Epidemiological and molecular surveillance of norovirus in the Brazilian Amazon: description of recombinant genotypes and improvement of evolutionary analysis

Noroviruses are highly infectious, genetically diverse viruses. Global outbreaks occur frequently, making molecular surveillance important for infection monitoring. This cross-sectional descriptive study aimed to monitor cases of norovirus gastroenteritis in the Brazilian Amazon. Fecal samples were tested by immunoenzymatic assay, RT-PCR and genetic sequencing for the ORF1/ORF2 and protease regions. Bayesian inference with a molecular clock was employed to construct the phylogeny. The norovirus prevalence was 25.8%, with a higher positivity rate among children aged 0-24 months. Genogroup GII accounted for 98.1% of the sequenced samples, while GI accounted for 1.9% of them. The GII.P16/GII.4 genotype was the most prevalent, with an evolution rate of 2.87x10−3 and TMRCA estimated in 2012. This study demonstrates that norovirus is a primary causative agent of gastroenteritis and provides data on viral genetic diversity that may facilitate infection surveillance and vaccine development

Detecção e genotipagem de norovírus em diferentes amostras de água e esgoto não tratado na cidade de Belém, Pará, Brasil, 2008 a 2010

Enteric viruses excreted in feces from infected individuals dispersed in aquatic environments by sewage discharge. Among these viruses, the norovirus (NoV) is actually considered the main cause of gastroenteritis outbreaks worldwide, resulting from the ingestion of contaminated food and water as well as is also associated with hospitalizations. This research aimed to detect and partially characterize the human NoV (GI/GII) in different water matrices and in untreated sewage from Metropolitan Region of Belem. The study involved superficial waters from bay (Ver-o-Peso), river (Acai’s Port), stream (Tucunduba) and two lakes (Bolonha and Agua Preta), as well as treated water (WTP-Bolonha) and untreated sewage (SLP-UNA), monthly collected over two years . The water and sewage (2 liters) were initially concentrated on filtering membranes to obtain a final volume of 2 mL. The nucleic acid was extracted by silica method and submitted to semi nested RT-PCR (reverse transcription Polymerase chain reaction) using NoV GI and GII specific primers. The cDNA obtained after reverse transcription was also used to investigate the GI/GII by TaqMan® real time PCR. The positive samples for both molecular methods were analyzed for 5’end ORF2 by nested (for GI) and semi nested (for GII) in order to obtain amplicon for identification of circulating strains, being further purified using a commercial kit and submitted to molecular characterization in the automated sequencer. The obtained sequences were edited, aligned and compared to others available in gene bank (NCBI) and in the site NoV genotyping tool. In the period of November 2008 to October 2010, 168 water and sewage samples were collected and analyzed for NoV presence, obtaining a positivity of 33.9% (57/168) of which 21.1% (12/57) were positive only by TaqMan® real time PCR, 19.3% (11/57) only by semi nested and 59.6% (34/57) for both. Considering the two methodologies used, in the positive cases GI (82.5% - 47/57) was most frequent than GII (79.0% - 45/57). However, in most samples there was coexistence of the two genogroups (61.4% - 35/57), mainly in the Tucunduba and SLP-UNA samples, considered the most NoV contaminated sites. On the other hand, in WTP-Bolonha this agent was not found. Of 57 positive samples by TaqMan® real time PCR and/or semi nested RT-PCR, 53 were retested for 5’end ORF2, since four samples showed insufficient quantity of material which allowed a new analyze, so, in 47.2% (25/53) the NoV genome was detected, of these 12% (3/25) belonging to GI, 24% (6/25) to GII and 64% (16/25) for both. The most frequent GI and GII genotypes were GI.8 (n=8) and GII.4 (n=12), respectively, but others genotypes were also observed with lower incidence as GII.6 (n=3), GII.9 (n=2), GII.12 (n=1), GII.14 (n=1), GI.1 (n=1) and GI.4 (n=2). Due to low quality of sequences obtained, eight samples could not be genotyped for GI and three for GII. Of 96 samples with concentration of thermotolerant coliforms above the recommended, 34 (35.4%) were also NoV positive. Increase on conductivity and total dissolved solids was observed in materials from Ver-o-Peso and Tucunduba, as well as the turbidity was notably higher in these places and the Acai’s Port. In the less rainy period (July to November) there was a trend in positivity increasing for NoV, and in the highest rainfall (December to June) a decrease in the incidence of this agent was noted. The results obtained in the present study indicate the circulation of NoV GI and GII in aquatic environments in Belem, revealing the degradation that these water bodies have suffered, as a result of poverty or lack of sanitation in our city, allowing the permanence of pathogens in these ecosystems, along with its effluents.CNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoFAPESPA - Fundação Amazônia de Amparo a Estudos e PesquisasOs vírus entéricos eliminados pelas fezes de indivíduos infectados se dispersam nos ambientes aquáticos por meio do lançamento de esgoto. Dentre esses vírus os norovírus (NoV) são atualmente considerados a principal causa de surtos de gastrenterite mundialmente, decorrentes da ingestão de água e alimentos contaminados, como também estão associados a hospitalizações. O objetivo dessa pesquisa foi detectar e caracterizar parcialmente os NoV humanos (genogrupos I e II) em diferentes tipos de água e esgoto bruto da Região Metropolitana de Belém. O estudo envolveu águas superficiais de baía (Ver-o-Peso), rio (Porto do Açaí), igarapé (Tucunduba) e dois mananciais (Bolonha e Água Preta), como também água tratada (ETA-Bolonha) e esgoto bruto (EEE-UNA), coletadas mensalmente ao longo de dois anos. Essas águas e esgoto (2 litros) foram inicialmente concentradas em membranas filtrantes obtendo-se um volume final de 2mL. O ácido nucléico foi extraído pelo método da sílica e submetido à reação de semi nested RT-PCR (reação em cadeia mediada pela Polimerase precedida de transcrição reversa) utilizando iniciadores específicos para NoV GI e GII. O cDNA obtido após transcrição reversa foi utilizado para pesquisa de GI/GII também por TaqMan® PCR em tempo real. As amostras positivas por ambas as metodologias moleculares foram analisadas para a região 5’-terminal da ORF2 por nested (GI) e semi nested (GII) com o intuito de obter amplicon para identificação das cepas circulantes, sendo posteriormente purificados com uso de kit comercial e submetidos a caracterização molecular em sequenciador automático. As sequências obtidas foram editadas, alinhadas e comparadas com outras depositadas no banco de genes (GenBank - NCBI) e no site NoV genotyping tool. No período de novembro de 2008 a outubro de 2010, 168 amostras de água e esgoto foram coletadas e analisadas quanto a presença de NoV, obtendo-se positividade de 33,9% (57/168), das quais 21,1% (12/57) foram positivas somente por TaqMan® PCR em tempo real, 19,3% (11/57) por semi nested e 59,6% (34/57) por ambas. Considerando as duas metodologias utilizadas, nos casos positivos, GI (82,5% -47/57) foi mais frequente do que GII (79,0% - 45/57). Porém, na maioria das amostras houve coexistência dos dois genogrupos (61,4% - 35/57), principalmente nas amostras do igarapé Tucunduba e EEE-UNA, considerados os locais mais contaminados por NoV. Por outro lado, na ETA-Bolonha esse agente não foi encontrado. Das 57 amostras positivas por TaqMan® PCR em tempo real e/ou semi nested RT-PCR, 53 foram retestadas para a região 5’-terminal da ORF2, uma vez que quatro apresentaram quantidade insuficiente de material que permitisse uma nova análise, assim em 47,2% (25/53) o genoma de NoV foi detectado, das quais 12% (3/25) pertenciam ao GI, 24% (6/25) ao GII e 64% (16/25) para ambos. Os genótipos mais frequentes de GI e GII foram respectivamente GI.8 (n=8) e GII.4 (n=12), porém outros genótipos foram observados com menor incidência como GII.6 (n=3), GII.9 (n=2), GII.12 (n=1), GII.14 (n=1), GI.1 (n=1) e GI.4 (n=2). Devido a baixa qualidade das sequências obtidas oito amostras não puderam ser genotipadas para GI e três para GII. Das 96 amostras com concentração de coliformes termotolerantes acima do recomendado, 34 (35,4%) também foram positivas para NoV. Aumento na condutividade e sólidos totais dissolvidos foi observado nos materiais do Ver-o-Peso e igarapé Tucunduba, assim como a turbidez foi nitidamente mais elevada nesses locais e no Porto do Açaí. No período menos chuvoso (julho a novembro) houve uma tendência no aumento da positividade para NoV, e nos meses de maior pluviosidade (dezembro a junho) notou-se um decréscimo na incidência desse agente. Os resultados obtidos no presente estudo apontam a circulação de NoV GI e GII nos ambientes aquáticos de Belém, revelando a degradação que estes corpos hídricos vêm sofrendo como consequência da precariedade ou ausência de saneamento na nossa cidade, permitindo a permanência nesses ecossistemas, juntamente com seus efluentes, de patógenos causadores de doenças

Occurrence of norovirus genogroups I and II in recreational water from four beaches in Belém city, Brazilian Amazon region

State University of Pará. Program in Parasitary Biology in the Amazon. Belém, PA, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Programa de Pós-graduação em Virologia. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.This study aimed to investigate the presence of norovirus (NoV) in recreational waters of four estuarine beaches located in Mosqueiro Island, Belém city, Brazilian Amazon, during two years of monitoring (2012 and 2013). NoV particles were concentrated on filtering membrane by the adsorption-elution method and detected by semi-nested RT-PCR and sequencing. NoV positivity was observed in 37.5% (39/104) of the surface water samples, with genogroup GI (69.2%) occurring at a higher frequency than GII (25.7%), with a cocirculation of both genogroups in two samples (5.1%). This virus was detected in all sampling points analyzed, showing the highest detection rate at the Paraíso Beach (46.2%). Statistically, there was a dependence relationship between tide levels and positive detection, with a higher frequency at high tide (46.7%) than at low tide (25%) periods. Months with the highest detection rates (April 2012 and April/May 2013) were preceded by periods of higher precipitation (March 2012 and February/March 2013). Phylogenetic analysis showed the circulation of the old pandemic variant (GII.4-US_95-96) and GI.8. The NoV detection demonstrated viral contamination on the beaches and evidenced the health risk to bathers, mainly through recreational activities such as bathing, and highlighted the importance of including enteric viruses research in the recreational water quality monitoring

Retrospective molecular analysis of norovirus recombinant strains in the amazon region, Brazil

Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Programa de Iniciação Científica. Ananindeua, PA, Brasil.Federal University of Pará. Postgraduate Program in Biology of Infectious and Parasitic Agents. Belém, PA, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Background: Noroviruses are enteric viruses that cause acute gastroenteritis worldwide. Over two decades, GII.4 genotype was responsible for most cases. However, recombinant strains have emerged and changed the epidemiological context of these infections. Objectives: The aim of this study was to identify the recombinant genetic strains of norovirus causing gastroenteritis in Brazilian children from the Amazon region. Methods: We analyzed 534 cases of gastroenteritis between 2015 and 2016. Genotypic characterization was performed by partial sequencing of ORF1 and ORF2. Evolutionary history was inferred by Bayesian inference using MrBayes. Recombinant strains were confirmed by Simplot and RDP4 analysis. Findings: We performed viral detection tests and identified a norovirus frequency of 31.8% (175/534). Based on viral RdRp and VP1 genes, nine genotypes were identified: GIIP31/GII.4, GII·P16/GII.4, GII·P7/GII.6, GII·P21/GII.13, GII·P33/GII.1, GII·P17/GII.17, GI·P7/GI.7, GII·P4/NT, and GII.7/NT. The phylogenetic tree showed evolutionary relationships among the genotypes, including the recombinant strains. This is the first description of GII·P33/GII.1 and GII·P21/GII.13 genotypes in Brazil. Conclusion: Norovirus evolution has been characterized by the continuous replacement of variants that have new antigenic properties. In recent years, recombinant strains have displaced GII.4, improving the viral fitness and influencing the viral transmissibility and pathogenicity

Epidemiology and molecular detection of human adenovirus and non-polio enterovirus in fecal samples of children with acute gastroenteritis: A five-year surveillance in northern Brazil.

Acute gastroenteritis (AGE) is a common pediatric infection that remains a significant cause of childhood morbidity and mortality worldwide, especially in low-income regions. Thus, the objective of this study was to detect human adenovirus (HAdV) and non-polio enterovirus (NPEV) in fecal samples from the Gastroenteritis Surveillance Network, and to identify circulating strains by nucleotide sequencing. A total of 801 fecal samples were tested using qPCR/RT-qPCR, and 657 (82.0%) were inoculated into HEp-2C and RD cell lines. The HAdV and NPEV positivity rates obtained using qPCR/RT-qPCR were 31.7% (254/801) and 10.5% (84/801), respectively, with 5.4% (43/801) co-detection. Cytopathic effect was observed in 9.6% (63/657) of patients, 2.7% (18/657) associated with HAdV, and 6.2% (41/657) associated with NPEV after testing by ICC-PCR. A comparison of the two methodologies demonstrated an agreement of 93.5% for EVNP and 64.4% for HAdV. These two viruses were detected throughout the study period, with HAdV positivity rates ranging from 41% in Amapá to 18% in Pará. The NEPV varied from 18% in Pará/Rondônia to 3% in Acre. The most affected age group was over 60 months for both HAdV and NPEV. Samples previously positive for rotavirus and norovirus, which did not show a major difference in the presence or absence of diarrhea, fever, and vomiting, were excluded from the clinical analyses of these two viruses. These viruses circulated over five years, with a few months of absence, mainly during the months corresponding to the waves of SARS-CoV-2 infection in Brazil. Five HAdV species were identified (A, B, C, D, and F), with a greater predominance of HAdV-F41 (56.5%) followed by HAdV-C (15.2%). Three NPEV species (A, B, and C) were detected, with serotypes E14 (19.3%) and CVA-24 (16.1%) being the most prevalent. The present study revealed a high diversity of NPEV and HAdV types circulating in children with AGE symptoms in the northern region of Brazil

Occurrence of norovirus Giv In environmental water samples from Belém City, Amazon Region, Brazil

Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Federal University of Para. Tropical Medicine Center. Postgraduate Program in Tropical Diseases. Belém, PA, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Noroviruses are the major cause of non-bacterial acute gastroenteritis outbreaks in humans, with few reports about the occurrence of the norovirus GIV strain. We investigated the presence of norovirus GIV in surface water (river, bay, and stream) and untreated sewage, and we determined a positivity rate of 9.4 % (9/96). The strains genotyped were GIV.1. To our knowledge, this is the first report of GIV in Brazil

Detection of G3 human-like rotavirus in institutionalized dogs from Brazil

Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Programa de Pós-Graduação em Virologia. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Programa de Pós-Graduação em Virologia. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Zoonosis Control Center. Belém, PA, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Viral gastroenteritis is a common clinical problem in dogs and group A rotavirus (RVA) is one of the agents involved in this etiology. It mainly affects dogs in the first 6 months of life, and these animals are considered an important reservoir and potential transmitters of the virus to other susceptible hosts, such as humans. Among the different types of RVA, G3 is the most detected in dogs, and this genotype is also involved in infections in other animals, including humans. Thus, the present study aims to investigate the presence of RVA in samples of dogs from a public kennel. A total of 64 fecal samples from dogs with diarrhea were analyzed, collected from April 2019 to March 2020, from the kennel of the Zoonosis Control Center, located in Belém, a city in the North of Brazil. The extracted genetic material was subjected to reverse transcription followed by real-time PCR (RT-qPCR); the positives were tested by RT-PCR with a specific primer for the RVA VP7 gene, after nucleotide sequencing and phylogenetic analysis. One sample was subjected to high performance sequencing. A positivity of 7.8% (5/64) was observed for RVA, all characterized as G3, grouping in the G3-III lineage, with greater similarity to human samples. Different regions of the RVA genome fragments were found. These results emphasize the need for animal health surveillance to better understand the global strain dispersion of RVA and elucidate possible interspecies transmission events, monitoring the genetic diversity of this pathogen

Two-year monitoring of enterovirus and rotavirus A in recreational freshwater from an island region, Pará State, northern Brazil

Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Brazilian Ministry of Education. Federal University of Para. Institute of Biological Sciences. Virology laboratory. Belem, PA, Brazil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Enteric viruses are major causes of waterborne diseases and are present in large quantities in the stools of infected individuals. Its viability in the environment lasts for months, favoring the contamination of water used for consumption and recreation. The study aimed to monitor monthly the circulation of enterovirus (EV) and group A rotavirus (RVA) in recreational freshwater from an island region used as a bathhouse in northern Brazil, from January 2012 to December 2013. The viral RNA was obtained using guanidine isothiocyanate/silica after viral concentration by adsorption-elution method. The molecular detection was carried out by semi (EV) and nested-PCR (RVA) and the amplicons were sequenced on automated sequencer. At least one of these viruses was detected on 40.4% (42/104) of the samples. RVA was the most frequent (n = 32; 30.8%) when compared to EV (n = 20; 19.2%). Co-circulation between both was identified in 9.6% (n = 10). The highest viral positivity was found in SP02 (46.1%). The highest viral positivity was observed during high tides (57.7%; 60/104). Most EV samples were characterized as coxsackievirus (CV) A5 (85.7%, 12/14) and others as Sabin 1 poliovirus (14.2%, 2/14). The RVA positive samples were genotyped as G2, G3, G9, G12, P[8], P[4], and P[6]. These viruses were detected in 35.6% (37/104) of the samples with an acceptable concentration of fecal coliform bacteria. These results demonstrate the contamination of surface water intended for recreation by enteric viruses of Public Health concern even when bacterial indicators are within the tolerated limit, a factor that confirms the need for public policies aimed the sewage treatment before its release into water bodies

Surto de norovírus em um navio cruzeiro ao longo da costa brasileira, março de 2011

Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Programa de Pós-Graduação em Virologia. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Universidade do Estado do Pará. Centro de Ciências Biológicas e da Saúde. Programa de Pós-Graduação em Biologia Parasitária na Amazônia. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Vigilância em Saúde do Estado do Pará. Belém, PA, Brasil.Centro de Informações Estratégicas em Vigilância em Saúde. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Outbreaks of gastrointestinal disease may occur on board of cruise ships due to the consumption of contaminated water or food, with a fast person-to-person transmission. Epidemiologic investigations carried out by Centers for Disease Control and Prevention in USA, have confirmed that more than 95% of gastroenteritis outbreaks in cruise ships are caused by norovirus (NoV). In March 2011 an outbreak of acute gastroenteritis (AGE) occurred on a cruise ship with 1,224 passengers and 554 crew members that sailed from Rio de Janeiro, Rio de Janeiro State (Southeast, Brazil) to Manaus, Amazonas State (North) and stopovers in Recife, Pernambuco State, and Fortaleza, Ceará State (Northeast) and Belém, Pará State (North). Epidemiological data were obtained and seven rectal swab samples were collected and tested for NoV detection and characterization by molecular techniques. A total of 53 persons (42 passengers and 11 crew members) developed AGE, 75.5% of whom were older than 60 years old. The symptoms duration was less than 48 h, most of the patients presenting vomiting (79.2%) and diarrhea (73.6%). Most of the cases varied from mild to moderate and only one patient needed parenteral rehydration. Cases of AGE were recorded in eight of 12 vessel floors, especially in the recreational areas. The seven rectal samples collected were all NoV-positive by RT-PCR and all NoV strains were genogrouped as GII by semi-nested PCR. The quantitative real-time PCR produced a 57.1% NoV positivity rate. The partial nucleotide sequencing classified five (71.4%) of these samples as GII.P4. Our findings highlight the need for continuous viral enteropathogens surveillance including cruise ships considering the increase of this kind of touristic option in Brazil.Os surtos da doença gastrointestinal podem ocorrer em navios cruzeiros devido ao consumo de água e comida contaminadas, com rápida transmissão de uma pessoa a outra. Investigações epidemiológicas realizadas pelos Centros de Controle e Prevenção de Doenças, nos EUA, confirmaram que mais de 95% dos surtos de gastroenterite em navios são causados por norovírus (NoV). Em março de 2011, um surto de gastroenterite aguda (GEA) ocorreu em um cruzeiro com 1.224 passageiros e 554 tripulantes que partiu do Rio de Janeiro, Estado do Rio de Janeiro (Sudeste do Brasil) para Manaus, Estado do Amazonas (Norte) com paradas em Recife, Estado do Pernambuco, e Fortaleza, Estado do Ceará (Nordeste) e Belém, Estado do Pará (Norte). Dados epidemiológicos foram obtidos e sete amostras por swab retal foram coletadas e testadas para a detecção e caracterização do NoV por meio de técnicas moleculares. Um total de 53 pessoas (42 passageiros e 11 tripulantes) desenvolveram AGE, dos quais 75,5% eram maiores de 60 anos de idade. Os sintomas duraram menos de 48 h, a maioria dos pacientes apresentou vômito (79,2%) e diarreia (73,6%). A maior parte dos casos obteve variação entre leve e moderado e apenas um paciente necessitou de reidratação parental. Casos de AGE foram registrados em oito dos 12 andares do navio, principalmente nas áreas de recreação. As sete amostras de swab retal coletadas revelaram resultado positivo para NoV por meio de RT-PCR e todas as cepas foram genogrupadas como GII pelo semi-nested PCR. O PCR quantitativo em tempo real produziu uma taxa de positividade de 57,1% para NoV. O sequenciamento parcial de nucleotídeos classificou cinco (71,4%) das sete amostras como GII.P4. Os resultados destacam a necessidade de vigilância contínua dos enteropatógenos virais, incluindo navios cruzeiros, considerando o aumento deste tipo de opção turística no Brasil

Evolutionary and molecular analysis of complete genome sequences of norovirus from Brazil: emerging recombinant strain GII.P16/GII.4

PAPQ/PROPESP ; PPG-BAIP/UFPA ; Evandro Chagas Institute, Secretary of Health Surveillance, Ministry of Health (IEC/SVS/MS)Federal University of Pará. Institute of Biological Sciences. Program in Biology of Infectious and Parasitic Agents. Belém, PA, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Federal University of Pará. Institute of Biological Sciences. Program in Biology of Infectious and Parasitic Agents. Belém, PA, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Noroviruses (NoVs) are enteric viruses that cause acute gastroenteritis, and the pandemic GII.4 genotype is spreading and evolving rapidly. The recombinant GII.P16/GII.4_Sydney strain emerged in 2016, replacing GII.P31/GII.4_Sydney (GII.P31 formerly known as GII.Pe) in some countries. We analyzed the complete genome of 20 NoV strains (17 GII.P31/GII.4_ Sydney and 3 GII.P16/GII.4_Sydney) from Belém and Manaus, Brazil, collected from 2012 to 2016. Phylogenetic trees were constructed by maximum likelihood method from 191 full NoV-VP1 sequences, demonstrated segregation of the Sydney lineage in two larger clades, suggesting that GII.4 strains associated with GII.P16 already have modifications compared with GII.P31/GII.4. Additionally, the Bayesian Markov Chain Monte Carlo method was used to reconstruct a time-scaled phylogenetic tree formed by GII.P16 ORF1 sequences (n = 117) and three complete GII.P16 sequences from Belém. The phylogenetic tree indicated the presence of six clades classified into different capsid genotypes and locations. Evolutionary rates of the ORF1 gene of GII.P16 strains was estimated at 2.01 × 10–3 substitutions/site/year, and the most recent common ancestors were estimated in 2011 (2011–2012, 95% HPD). Comparing the amino acid (AA) sequence coding for ORF1 with the prototype strain GII.P16/GII.4, 36 AA changes were observed, mainly in the non-structural proteins p48, p22, and RdRp. GII.P16/GII.4 strains of this study presented changes in amino acids 310, 333, 373, and 393 of the antigenic sites in the P2 subdomain, and ML tree indicating the division within the Sydney lineage according to the GII.P16 and GII.P31 polymerases. Notably, as noroviruses have high recombination rates and the GII.4 genotype was prevalent for a long time in several locations, additional and continuous evolutionary analyses of this new genotype should be needed in the future