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. 2023 Nov 24;15(12):2303.
doi: 10.3390/v15122303.

Biological Specimen Banking as a Time Capsule to Explore the Temporal Dynamics of Norovirus Epidemiology

Floriana Bonura  1 , Chiara Filizzolo  1 , Mariangela Pizzo  1 , Giuseppa L Sanfilippo  1 , Federica Cacioppo  1 , Emilia Palazzotto  1 , Francesca Di Bernardo  2 , Antonina Collura  2 , Vito Martella  3 , Simona De Grazia  1 , Giovanni M Giammanco  1
Affiliations

Biological Specimen Banking as a Time Capsule to Explore the Temporal Dynamics of Norovirus Epidemiology

Floriana Bonura et al. Viruses. .

Abstract

Norovirus is recognised as a major cause of epidemic and sporadic acute gastroenteritis (AGE) in all age groups. Information on the genetic diversity of the noroviruses circulating in the 1980s and 1990s, before the development and adoption of dedicated molecular assays, is limited compared with the last decades. Between 1986 and 2020, uninterrupted viral surveillance was conducted in symptomatic children hospitalized with AGE in Palermo, Italy, providing a unique time capsule for exploring the epidemiological and evolutionary dynamics of enteric viruses. A total of 8433 stool samples were tested using real-time RT-PCR. All samples were stored at -20 or -80 °C until processing. In this 35-year long time span, noroviruses of genogroup II (GII) were detected in 15.6% of AGE requiring hospitalization, whilst GI noroviruses were detected in 1.4% of AGE. Overall, the predominant norovirus capsid (Cap) genotype was GII.4 (60.8%), followed by GII.3 (13.3%) and GII.2 (12.4%). Temporal replacement of the GII.4 Cap variants associated with different polymerase (Pol) types were observed over the study period. The chronology of emergence and circulation of the different GII.4 variants were consistent with data available in the literature. Also, for GII.3 and GII.2 NoVs, the circulation of different lineages/strains, differing in either the Cap or Pol genes or in both, was observed. This long-term study revealed the ability of noroviruses to continuously and rapidly modify their genomic makeup and highlights the importance of surveillance activities in vaccine design.

Keywords: GII.2; GII.3; GII.4; Italy; evolution; genotypes; norovirus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Prevalences of norovirus GI and GII infections in children hospitalized with AGE in Palermo, Italy, over the study period.
Figure 2
Figure 2
Monthly distributions and rates of norovirus positivity in samples collected from January 2002 to December 2020. Overall monthly collection of samples studied over the 19 years, from January 2002 to December 2020 (a) and cumulative monthly rates of norovirus positivity (b).
Figure 3
Figure 3
Temporal distribution of Cap (a) and Pol (b) norovirus genotypes and Cap/Pol genotype combinations (c) over the study period.
Figure 3
Figure 3
Temporal distribution of Cap (a) and Pol (b) norovirus genotypes and Cap/Pol genotype combinations (c) over the study period.
Figure 4
Figure 4
Phylogenetic analysis of partial ORF2 region in Italian GII.4 (a), GII.3 (b) and GII.2 (c) norovirus strains.
Figure 4
Figure 4
Phylogenetic analysis of partial ORF2 region in Italian GII.4 (a), GII.3 (b) and GII.2 (c) norovirus strains.
Figure 4
Figure 4
Phylogenetic analysis of partial ORF2 region in Italian GII.4 (a), GII.3 (b) and GII.2 (c) norovirus strains.
Figure 5
Figure 5
Evolutionary analysis of amino acids in representative GII.4 strains collected from 1987 to 2020. H.E, hypervariable Epitope; Amino acid substitutions in small characters were found in a minority of the sequences analysed. #() Number of Italian GII.4 NoV strains analysed.
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