapsid Proteins ,Humans ,Amino Acid Sequence ,RNA, Messenger ,skin and connective tissue diseases ,Conserved Sequence ,Phylogeny ,Coronavirus ,Genomic organization ,Polyproteins ,Genetics ,Multidisciplinary ,Membrane Glycoproteins ,biology ,fungi ,Nucleic acid sequence ,virus diseases ,Sequence Analysis, DNA ,Nucleocapsid Proteins ,biology.organism_classification ,medicine.disease ,RNA-Dependent RNA Polymerase ,Virology ,body regions ,Severe acute respiratory syndrome-related coronavirus ,Spike Glycoprotein, Coronavirus ,RNA, Viral ,Severe acute respiratory syndrome - Abstract
In March 2003, a novel coronavirus (SARS-CoV) was discovered in association with cases of severe acute respiratorysyndrome (SARS). The sequence of the complete genome of SARS-CoV was determined, and the initial characterization of the viral genome is presented in this report. The genome of SARS-CoV is 29,727 nucleotides in length and has 11 open reading frames, and its genome organization is similar to that of other coronaviruses. Phylogenetic analyses and sequence comparisons showed that SARS-CoV is not closelyrelated to anyof the previouslycharacterized coronaviruses.
- Published
- 2003
26. Detection and characterisation of human astroviruses in children with acute gastroenteritis in Blantyre, Malawi
- Author
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Benson D.M. Thindwa, Joseph S. Bresee, Roger I. Glass, Malcolm E. Molyneux, C. Anthony Hart, Jennifer L. Holmes, Robin L. Broadhead, Stephan S. Monroe, Winifred Dove, Nigel A. Cunliffe, Jailosi S. Gondwe, and Julie Greensill
- Subjects
Male ,Malawi ,Genotype ,HIV Infections ,Disease ,Virus ,Astrovirus ,Risk Factors ,Astroviridae Infections ,Virology ,Humans ,Medicine ,Risk factor ,biology ,Reverse Transcriptase Polymerase Chain Reaction ,business.industry ,Infant ,virus diseases ,biology.organism_classification ,Gastroenteritis ,Infectious Diseases ,Child, Preschool ,Concomitant ,Acute Disease ,Lentivirus ,Female ,Viral disease ,business ,Mamastrovirus - Abstract
In a 2-year hospital-based study of paediatric gastroenteritis in Blantyre, Malawi, astroviruses were detected by enzyme immunoassay in 15 (1.9%) of 786 inpatients and in 9 (2.3%) of 400 outpatients. Greater disease severity was noted in children coinfected with human immunodeficiency virus (HIV). Six human astrovirus (HAstV) genotypes were identified, including HAstV-1 (25%), HAstV-2 (21%), HAstV-3 (25%), HAstV-4 (13%), HAstV-5 (4%), and HAstV-8 (13%). Although astroviruses are not major causes of gastroenteritis among children admitted to hospital in Blantyre, concomitant HIV infection appears to be a risk factor for increased severity of disease.
- Published
- 2002
27. The Human Enteric Caliciviruses: an Expanded Role for Old Viruses
- Author
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Gaël Belliot, Umesh D. Parashar, Jacqueline S. Noel, Roger I. Glass, Tamie Ando, Stephan S. Monroe, Joseph S. Bresee, and Rebecca L. Fankhauser
- Subjects
Molecular epidemiology ,law ,viruses ,Outbreak ,Disease ,Biology ,Molecular diagnostics ,Virology ,Virus ,Polymerase chain reaction ,Contaminated food ,law.invention - Abstract
The human enteric caliciviruses, previously known as the Norwalk family of viruses, the "classic human caliciviruses," or the small round-structured viruses, are a group of enteric pathogens that are a common cause of gastroenteritis in children and adults alike. When the gene encoding the capsid was expressed in baculovirus, the resulting protein self-assembled into virus-like particles that looked like natural virus by electron microscopy (EM) and provided replenishable reagents for serologic testing, structural studies, and antigen to develop immunoassays for antigen detection. These molecular discoveries and diagnostic advances have permitted researchers to reassess the clinical and epidemiologic features of illness caused by the caliciviruses and to reconsider public health approaches to their prevention and control. This chapter provides a review to highlight some of the advances in our understanding of calicivirus-associated gastroenteritis following the introduction of new molecular diagnostics, with illustrations drawn from several recent epidemic investigations. Tracing some epidemics back to their source has extended the use of diagnostics to the detection of viruses in contaminated food and water. Despite the major advances in the knowledge of the caliciviruses based upon the understanding of their sequence and molecular organization, the search for simple diagnostic assays has been difficult. Nonetheless, in the process of sequencing many strains, the human enteric caliciviruses fell into two distinct genera. The ability to sequence polymerase chain reaction (PCR) products made it possible to trace the molecular epidemiology of caliciviruses in outbreaks of disease.
- Published
- 2014
28. Characterization of Capsid Genes, Expressed in the Baculovirus System, of Three New Genetically Distinct Strains of 'Norwalk-Like Viruses'
- Author
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Stephan S. Monroe, Jin-Fen Li, Charles D. Humphrey, Gaël Belliot, Jacqueline S. Noel, Tamie Ando, Yoshiyuki Seto, and Roger I. Glass
- Subjects
Microbiology (medical) ,Serotype ,Antigenicity ,viruses ,Molecular Sequence Data ,Spodoptera ,Antibodies, Viral ,Virus ,Immunoglobulin G ,Disease Outbreaks ,Capsid ,Immune system ,Antigen ,Virology ,Animals ,Humans ,Amino Acid Sequence ,Antigens, Viral ,Caliciviridae Infections ,Recombination, Genetic ,biology ,Norovirus ,Virion ,Gastroenteritis ,biology.protein ,Antibody ,Baculoviridae - Abstract
“Norwalk-like viruses” (NLVs), members of a newly defined genus of the family Caliciviridae , are the most common agents of outbreaks of gastroenteritis in the United States. Two features of NLVs have hindered the development of simple methods for detection and determination of serotype: their genetic diversity and their inability to grow in cell culture. To assess the immune responses of patients involved in outbreaks of gastroenteritis resulting from infection with NLVs, we previously used recombinant-expressed capsid antigens representing four different genetic clusters, but this panel proved insufficient for detection of an immune response in many patients. To extend and further refine this panel, we expressed in baculovirus the capsid genes of three additional genetically distinct viruses, Burwash Landing virus (BLV), White River virus (WRV), and Florida virus. All three expressed proteins assembled into virus-like particles (VLPs) that contained a full-length 64-kDa protein, but both the BLV and WRV VLPs also contained a 58-kDa protein that resulted from deletion of 39 amino acids at the amino terminus. The purified VLPs were used to measure the immune responses in 403 patients involved in 37 outbreaks of acute gastroenteritis. A majority of patients demonstrated a fourfold rise in the titer of immunoglobulin G to the antigen homologous to the outbreak strain, but most seroconverted in response to other genetically distinct antigens as well, suggesting no clear pattern of type-specific immune response. Further study of the antigenicity of the NLVs by use of VLPs should allow us to design new detection systems with either broader reactivity or better specificity and to define the optimum panel of antigens required for routine screening of patient sera.
- Published
- 2001
29. A Prospective Case‐Control Study of the Role of Astrovirus in Acute Diarrhea among Hospitalized Young Children
- Author
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Stephan S. Monroe, Jacqueline S. Noel, Penelope H. Dennehy, Roger I. Glass, Sara M. Nelson, and Sara Spangenberger
- Subjects
Diarrhea ,Male ,Serotype ,Pediatrics ,medicine.medical_specialty ,viruses ,Reoviridae ,medicine.disease_cause ,Astrovirus ,Immunoenzyme Techniques ,Feces ,fluids and secretions ,Astroviridae Infections ,Rotavirus ,medicine ,Humans ,Immunology and Allergy ,Prospective Studies ,Serotyping ,Child ,Prospective cohort study ,biology ,business.industry ,Infant, Newborn ,Case-control study ,Infant ,virus diseases ,biology.organism_classification ,Infectious Diseases ,El Niño ,Case-Control Studies ,Child, Preschool ,Immunology ,Female ,Seasons ,medicine.symptom ,business ,Mamastrovirus - Abstract
This study examines the importance of astroviruses as a cause of acute diarrhea in hospitalized children
- Published
- 2001
30. RT-PCR identification and typing of astroviruses and Norwalk-like viruses in hospitalized patients with gastroenteritis: evidence of nosocomial infections
- Author
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Stephan S. Monroe, C Chamoux, H Laveran, C Mollat, H Piloquet, O. Traoré, S Billaudel, and Gaël Belliot
- Subjects
Serotype ,Molecular Sequence Data ,medicine.disease_cause ,Virus ,Microbiology ,Feces ,Astroviridae Infections ,Virology ,Rotavirus ,medicine ,Humans ,Typing ,Child ,Phylogeny ,Caliciviridae Infections ,Cross Infection ,biology ,Reverse Transcriptase Polymerase Chain Reaction ,Virion ,Infant ,Sequence Analysis, DNA ,Middle Aged ,biology.organism_classification ,Caliciviridae ,Gastroenteritis ,Latex fixation test ,Microscopy, Electron ,Norwalk virus ,Infectious Diseases ,Child, Preschool ,Viral disease ,Mamastrovirus - Abstract
Background: Astroviruses (HAstVs) and ‘Norwalk-like viruses' (NLV) are frequent causes of gastroenteritis worldwide, though no data on the strains in circulation or their prevalence is available for France. Objectives: We applied molecular methods to detect HAstVs and NLVs by reverse transcription-polymerase chain reaction (RT-PCR) in fecal samples collected during a 2-year period from children and adults hospitalized with gastroenteritis. Study design: All samples negative for rotavirus and adenovirus by latex agglutination which contained small (25–40 nm) viral particles observed by electron microscopy (EM) were examined by RT-PCR. RT-PCR products were sequenced to characterize the HAstV and NLV strains present. Results: A total of 75 samples were analyzed by RT-PCR, of which 15 were positive for HAstV and 24 for NLV. Several distinct strains of serotype 1 HAstV, the predominant serotype, circulated during the period. Nineteen of the 24 NLVs were of the G2 genogroup including Mexico-like ( n =10), Bristol-like ( n =8), and Hawaii-like viruses ( n =1); two were genogroup 1. Overall, seven (47%) of the 15 HAstV infections and nine (37.5%) of the 24 NLV infections appeared to be nosocomially acquired based on the date of admission in hospital and the date of illness. Conclusion: This study provides additional evidence of the importance of nosocomial infections caused by NLV and HAstV.
- Published
- 2000
31. The Epidemiology of Enteric Caliciviruses from Humans: A Reassessment Using New Diagnostics
- Author
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Gaël Belliot, Stephan S. Monroe, Joseph S. Bresee, Tamie Ando, Rebecca L. Fankhauser, Jacqueline S. Noel, Anthony W. Mounts, Roger I. Glass, and Umesh D. Parashar
- Subjects
Adult ,medicine.medical_specialty ,Molecular Diagnostic Method ,Disease Outbreaks ,Feces ,Epidemiology ,medicine ,Hospital discharge ,Humans ,Immunology and Allergy ,Intensive care medicine ,Aged ,Caliciviridae Infections ,biology ,business.industry ,Public health ,Outbreak ,Middle Aged ,biology.organism_classification ,Virology ,Caliciviridae ,Gastroenteritis ,Norwalk virus ,Diarrhea ,Infectious Diseases ,Acute Disease ,Public Health ,Viral disease ,medicine.symptom ,business - Abstract
In the United States, acute gastroenteritis is one of the most commonly noted illnesses on hospital discharge records and death certificates, yet few of these cases have an etiologic diagnosis. The application of new molecular diagnostic methods has shown caliciviruses (previously referred to as the Norwalk family of viruses or small round structured viruses) to be the most common cause of acute gastroenteritis (AGE) outbreaks in the United States, and they may emerge as a common cause of sporadic cases of AGE among both children and adults. Novel molecular methods have permitted outbreak strains to be traced back to their common source and have led to the first identification of virus in implicated vehicles of infection-water, shellfish, and foods contaminated both at their source and by food handlers. The broad application of these methods to routine diagnosis in hospitals and public health laboratories is advancing our appreciation of the full burden of calicivirus-associated diarrhea, and it is opening new avenues for its prevention and control.
- Published
- 2000
32. A Foodborne Outbreak of Gastroenteritis Associated with Norwalk‐like Viruses: First Molecular Traceback to Deli Sandwiches Contaminated during Preparation
- Author
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Kate Hendricks, Stephan S. Monroe, Rebecca L. Fankhauser, Sudha Reddy, Nicholas A. Daniels, Steven M. Rowe, Roger I. Glass, David Bergmire-Sweat, Paul S. Mead, Robert L. Atmar, and Kellogg J. Schwab
- Subjects
Adult ,Diarrhea ,Male ,Food handlers ,Adolescent ,Universities ,Food Handling ,Cafeteria ,Biology ,medicine.disease_cause ,Polymerase Chain Reaction ,Disease Outbreaks ,Foodborne Diseases ,Feces ,medicine ,Humans ,Immunology and Allergy ,Caliciviridae Infections ,Food poisoning ,digestive, oral, and skin physiology ,Infant ,Outbreak ,biology.organism_classification ,medicine.disease ,Texas ,Virology ,Caliciviridae ,Gastroenteritis ,Norwalk virus ,Infectious Diseases ,Case-Control Studies ,Norovirus ,Female ,Viral disease - Abstract
In March 1998, an outbreak of acute gastroenteritis occurred among students at a Texas university. Overall, 125 ill students sought medical care. Case-control studies revealed that illness was significantly associated with eating foods from the university's main cafeteria deli bar on 9 and 10 March. Stool specimens from 9 (50%) of 18 ill students and samples of deli ham showed evidence of Norwalk-like viruses (NLVs) by reverse-transcriptase (RT) polymerase chain reaction (PCR) assay. A food handler who prepared sandwiches for lunch on 9 March reported that her infant had been sick with watery diarrhea since just before the outbreak. A stool sample from the infant was positive for NLV by RT-PCR, and the sequence of the amplified product was identical to that of amplified product from deli ham and students' stool specimens. This is the first time RT-PCR and sequence analysis have successfully confirmed viral contamination of a food item likely to have been contaminated by a food handler.
- Published
- 2000
33. Identification of a Distinct Common Strain of 'Norwalk‐like Viruses' Having a Global Distribution
- Author
-
Stephan S. Monroe, Tamie Ando, Jacqueline S. Noel, Roger I. Glass, and Rebecca L. Fankhauser
- Subjects
Biology ,Global Health ,medicine.disease_cause ,Disease Outbreaks ,medicine ,Global health ,Immunology and Allergy ,Phylogeny ,Caliciviridae Infections ,Molecular Epidemiology ,Geography ,Molecular epidemiology ,Transmission (medicine) ,Strain (biology) ,Outbreak ,DNA-Directed RNA Polymerases ,Virology ,United States ,Gastroenteritis ,Norwalk virus ,Infectious Diseases ,Population Surveillance ,Norovirus ,Identification (biology) ,Seasons ,Viral disease - Abstract
"Norwalk-like viruses" (NLVs) are the most common cause of outbreaks of nonbacterial gastroenteritis. During molecular surveillance of NLV strains from 152 outbreaks of gastroenteritis that occurred in the US between August 1993 and July 1997, we identified an NLV strain that predominated during the 1995-1996 season. The "95/96-US" strain caused 60 outbreaks in geographically distant locations within the US and was identified, by sequence comparisons, in an additional 7 countries on 5 continents during the same period. This is the first demonstration linking a single NLV strain globally and suggests that the circulation of these strains might involve patterns of transmission not previously considered. The diagnostic techniques are now available to establish a global network for surveillance of NLV strains that would highlight the importance of NLVs worldwide and allow molecular identification of common strains having a global distribution so as to consider interventions for their control.
- Published
- 1999
34. An Outbreak of Acute Gastroenteritis in a Geriatric Long-Term–Care Facility: Combined Application of Epidemiological and Molecular Diagnostic Methods
- Author
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Roger I. Glass, A Marx, Joseph S. Bresee, David K. Shay, C Brage, Charles D. Humphrey, Jacqueline S. Noel, Stephan S. Monroe, S Lipsky, E R Alexander, and Tamie Ando
- Subjects
Adult ,Male ,Washington ,Microbiology (medical) ,medicine.medical_specialty ,Epidemiology ,Statistics as Topic ,Disease Outbreaks ,Risk Factors ,medicine ,Homes for the Aged ,Humans ,Infection control ,Risk factor ,Aged ,Caliciviridae Infections ,Aged, 80 and over ,Cross Infection ,Infection Control ,biology ,business.industry ,Outbreak ,Middle Aged ,biology.organism_classification ,Caliciviridae ,Gastroenteritis ,Nursing Homes ,Norwalk virus ,Infectious Diseases ,Relative risk ,Immunology ,Emergency medicine ,Female ,Contact Tracing ,business ,Contact tracing - Abstract
Objective:To assess possible transmission modes of, and risk factors for, gastroenteritis associated with Norwalk-like viruses (NLVs) in a geriatric long-term-care facility.Methods:During a prolonged outbreak of acute gastroenteritis, epidemiological data on illness among residents and employees were collected in conjunction with stool, vomitus, and environmental specimens for viral testing. NLVs were identified by electron microscopy in stool and vomitus specimens, and further characterized by reverse-transcriptase polymerase chain reaction and nucleotide sequencing. Potential risk factors were examined through medical-record review, personal interview, and a self-administered questionnaire sent to all employees.Results:During the outbreak period, 52 (57%) of 91 residents and 34 (35%) of 90 employees developed acute gastroenteritis. Four case-residents were hospitalized; three residents died at the facility shortly after onset of illness. A point source was not identified; no association between food or water consumption and gastroenteritis was identified. A single NLV strain genetically related to Toronto virus was the only pathogen identified. Residents were at significantly higher risk of gastroenteritis if they were physically debilitated (relative risk [RR], 3.5; 95% confidence interval [CI95], 1.0-12.9), as were employees exposed to residents with acute gastroenteritis (RR, 2.6; CI95, 1.1-6.5) or ill household members (RR, 2.3; CI95, 1.4-3.6). Adherence to infection control measures among the nursing staff may have reduced the risk of gastroenteritis, but the reduction did not reach statistical significance.Conclusions:In the absence of evidence for food-borne or waterborne transmission, NLVs likely spread among residents and employees of a long-term-care facility through person-to-person or airborne droplet transmission. Rapid notification of local health officials, collection of clinical specimens, and institution of infection control measures are necessary if viral gastroenteritis transmission is to be limited in institutional settings
- Published
- 1999
35. An outbreak of viral gastroenteritis associated with consumption of sandwiches: implications for the control of transmission by food handlers
- Author
-
Jacqueline S. Noel, Charles R. Eddy, Kathy S. Williams, Stephan S. Monroe, L. Dow, T. Ingram, Umesh D. Parashar, Tamie Ando, R. L. Fankhauser, J. Miller, J. S. Bresee, Charles D. Humphrey, and Roger I. Glass
- Subjects
medicine.medical_specialty ,Food Handling ,Epidemiology ,Disease ,Virus ,Disease Outbreaks ,law.invention ,law ,Environmental health ,medicine ,Humans ,Food microbiology ,Caliciviridae Infections ,biology ,Reverse Transcriptase Polymerase Chain Reaction ,business.industry ,Outbreak ,biology.organism_classification ,Virology ,Caliciviridae ,Gastroenteritis ,Norwalk virus ,Infectious Diseases ,Transmission (mechanics) ,Food Microbiology ,Viral disease ,business ,Research Article - Abstract
Although food handlers are often implicated as the source of infection in outbreaks of food-borne viral gastroenteritis, little is known about the timing of infectivity in relation to illness. We investigated a gastroenteritis outbreak among employees of a manufacturing company and found an association (RR=14·1, 95% CI=2·0–97·3) between disease and eating sandwiches prepared by 6 food handlers, 1 of whom reported gastroenteritis which had subsided 4 days earlier. Norwalk-like viruses were detected by electron microscopy or reverse transcriptase-polymerase chain reaction (RT-PCR) in stool specimens from several company employees, the sick food handler whose specimen was obtained 10 days after resolution of illness, and an asymptomatic food handler. All RT-PCR product sequences were identical, suggesting a common source of infection. These data support observations from recent volunteer studies that current recommendations to exclude food handlers from work for 48–72 h after recovery from illness may not always prevent transmission of Norwalk-like viruses because virus can be shed up to 10 days after illness or while exhibiting no symptoms.
- Published
- 1998
36. Molecular Epidemiology of 'Norwalk‐like Viruses' in Outbreaks of Gastroenteritis in the United States
- Author
-
Rebecca L. Fankhauser, Jacqueline S. Noel, Tamie Ando, Roger I. Glass, and Stephan S. Monroe
- Subjects
Meat ,Restaurants ,medicine.disease_cause ,Disease Outbreaks ,law.invention ,law ,medicine ,Animals ,Homes for the Aged ,Humans ,Immunology and Allergy ,Child ,Phylogeny ,Aged ,Caliciviridae Infections ,Molecular Epidemiology ,Molecular epidemiology ,biology ,Calicivirus ,Infant ,Outbreak ,biology.organism_classification ,Ostreidae ,Virology ,United States ,Caliciviridae ,Gastroenteritis ,Nursing Homes ,Norwalk virus ,Infectious Diseases ,Transmission (mechanics) ,Child, Preschool ,Norovirus ,Viral disease - Abstract
Fecal specimens from 90 outbreaks of nonbacterial gastroenteritis reported to 33 state health departments from January 1996 to June 1997 were examined to determine the importance of and to characterize "Norwalk-like viruses" (NLVs) in these outbreaks. NLVs were detected by reverse transcription-polymerase chain reaction in specimens from 86 (96%) of 90 outbreaks. Outbreaks were most frequent in nursing homes and hospitals (43%), followed by restaurants or events with catered meals (26%); consumption of contaminated food was the most commonly identified mode of transmission (37%). Nucleotide sequence analysis showed great diversity between strains but also provided evidence indicating the emergence of a common, predominant strain. The application of improved molecular techniques to detect NLVs demonstrates that most outbreaks of nonbacterial gastroenteritis in the United States appear to be associated with these viruses and that sequence analysis is a robust tool to help link or differentiate these outbreaks.
- Published
- 1998
37. A prospective study of astrovirus diarrhea of infancy in Mexico City
- Author
-
Ardythe L. Morrow, Stephan S. Monroe, Jacqueline S. Noel, Larry K. Pickering, F R Velázquez, Guillermo M. Ruiz-Palacios, Juan J. Calva, M. Guerrero, Julia Martinez, Douglas K. Mitchell, Roger I. Glass, and Gustavo Rosales
- Subjects
Male ,Microbiology (medical) ,Pediatrics ,medicine.medical_specialty ,Longitudinal study ,Astrovirus ,Cohort Studies ,Immunoenzyme Techniques ,Feces ,Pregnancy ,Astroviridae Infections ,Mexico city ,Epidemiology ,medicine ,Infant diarrhea ,Humans ,Longitudinal Studies ,Prospective Studies ,Prospective cohort study ,Mexico ,biology ,business.industry ,Infant, Newborn ,Infant ,biology.organism_classification ,Diarrhea ,Infectious Diseases ,Diarrhea, Infantile ,Pediatrics, Perinatology and Child Health ,Immunology ,Cohort ,Female ,medicine.symptom ,business ,Mamastrovirus - Abstract
To describe the epidemiologic and clinical characteristics of astrovirus-associated diarrhea in a cohort of young children from a periurban community in Mexico City.From November, 1988, through December, 1991, a total of 214 children were enrolled in a longitudinal study of diarrhea and monitored from birth to 18 months of age. A stool specimen was collected during each episode of diarrhea. Specimens from a total of 510 diarrhea episodes were tested for astrovirus by enzyme immunoassay and examined for other enteric pathogens. The antigenic types of astrovirus were determined by a typing enzyme immunoassay.Astrovirus was detected in 26 (5%) of 510 diarrhea episodes, with an incidence rate of 0.1 episode/child year; the highest rate was in children 13 to 18 months of age. Astrovirus-associated diarrhea was characterized by a median of 4 stools (range, 2 to 10) during the first 24 h, a median duration of 3 days (range, 1 to 21), vomiting (20%), and fever (7%). No cases of dehydration or repeat symptomatic infections were observed. Coinfection with another pathogen was detected in 11 of the 26 episodes (42%). Serotype 2 (35%) was most common, followed by serotypes 4 (15%), 3 (11%), and 1 and 5 (4% each); 31% were nontypable. Astrovirus-associated diarrhea was less severe, as measured by the number of stools (4.3 +/- 1.9), than diarrhea caused by rotavirus (7.1 +/- 2.8) or when coinfections occurred (5.5 +/- 1.6; P = 0.008).Astrovirus was associated with 5% of the episodes of diarrhea in this cohort of young Mexican children and presented as a mild secretory diarrhea. Five predominant antigenic types were detected with type 2 being the most common.
- Published
- 1998
38. A Viral Gastroenteritis Outbreak Associated with Person-to-Person Spread among Hospital Staff
- Author
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J. John Weems, Stephan S. Monroe, James J. Gibson, Tamie Ando, Jacqueline S. Noel, Joseph S. Bresee, John Horan, Connie Steed, David K. Kim, and Victor M. Cáceres
- Subjects
Adult ,Male ,Microbiology (medical) ,Veterinary medicine ,medicine.medical_specialty ,Referral ,Epidemiology ,South Carolina ,Nursing Staff, Hospital ,Disease Outbreaks ,Infectious Disease Transmission, Professional-to-Patient ,Medicine ,Humans ,Risk factor ,Aged ,Caliciviridae Infections ,Aged, 80 and over ,Cross Infection ,business.industry ,Public health ,Outbreak ,Middle Aged ,Gastroenteritis ,Diarrhea ,Norwalk virus ,Infectious Diseases ,Relative risk ,Emergency medicine ,Female ,Viral disease ,medicine.symptom ,business - Abstract
Objective To identify the etiologic agent and risk factors associated with a hospital ward outbreak of gastroenteritis. Setting A regional referral hospital in upstate South Carolina. Methods We reviewed patient charts, surveyed staff, and tested stool from acutely ill persons. A case was defined as diarrhea and vomiting in a staff member or patient from January 5 to 13, 1996. Results The initial case occurred on January 5 in a staff nurse who subsequently was hospitalized on the ward and visited by many staff colleagues. The staff were at a significantly greater risk for gastroenteritis than were patients (28/89 [31%] vs 10/91 [11%]; relative risk [RR], 2.9; 95% confidence interval [CI95], 1.5-5.5). All 10 case-patients had been exposed to case-nurses (assigned nurses who were primary caretakers), and eight had documented exposure to case-nurses 1 to 2 days before their illness. Patients exposed to case-nurses had a significantly increased risk of illness (8/57 [14%] vs 0/32; RR, >4.5; CI95, undefined). Neither staff nor patients had significantly increased risk from food, water, ice, or exposure to case-patients. Electron microscopy identified small round-structured viruses (SRSVs) in nine of nine stool samples. Conclusion This nosocomial outbreak of gastroenteritis was likely caused by SRSVs introduced by a staff member and spread via person-to-person transmission from and among staff. The potential for spread of SRSV-associated gastroenteritis from and among staff should be considered in developing strategies to prevent similar outbreaks in hospital settings.
- Published
- 1998
39. Age-Stratified Seroprevalence of Neutralizing Antibodies to Astrovirus Types 1 to 7 in Humans in The Netherlands
- Author
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Stephan S. Monroe, Marion Koopmans, Jan Vinjé, and M. H. L. Bijen
- Subjects
Adult ,Microbiology (medical) ,Serotype ,Adolescent ,viruses ,Immunoelectron microscopy ,Clinical Biochemistry ,Immunology ,Population ,Cell Culture Techniques ,Enzyme-Linked Immunosorbent Assay ,Cross Reactions ,Antibodies, Viral ,Article ,Virus ,Astrovirus ,Microbiology ,fluids and secretions ,Neutralization Tests ,Astroviridae Infections ,Prevalence ,Tumor Cells, Cultured ,Animals ,Humans ,Immunology and Allergy ,Seroprevalence ,Typing ,Serotyping ,Child ,Microscopy, Immunoelectron ,education ,Genotyping ,Aged ,Netherlands ,education.field_of_study ,biology ,Age Factors ,Infant, Newborn ,Infant ,virus diseases ,Middle Aged ,biology.organism_classification ,Virology ,Child, Preschool ,Rabbits ,Mamastrovirus - Abstract
Astroviruses are a new family of positive-stranded RNA viruses that cause gastroenteritis in a wide range of animals and in humans. Seven types of astrovirus, tentatively considered serotypes, have been distinguished by enzyme-linked immunosorbent assays (ELISA) or immunoelectron microscopy, but it is unclear whether the serotype designation is used properly. To test human sera for the presence of neutralizing antibodies and to type field strains, neutralization tests (NT) using CaCo2 tissue-culture-adapted astrovirus strains 1 to 7 and the corresponding rabbit reference sera were developed. In rabbits, neutralizing antibodies were predominantly serotype specific, with the exception of low-level cross-reactivity in astrovirus serotype 4 reference serum with astrovirus serotype 1 virus. Similarly, in humans, no evidence of cross-reactivity was found for the serotype combinations tested (all except the combination 1 and 7 and the combination 6 and 7). Typing by NT was concordant with typing by ELISA and genotyping, with one exception. The seroprevalence rates of neutralizing antibodies in an age-stratified sample of the population in Utrecht Province ( n = 242) were 91% for astrovirus serotype 1, 69% for astrovirus serotype 3, 56% for astrovirus serotype 4, 36% for astrovirus serotype 5, 31% for astrovirus serotype 2, 16% for astrovirus serotype 6, and 10% for astrovirus serotype 7. Acquisition of antibodies was slower among persons seropositive for astrovirus serotype 5 than among those seropositive for astrovirus serotypes 1 to 4, suggesting that the epidemiology of serotype 5 astrovirus is different from that of astrovirus serotypes 1 to 4.
- Published
- 1998
40. Correlation of patient immune responses with genetically characterized small round-structured viruses involved in outbreaks of nonbacterial acute gastroenteritis in the United States, 1990 to 1995
- Author
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Kim Y. Green, José Paulo G Leite, Jacqueline S. Noel, Tamie Ando, Mary K. Estes, Roger I. Glass, Stephan S. Monroe, Yoshiyuki Seto, and Kate E. Dingle
- Subjects
biology ,viruses ,Outbreak ,biology.organism_classification ,Virology ,Virus ,Caliciviridae ,Microbiology ,Serology ,Infectious Diseases ,Capsid ,Antigen ,Antigenic variation ,Norwalk virus - Abstract
Small round-structured viruses (SRSVs) are a genetically and antigenically diverse group of caliciviruses that are the most common cause of outbreaks of acute nonbacterial gastroenteritis. We have applied both molecular techniques to characterize SRSVs in fecal specimens and serologic assays using four different expressed SRSV antigens to examine the distribution of outbreak strains in the United States and determine if the immune responses of patients were strain specific. Strains from 23 outbreaks of SRSV gastroenteritis were characterized by reverse transcription-PCR and nucleotide sequencing of a 277-base region of the capsid gene. These strains segregated into two distinct genogroups, I and II, comprising four and six clusters of strains respectively, each representing a distinct phylogenetic lineage. Serum IgG responses in patients were measured by enzyme immunoassay using expressed capsid antigens of Norwalk virus (NV), Toronto virus (TV), Hawaii virus (HV), and Lordsdale virus (LV), representing four of the 10 clusters. While strains in genogroups I and II were antigenically distinct, within genogroups, the specificity of the immune response varied greatly. Patients infected with genogroup I strains which had as much as 38.5% aa divergence from NV demonstrated relatively homologous seroresponses to the single NV antigen. In contrast, in genogroup II, homologous seroresponses to TV and HV were only present when the infecting strains showed less than 6.5% aa divergence from these antigens. These results suggest that TV and HV represent not only separate genetic clusters in genogroup II but also separate antigenic groups, each of which is related but distinguishable. In addition, two genetically distinct SRSV strains were identified for which we have no homologous antigen. This study suggests that while current molecular diagnostics are capable of detecting the full range of SRSVs, additional expressed antigens will be required to detect an immune response to SRSV infection caused by all the antigenically diverse strains.
- Published
- 1997
41. Parkville virus: A novel genetic variant of human calicivirus in the Sapporo virus clade, associated with an outbreak of gastroenteritis in adults
- Author
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Stephan S. Monroe, Roger I. Glass, Paul R. Lambden, Charles D. Humphrey, Jacqueline S. Noel, B. L. Liu, Evelyn M. Rodriguez, Tamie Ando, D. M. Dwyer, and Ian N. Clarke
- Subjects
Genetics ,biology ,Sequence analysis ,viruses ,Calicivirus ,Sapporo Virus ,biology.organism_classification ,Virology ,Caliciviridae ,Virus ,Infectious Diseases ,Capsid ,Clade ,Norwalk virus - Abstract
This report describes the characterization of Parkville virus, the etiologic agent of an outbreak of foodborne gastroenteritis, that has the morphology of a calicivirus and genetic properties that distinguish it from previously identified strains in the Sapporo/Manchester virus clade. Sequence analysis of the Parkville virus genome showed it contained the RNA-dependent RNA polymerase motifs GLPSG and YGDD characteristic of members of the family Caliciviridae with an organization identical to that reported for the Manchester virus where the capsid region of the polyprotein is fused to the RNA polymerase. Parkville virus however, demonstrates considerable sequence divergence from both the Manchester and Sapporo caliciviruses, providing the first indications that genetic diversity exists within caliciviruses of this previously homogeneous clade. On the basis of recent advances in the genetic characterization of members of the family Caliciviridae, we propose a new interim phylogenetic classification system in which Parkville virus would be included with Manchester and Sapporo virus as a separate group distinct from the small round-structured viruses (Norwalk-like viruses) that also cause diarrhea in humans.
- Published
- 1997
42. A one-tube method of reverse transcription-PCR to efficiently amplify a 3-kilobase region from the RNA polymerase gene to the poly(A) tail of small round-structured viruses (Norwalk-like viruses)
- Author
-
R. I. Glass, Tamie Ando, Jacqueline S. Noel, and Stephan S. Monroe
- Subjects
Microbiology (medical) ,Genes, Viral ,DNA polymerase ,RNA-dependent RNA polymerase ,Polymerase Chain Reaction ,chemistry.chemical_compound ,Virology ,RNA polymerase ,Humans ,RNA, Messenger ,Caliciviridae Infections ,DNA Primers ,Base Sequence ,biology ,RNA-Directed DNA Polymerase ,RNA ,DNA-Directed RNA Polymerases ,Molecular biology ,Reverse transcriptase ,Gastroenteritis ,Reverse transcription polymerase chain reaction ,Norwalk virus ,chemistry ,Evaluation Studies as Topic ,biology.protein ,RNA, Viral ,Moloney murine leukemia virus ,Primer (molecular biology) ,Research Article - Abstract
Amplification of a 3-kb genome region from the RNA polymerase gene to the 3' poly(A) tail of small round-structured virus (SRSV) by reverse transcription-PCR (RT-PCR) has been difficult to achieve because of a stable secondary structure in a region between the RNA polymerase gene and the 5' end of the second open reading frame. We have developed a one-tube RT-PCR method to efficiently amplify this region. The method comprises three procedures: purification of poly(A)+ RNA from a starting RNA solution by oligo(dT)30 covalently linked to latex particles, buffer exchange, and continuous RT and PCR in a single tube containing all reaction components. The key elements of this method are (i) first-strand cDNA synthesis with the Superscript II version of RNase H- Moloney murine leukemia virus reverse transcriptase at 50 degrees C for 10 min by using the RNA-oligo(dT)30 hybrid on the latex particles as the template and primer, and (ii) PCR by Taq and Pwo DNA polymerases mixed together with a mixture of 12 phased oligo(dT)25 antisense primers. The detection threshold of the one-tube RT-PCR method was as little as 0.2 ng of the crude RNA used as the source of the template. Using this method, we obtained 3-kb products from 24 SRSV strains previously characterized into four genetic groups. These included 5 P1-A, 4 P1-B, 5 P2-A, and 10 P2-B strains. Because SRSVs have not yet been cultivated in vitro, this novel method should facilitate molecular characterization of SRSVs to provide a firm scientific foundation for improvements and refinements of SRSV diagnostics.
- Published
- 1997
43. Outbreak of gastroenteritis in military recruits associated with serotype 3 astrovirus infection
- Author
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Stephan S. Monroe, Henri Laveran, and Gaël Belliot
- Subjects
Adult ,Serotype ,viruses ,Dot blot ,Virus ,Disease Outbreaks ,Serology ,Astrovirus ,Microbiology ,Feces ,fluids and secretions ,Astroviridae Infections ,Virology ,Animals ,Humans ,Serotyping ,Seroconversion ,biology ,virus diseases ,Outbreak ,biology.organism_classification ,Gastroenteritis ,Military Personnel ,Infectious Diseases ,RNA, Viral ,Rabbits ,Viral disease ,Caco-2 Cells ,Mamastrovirus - Abstract
A serotype 3 astrovirus was identified in stool samples from an outbreak of acute gastroenteritis that occurred among military recruits in France. Sixteen stools samples and eight pairs of acute- and convalescent-phase serum were collected from affected individuals. Astrovirus was detected in two stool samples by electron microscopy and in four stool samples by reverse transcriptase-polymerase chain reaction (RT-PCR). Seroconversion to the astrovirus present in one stool was detected in seven patients by using solid-phase immune electron microscopy (SPIEM) and dot blot. For three patients, the serological results were consistent with the PCR results, indicating that astrovirus was a cause of gastroenteritis in these young adults. This study describes the characterization of the serotype 3 astrovirus associated with this outbreak. The virus has a buoyant density in cesium chloride of 1.365 gm/ml and contains two proteins immuno-precipitated with rabbit serum. Only the larger protein was recognized by immunoblotting using a convalescent-phase human serum. The protein composition of this virus differs from that reported for serotype 1 astrovirus, indicating heterogeneity in the capsid composition among astrovirus serotypes.
- Published
- 1997
44. Norovirus and Child Care
- Author
-
Stephan S. Monroe, Roger I. Glass, Marc-Alain Widdowson, R. Suzanne Beard, Sandra S. Chaves, Sandra N. Bulens, Elmira T. Isakbaeva, and Susan M. Adams
- Subjects
Adult ,Microbiology (medical) ,media_common.quotation_subject ,medicine.disease_cause ,Disease Outbreaks ,Feces ,fluids and secretions ,Hygiene ,Environmental health ,medicine ,Humans ,Caliciviridae Infections ,media_common ,Child care ,biology ,business.industry ,Norovirus ,Infant ,Outbreak ,Child Day Care Centers ,biology.organism_classification ,Virology ,Caliciviridae ,Gastroenteritis ,Diarrhea ,Infectious Diseases ,Pediatrics, Perinatology and Child Health ,Female ,Viral disease ,medicine.symptom ,business - Abstract
An infant with diarrhea attended a community playgroup. In the subsequent 48 hours, 6 of the 7 mothers and children reported gastroenteritis; fecal specimens from 5 persons tested positive for norovirus, with identical sequences. No breach of hygiene or contact with fecal matter was identified. Excluding the child with gastroenteritis from the playgroup could have prevented this outbreak.
- Published
- 2005
45. Are Noroviruses Emerging?
- Author
-
Roger I. Glass, Stephan S. Monroe, and Marc-Alain Widdowson
- Subjects
Microbiology (medical) ,medicine.medical_specialty ,Epidemiology ,viruses ,Prevalence ,lcsh:Medicine ,Disease ,Biology ,medicine.disease_cause ,Disease cluster ,Communicable Diseases ,Communicable Diseases, Emerging ,lcsh:Infectious and parasitic diseases ,Disease Outbreaks ,Environmental health ,medicine ,Humans ,lcsh:RC109-216 ,Caliciviridae Infections ,Emerging ,Transmission (medicine) ,Public health ,lcsh:R ,Norovirus ,Outbreak ,Virology ,United States ,Gastroenteritis ,Infectious Diseases ,Commentary ,Food Microbiology ,Water Microbiology - Abstract
In 1972, noroviruses (previously called "Norwalk-like viruses") were discovered as the first viruses definitively associated with acute gastroenteritis. During the next 2 decades, researchers were unable to develop simple methods to detect these common viruses or to find the etiologic agents of nonbacterial gastroenteritis outbreaks and hospitalizations. Indeed, of >2,500 foodborne outbreaks reported to the Centers for Disease Control and Prevention from 1993 to 1997, 75% (23). In addition, we now eat more foods that have been handled by a variety of potentially infected people; 46% of household food expenditures is now spent on eating out, compared with 32% in 1972 (24). We also eat more of the foods that are likely to be contaminated with norovirus; consumption of fresh vegetables and fruit has risen >20% in the last 30 years (25), and this produce is often grown in countries where crops are still irrigated with sewage-contaminated water. Finally, more people than ever are traveling and have an increased risk for norovirus infection through exposure to hotels, airplanes, and cruise ships. From 1993 to 1998, for example, the number of cruise ship passengers in the United States increased by 50% (26). Faced with these trends, how should the public health community respond? First, research on the disease prevalence of noroviruses is only beginning. If noroviruses are an increasingly common cause of infectious gastroenteritis, with some cases resulting in diarrhea-related deaths and hospitalizations, then substantially greater investments are required in their diagnosis. Increased use of diagnostics along with improved surveillance, such as in sentinel sites, will permit identification of new strains and shifts in the epidemiology of norovirus disease. The development of easy-to-use, sensitive assays for use by clinical and public health laboratories should also have a high priority. Second, we do not know how to stop norovirus transmission. Foods can be contaminated with norovirus either at the source (27) or at the point of service by infected food handlers. Noroviruses can spread by water, direct person-to-person contact, or airborne droplets of vomitus (28), and they can persist in the environment as a source of continuing infection despite efforts at disinfection (29). Recent advances in finding a cell culture system for noroviruses may allow for assessing the efficacy of various disinfectants (30), but only by full epidemiologic investigation of viral gastroenteritis outbreaks and by application of molecular tests will transmission routes be determined, differences in epidemiology between strains be detected, and targeted control measures implemented. Norovirus infections are common and likely to become more so. Effective prevention strategies must now be designed and implemented.
- Published
- 2005
46. Outbreaks of gastroenteritis in elderly nursing homes and retirement facilities associated with human caliciviruses
- Author
-
Xianmin Dai, Stephan S. Monroe, E. Barrett, Jian Hu, Larry K. Pickering, Xi Jiang, David O. Matson, E. Turf, and Charles D. Humphrey
- Subjects
biology ,business.industry ,Outbreak ,biology.organism_classification ,Virology ,Virus ,Caliciviridae ,Serology ,Diarrhea ,Titer ,Infectious Diseases ,medicine ,Viral disease ,medicine.symptom ,business ,Norwalk virus - Abstract
Eleven outbreaks of acute gastroenteritis, eight of which were in nursing homes or retirement facilities, were reported in virginia during the winter of 1993-1994. Serum samples (four outbreaks) and stool samples (two outbreaks) from involved people were tested for human calicivirus (HuCV) infection by enzyme immune assays (EIAs) using recombinant Norwalk virus (rNV) and Mexico virus (rMX) capsid antigens and reverse transcription-polymerase chain reaction (RT-PCR). Of the 31 pairs of acute and convalescent serum specimens tested, 24 had a fourfold or more titer increase to rMX and 4 responded to rNV. In all four outbreaks, the geometric mean titers (GMTs) against rMX were significantly higher than those against rNV in the convalescent, but not in the acute phase of illness. The antibody response to rMX among these patients was also higher than to rNV (summary mean 32-fold increase vs. 0.7-fold increase, respectively, P < .001). Antigen was detected in 5 of 21 stool specimens tested by the rMX EIA, RNA in 12 of 17 stool specimens tested by RT-PCR, and small round structured virus (SRSV) particles in 12 of 21 by electron microscopy (EM); none were positive by the rNV EIA. Sequence analysis of the RT-PCR-amplified products from the viral RNA polymerase region revealed 92-93% amino acid identity with Snow Mountain agent (SMA), 86% with MX, 58-59% with NV, and 31-32% with Sapporo HuCV, suggesting that these viruses belong to the SMA HuCV genogroup.
- Published
- 1996
47. A University Outbreak of Gastroenteritis Due to a Small Round-Structured Virus: Application of Molecular Diagnostics to Identify the Etiologic Agent and Patterns of Transmission
- Author
-
Patricia E. Kludt, Charles D. Humphrey, Ermias D. Belay, Stephan S. Monroe, Howard E. Gary, Daniel M. Hamlin, Jacqueline S. Noel, David S. Rosenthal, Paul E. Kilgore, Tamie Ando, Jonathan Freeman, and Roger I. Glass
- Subjects
medicine.medical_specialty ,Restaurants ,Universities ,Biology ,medicine.disease_cause ,Virus ,Disease Outbreaks ,Microbiology ,law.invention ,law ,Epidemiology ,medicine ,Humans ,Immunology and Allergy ,Feces ,Outbreak ,Molecular diagnostics ,Virology ,Gastroenteritis ,Norwalk virus ,Infectious Diseases ,Transmission (mechanics) ,Massachusetts ,Case-Control Studies ,Norovirus ,Viral disease ,Caliciviridae - Abstract
An epidemiologic investigation of a gastroenteritis outbreak in December 1994 indicated that salad consumption during lunch was linked with illness on 2 days (5 December : odds ratio [OR] = 3.1, 95% confidence interval [CI] = 2.0-5.0 ; 6 December : OR = 3.1, 95% CI = 1.9-4.9). Single stool or vomitus specimens from ill students and staff (case-patients) were examined for bacterial and viral pathogens. Small round-structured viruses (SRSVs) were detected by electron microscopy in stool specimens from 9 of 19 case-patients and in vomitus specimens from 3 of 5 case-patients. By reverse transcription-polymerase chain reaction (RT-PCR), the SRSVs were shown to be a G-2/P2-B type strain. The nucleotide sequences of RT-PCR products from vomitus and stool specimens of ill students were identical to stool specimens from the ill salad chef. These findings suggest that a single SRSV strain was the etiologic agent in the outbreak that was possibly transmitted to students through consumption of contaminated salad. Epidemiologic investigation in conjunction with molecular diagnostics may enable early identification of sources of infection and improve outbreak control.
- Published
- 1996
48. Virologic Features of an Astrovirus Diarrhea Outbreak in a Day Care Center Revealed by Reverse Transcriptase-Polymerase Chain Reaction
- Author
-
Larry K. Pickering, Roger I. Glass, David O. Matson, Xi Jiang, Stephan S. Monroe, and Douglas K. Mitchell
- Subjects
Diarrhea ,medicine.medical_specialty ,viruses ,Molecular Sequence Data ,Biology ,Polymerase Chain Reaction ,Disease Outbreaks ,law.invention ,Astrovirus ,Feces ,fluids and secretions ,law ,Epidemiology ,medicine ,Humans ,Immunology and Allergy ,Polymerase chain reaction ,Base Sequence ,Molecular epidemiology ,Age Factors ,Infant, Newborn ,Infant ,virus diseases ,Outbreak ,Child Day Care Centers ,biology.organism_classification ,Virology ,Infectious Diseases ,Virus Diseases ,RNA, Viral ,Viral disease ,medicine.symptom ,Mamastrovirus - Abstract
Astroviruses cause outbreaks of diarrhea in children attending day care centers (DCCs). Reverse transcriptase-polymerase chain reaction (RT-PCR) was compared with EIA detection of astrovirus in stool specimens to characterize further the molecular epidemiology of an outbreak of astrovirus-associated gastroenteritis. Three hundred sixty-eight stool specimens collected prospectively from 36 children enrolled in a DCC during an 11-week outbreak of diarrhea were evaluated by EIA and RT-PCR. Astrovirus was detected in 32% of specimens by RT-PCR versus 10% by EIA (P < .001) and in 89% of children by RT-PCR versus 50% by EIA. The median duration of astrovirus excretion episodes detected by EIA was 1.5 days versus 4 days by RT-PCR (P = .06). Astrovirus was excreted for prolonged periods by immunocompetent children during this outbreak. RT-PCR was more sensitive than EIA for detection of astrovirus in stool specimens and redefined the epidemiology of astrovirus infection in this setting.
- Published
- 1995
49. Epidemiologic applications of novel molecular methods to detect and differentiate small round structured viruses (Norwalk-like viruses)
- Author
-
Roger I. Glass, Melvin A. Kohn, Jacqueline S. Noel, Jon R. Gentsch, Stephan S. Monroe, Scott F. Dowell, Helen G. Cicirello, Tamie Ando, and Qi Jin
- Subjects
Molecular Sequence Data ,Biology ,Polymerase Chain Reaction ,Virus ,Disease Outbreaks ,law.invention ,Feces ,law ,Sequence Homology, Nucleic Acid ,Virology ,Animals ,Humans ,Shellfish Poisoning ,Phylogeny ,Polymerase chain reaction ,Caliciviridae Infections ,Shellfish ,Southern blot ,Base Sequence ,Molecular epidemiology ,Phylogenetic tree ,Outbreak ,biology.organism_classification ,Ostreidae ,United States ,Caliciviridae ,Gastroenteritis ,Blotting, Southern ,Norwalk virus ,Infectious Diseases ,DNA, Viral ,RNA, Viral ,Viral disease - Abstract
The molecular epidemiology of a large, multi-state outbreak of oyster-associated gastroenteritis [Kohn et al. (1995): Journal of the American Medical Association 273:466–471. Dowell et al. (1995): Journal of Infectious Diseases 171:1497–1503.] was examined using new methods to detect small round structured viruses (SRSVs) by reverse transcription-polymerase chain reaction (RT-PCR) and to characterize strains by Southern hybridization and nucleotide sequencing of 81-bp of a PCR product amplified from the RNA polymerase gene. Of 37 stool specimens examined from patients in eight clusters of the multi-state outbreak, 32 (86%) gave RT-PCR products specific for SRSVs of PI-A phylogenetic group. Nineteen PCR products from the eight clusters were confirmed to have the identical sequence, indicating that this large outbreak was attributed to a single strain of SRSV. In one of the eight clusters, five (63%) of eight patients had a mixed infection with a second SRSV strain that belonged to P2-B phylogenetic group. Of 12 specimens from patients in five other outbreaks and one sporadic case which occurred at the same time as the multistate outbreak, 10 (83%) gave products specific for SRSVs representing four phylogenetic groups (PI-A, PI-B, P2-A, and P2- B). The sequences of the PI-A products from two outbreaks and that of the P2-B product from another outbreak were identical to the P1-A sequence from the eight clusters and the P2–6 sequence from the one cluster of the multistate outbreak, respectively. These results demonstrate the first application of these methods to enhance our understanding of the molecular epidemiology of SRSVs and provide answers of public health interest that could not have been obtained using classical epidemiologic methods alone. © 1995 Wiley-Liss, lnc.1
- Published
- 1995
50. A Multistate Outbreak of Oyster-Associated Gastroenteritis: Implications for Interstate Tracing of Contaminated Shellfish
- Author
-
Stephan S. Monroe, Jon R. Gentsch, Charles D. Humphrey, Scott F. Dowell, Roger I. Glass, Kathryn B. Kirkland, Rebecca A. Meriwether, Qi Jin, Tamie Ando, Catherine Slemp, Diane M. Dwyer, Helen G. Cicirello, and Carmela Groves
- Subjects
Oyster ,medicine.disease_cause ,Polymerase Chain Reaction ,Disease Outbreaks ,Microbiology ,Mississippi ,biology.animal ,medicine ,Animals ,Humans ,Immunology and Allergy ,Serotyping ,Shellfish ,Food poisoning ,Maryland ,biology ,Commerce ,food and beverages ,Outbreak ,Louisiana ,Bivalvia ,biology.organism_classification ,medicine.disease ,Ostreidae ,Caliciviridae ,Gastroenteritis ,Fishery ,Infectious Diseases ,Food Microbiology ,Norovirus ,Norwalk virus - Abstract
In November 1993, clusters of gastroenteritis in six states following oyster consumption were investigated to identify common features, and stool samples were obtained to identify a pathogen. Efforts were made to account for all potentially contaminated oysters using harvest tags and the interstate recall system. Consumption of oysters was associated with illness in 10 clusters; no other food was implicated. A Norwalk-like virus was detected by electron microscopy in 9 of 18 samples and by reverse transcription-polymerase chain reaction in 20 of 26 samples from 6 clusters. Nucleotide sequences of a 123-bp fragment from all specimens were identical, consistent with a common source outbreak. Implicated oysters were harvested from the Louisiana coast between 9 and 12 November. Although some were recalled and destroyed, most oysters harvested from the area during this time remain unaccounted for. Current regulations and commercial practices need to be revised to permit thorough tracing and recall of contaminated oysters and to improve control of future epidemics.
- Published
- 1995
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