Viral gastroenteritis associated with genogroup II norovirus among U.S. military personnel in Turkey, 2009

The present study demonstrates that multiple NoV genotypes belonging to genogroup II contributed to an acute gastroenteritis outbreak at a US military facility in Turkey that was associated with significant negative operational impact. Norovirus (NoV) is an important pathogen associated with acute g...

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Bibliographic Details
Published in:	PloS one Vol. 7; no. 5; p. e35791
Main Authors:	Ahmed, Salwa F, Klena, John D, Mostafa, Manal, Dogantemur, Jessica, Middleton, Tracy, Hanson, James, Sebeny, Peter J
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 11-05-2012 Public Library of Science (PLoS)
Subjects:	Adult Age Analysis Armed forces Bacteria Biology Caliciviridae Infections - epidemiology Caliciviridae Infections - virology Capsid Proteins - genetics Cladistic analysis Development and progression Disease Outbreaks Disease prevention Female Gastroenteritis Gastroenteritis - epidemiology Gastroenteritis - virology Genes, Viral Genotype Genotype & phenotype Genotypes Humans Infections Male Medical research Medicine Military Military aspects Military bases Military facilities Military Personnel Norovirus - classification Norovirus - genetics Norovirus - isolation & purification Occupational exposure Outbreaks Pathogens Persian Gulf War Phylogeny Polymerase chain reaction Public health Turkey - epidemiology United States - ethnology Viruses Waterborne infections Young Adult United States Turkey United States > US Afghanistan
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Summary:	The present study demonstrates that multiple NoV genotypes belonging to genogroup II contributed to an acute gastroenteritis outbreak at a US military facility in Turkey that was associated with significant negative operational impact. Norovirus (NoV) is an important pathogen associated with acute gastroenteritis among military populations. We describe the genotypes of NoV outbreak occurred at a United States military facility in Turkey. Stool samples were collected from 37 out of 97 patients presenting to the clinic on base with acute gastroenteritis and evaluated for bacterial and viral pathogens. NoV genogroup II (GII) was identified by RT-PCR in 43% (16/37) stool samples. Phylogenetic analysis of a 260 base pair fragment of the NoV capsid gene from ten stool samples indicated the circulation of multiple and rare genotypes of GII NoV during the outbreak. We detected four GII.8 isolates, three GII.15, two GII.9 and a sole GII.10 NoV. Viral sequences could be grouped into four clusters, three of which have not been previously reported in Turkey. The fact that current NoV outbreak was caused by rare genotypes highlights the importance of norovirus strain typing. While NoV genogroup II is recognized as causative agent of outbreak, circulation of current genotypes has been rarely observed in large number of outbreaks.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Conceived and designed the experiments: SFA JDK. Analyzed the data: SFA JDK MM. Wrote the paper: SFA JDK JD. Coordinated outbreak response, epidemiological data and fecal sample collection: TM. Coordinated Incirlik laboratory support: JH. Provided oversight of data analysis, reporting, and manuscript revision: PJS.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0035791