Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan:147:e227.
doi: 10.1017/S0950268819000852.

Norovirus waterborne outbreak in Chalkidiki, Greece, 2015: detection of GI.P2_GI.2 and GII.P16_GII.13 unusual strains

K Tryfinopoulou  1 , M Kyritsi  2 , K Mellou  1 , F Kolokythopoulou  2 , V A Mouchtouri  2 , M Potamiti-Komi  1 , A Lamprou  1 , Th Georgakopoulou  1 , C Hadjichristodoulou  2
Affiliations

Norovirus waterborne outbreak in Chalkidiki, Greece, 2015: detection of GI.P2_GI.2 and GII.P16_GII.13 unusual strains

K Tryfinopoulou et al. Epidemiol Infect. 2019 Jan.

Abstract

Noroviruses, along with rotaviruses, are among the leading causes of gastroenteritis worldwide and novel strains are periodically emerging. In August 2015, an unusual increase of gastroenteritis cases occurred in a touristic district in Kassandra peninsula, Chalkidiki, Northern Greece. Seven stool specimens from cases were tested positive for norovirus. Molecular investigation and phylogenetic analysis identified that there was co-circulation of norovirus GI.P2_GI.2 and the recombinant strain GII.P16_GII.13. A 1:1 case-control study conducted and showed that tap water consumption significantly associated with developing symptoms of gastroenteritis (odds ratio = 36.9, P = 0.018). The results of the epidemiological investigation, the co-circulation of two different norovirus strains, the information of a pipeline breakage at the water supply system before the onset of cases, and reports on flooded wells and sewage overflow, indicated the possibility of water contamination by sewage during the pipeline breakage leading to a large outbreak with a peak at 10 August and a possible secondary person-to-person transmission after the 16th of August. Norovirus GI.P2_GI.2 strains are rarely reported in Europe, while it is the first time that infection from the recombinant strain GII.P16_GII.13 is recorded in Greece.

Keywords: Norovirus; outbreak; possibly-waterborne; recombinant strain; touristic region.

PubMed Disclaimer

Conflict of interest statement

There is no conflict of interest to declare.

Figures

Fig. 1.
Fig. 1.
Number of recorded cases (n = 108) by date of symptoms onset and water sampling, 9–28 August 2015, municipal district of the main village and its coastal settlement, Kassandra peninsula, Chalkidiki.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Belliot G et al. (2014) The burden of norovirus gastroenteritis: an important foodborne and healthcare-related infection. Clinical Microbiology and Infection 20, 724–730. - PMC - PubMed
    1. Kroneman Α et al. (2013) Proposal for a unified norovirus nomenclature and genotyping. Archives of Virology 158, 2059–2068. - PMC - PubMed
    1. Xue L et al. (2017) Comparative phylogenetic analyses of recombinant noroviruses based on different protein-encoding regions show the recombination-associated evolution pattern. Scientific Reports 7, 4976. - PMC - PubMed
    1. van Beek J et al. (2018) Molecular surveillance of norovirus, 2005–16: an epidemiological analysis of data collected from the NoroNet network. The Lancet Infectious Diseases 18, 545–553. - PubMed
    1. van Beek J et al. (2013) Norovirus Molecular Platform: Noronet report, April 2013. Available at https://www.rivm.nl/sites/default/files/2018-11/NoroNet_update_APR2013_f....

MeSH terms