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. 2022 Feb 27;14(3):488.
doi: 10.3390/v14030488.

Epidemiological and Genetic Characterization of Norovirus Outbreaks That Occurred in Catalonia, Spain, 2017-2019

Eduard Anfruns-Estrada  1   2 , Sara Sabaté  3 , Efrén Razquin  3 , Thais Cornejo Sánchez  4 , Rosa Bartolomé  4 , Nuria Torner  5   6 , Conchita Izquierdo  5 , Nuria Soldevila  6   7 , Lorena Coronas  6   7 , Àngela Domínguez  6   7 , Cristina Fuentes  1   2 , Rosa M Pintó  1   2 , Albert Bosch  1   2 , Susana Guix  1   2 , The Working Group For The Study Of Outbreaks Of Acute Gastroenteritis In Catalonia Pi/
Affiliations

Epidemiological and Genetic Characterization of Norovirus Outbreaks That Occurred in Catalonia, Spain, 2017-2019

Eduard Anfruns-Estrada et al. Viruses. .

Abstract

Molecular characterization of human norovirus (HuNoV) genotypes enhances the understanding of viral features and illustrates distinctive evolutionary patterns. The aim of our study was to describe the prevalence of the genetic diversity and the epidemiology of the genotypes involved in HuNoV outbreaks in Catalonia (Spain) between 2017 and 2019. A total of 100 HuNoV outbreaks were notified with the predominance of GII (70%), followed by GI (27%) and mixed GI/GII (3%). Seasonality was observed for GII outbreaks only. The most prevalent genotypes identified were GII.4[P31] Sydney 2012, GII.4[P16] Sydney 2012 and GII.2[P16]. As compared to person-to-person (P/P) transmitted outbreaks, foodborne outbreaks showed significantly higher attack rates and lower duration. The average attack rate was higher in youth hostel/campgrounds compared to nursing homes. Only genotypes GI.4[P4], GII.2[P16], GII.4[P16], GII.4[P31] and GII.17[P17] were consistently detected every year, and only abundance of GII.2[P16] showed a negative trend over time. GII.4 Sydney 2012 outbreaks were significantly associated to nursing homes, while GII.2[P16] and GI.3[P3] were most frequently identified in youth hostel/campgrounds. The average attack rate was significantly higher when comparing GII.2[P16] vs. GI.4[P4], GII.2[P16] vs. GII.4[P31] Sydney 2012, and GII.6[P7] vs. GII.4[P31] Sydney 2012. No correlations were found between genotype and outbreak duration or age of affected individuals.

Keywords: Spain; acute gastroenteritis outbreaks; genotyping; human norovirus; molecular epidemiology; viral diversity.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Monthly distribution of total and GII number of HuNoV outbreaks, 2017–2019. J: January; F: February; M: March, A: April; M: May; J: June; J: July; A: August; S: September; O: October; N: November; D: December.
Figure 2
Figure 2
Distribution of genotypes identified per month of 93 typed outbreaks reported during 2017–2019. No outbreaks reported in January, July and August in 2017; February, September in 2018; and August in 2019.
Figure 3
Figure 3
Phylogenetic analysis of HuNoV strains isolated in outbreaks of gastroenteritis, based on RdRp (A,C,E) and VP1 regions (B,D,F). Panels A and B include all GI genotypes, panel C and D include all GII genotypes except GII.4, and panels E and F include all GII.4 variants. Bootstrap values above 75 are shown in the figure. Trees are drawn to scale, with branch lengths in the same units as those of the evolutionary distances used to infer the phylogenetic tree. Symbol indicates reference strains for the respective genotypes. Isolate names are composed of a letter code indicating the geographic region followed by the outbreak number, the year, and sample number.
Figure 3
Figure 3
Phylogenetic analysis of HuNoV strains isolated in outbreaks of gastroenteritis, based on RdRp (A,C,E) and VP1 regions (B,D,F). Panels A and B include all GI genotypes, panel C and D include all GII genotypes except GII.4, and panels E and F include all GII.4 variants. Bootstrap values above 75 are shown in the figure. Trees are drawn to scale, with branch lengths in the same units as those of the evolutionary distances used to infer the phylogenetic tree. Symbol indicates reference strains for the respective genotypes. Isolate names are composed of a letter code indicating the geographic region followed by the outbreak number, the year, and sample number.
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