Ying-Chun Dai

An outbreak caused by GII.17 norovirus with a wide spectrum of HBGA-associated susceptibility

During the past norovirus (NoV) epidemic season, a new GII.17 variant emerged as a predominant NoV strain, surpassed the GII.4 NoVs, causing outbreaks of acute gastroenteritis (AGE) in China. Here we report a study of an AGE outbreak in an elementary school in December 2014 caused by the new GII.17 NoV to explore the potential mechanism behind the sudden epidemics of the GII.17 NoV. A total of 276 individuals were sick with typical NoV infection symptoms of vomiting (93.4%), abdominal pain (90.4%), nausea (60.0%), and diarrhea (10.4%) at an attack rate of 5.7–16.9%. Genotyping of the symptomatic patients showed that individuals with a secretor positive status, including those with A, B, and O secretors and Lewis positive blood types, were sensitive to the virus, while the non-secretors and the Lewis negative individual were not. Accordingly, the recombinant capsid P protein of the GII.17 isolate showed a wide binding spectrum to saliva samples of all A, B, and O secretors. Thus, the broad binding spectrum of the new GII.17 variant could explain its widely spread nature in China and surrounding areas in the past two years.

Isolation and phylogenetic characterization of bat astroviruses in southern China.

Astroviruses are associated with acute gastroenteritis of human and many animal species. Recently, two studies have reported that novel astroviruses were found in bats. In order to extensively understand the genetic and phylogenetic characterization of bat astroviruses, we tested fecal samples of nine bat species that were collected at four natural habitats in three areas of southern China. The geographic distributions of the bats involved differed from previous reports. Three out of nine species of bats were observed to harbor astroviruses. These included Miniopterus schreibersii, Scotophilus kuhlii, and Rousettus leschenaultia. Phylogenetic analysis based on amino acid sequences of partial ORFs of astroviruses revealed that the bat astroviruses are not only divergent from previously described human and other animal astroviruses but also show remarkable diversity among themselves. However, five bat astroviruses were phylogenetically related to mink astrovirus, ovine astrovirus, and the recently discovered human astroviruses VA1, VA2, and VA3. The results indicate that astroviruses may have adapted to the Chiroptera, and bats may transmit astroviruses to humans and other animals, or vice versa.

Characterization of severe hand, foot, and mouth disease in Shenzhen, China, 2009–2013

Hand, foot, and mouth disease (HFMD) is caused by human enteroviruses, especially by enterovirus 71 (EV71) and coxsackievirus A16 (CA16). Patients infected with different enteroviruses show varied clinical symptoms. The aim of this study was to determine whether the etiological spectrum of mild and severe HFMD changed, and the association between pathogens and clinical features. From 2009 to 2013, a total of 2,299 stool or rectal specimens were collected with corresponding patient data. A dynamic view of the etiological spectrum of mild and severe HFMD in Shenzhen city of China was provided. EV71 accounted for the majority proportion of severe HFMD cases and fatalities during 2009–2013. CA16 and EV71 were gradually replaced by coxsackievirus A6 (CA6) as the most common serotype for mild HFMD since 2010. Myoclonic jerk and vomiting were the most frequent severe symptoms. Nervous system complications, including aseptic encephalitis and aseptic meningitis were observed mainly in patients infected by EV71. Among EV71, CA16, CA6, and CA10 infection, fever and pharyngalgia were more likely to develop, vesicles on the hand, foot, elbow, knee and buttock were less likely to develop in patients infected with CA10. Vesicles on the mouth more frequently occurred in the patients with CA6, but less in the patient with EV71. Associations between diverse enterovirus serotypes and various clinical features were discovered in the present study, which may offer further insight into early detection, diagnosis and treatment of HFMD. J. Med. Virol. 87:1471–1479, 2015.

Molecular epidemiology of norovirus gastroenteritis in children in Jiangmen, China, 2005-2007.

Human noroviruses (NoVs) are an important cause of epidemic acute gastroenteritis. Their role in sporadic cases, however, is less clear. In this study, we performed a two-year surveillance (September 2005 to August 2007) of NoV gastroenteritis in outpatient clinics in a southern city of China, Jiangmen City. NoVs were detected in 115 patients (115/881, 13.1%) with 30 (26.1%) co-infections with rotaviruses. Sequence analysis showed that all 115 NoVs belonged to genogroup II, with GII.4 being the most predominant (87.8%). NoV-associated infection can be seen year-around, with autumn and winter peaks. This study provides basic information on sporadic cases of major NoV gastroenteritis in children in different seasons, which is valuable for future disease control and prevention.

Evaluation of anti-norovirus IgY from egg yolk of chickens immunized with norovirus P particles

Noroviruses (NoVs) are a leading cause of epidemic acute gastroenteritis affecting millions of people worldwide. Understanding of NoV remains limited due to the lack of a cell culture system and small animal models. Currently, there are no effective vaccines or antivirals against NoVs. In this study, an approach for large-scale production of anti-NoV antibodies for use as a potential treatment for NoV disease using passive immunization was evaluated. NoV-specific immunoglobulins (IgYs) were produced by immunizing chickens with NoV P particles. The birds continuously produced high titers of antibodies in their eggs for at least 3months, in which NoV-specific antibody levels reached 4.7-9.2mg/egg yolk. The egg yolk antibodies strongly reacted with NoV P particles by both ELISA and Western blot and blocked NoV virus-like particle (VLP) and P particle binding to the histo-blood group antigen (HBGA) receptors with a BT(50) of about 1:800. The blocking activity of the chicken IgY remained after an incubation at 70°C for 30min or treatments at pH 4-9 for 3h. These data suggested that chicken IgY could be a practical strategy for large-scale production of anti-NoV antibodies for potential use as passive immunization against NoV infection, as well as for diagnostic purposes.

Seroprevalence of Antibodies against Noroviruses among Students in a Chinese Military Medical University

ABSTRACT Noroviruses (NVs) are important causes of nonbacterial gastroenteritis in humans, but the role of NVs as a cause of diseases in the Chinese people, particularly in Chinese military personnel, remains unclear. This study investigated antibody prevalence and factors that associate with the prevalence of antibody to NVs among students attending a military medical university. Serum specimens were tested by an enzyme-linked immunosorbent assay for immunoglobulin G antibody to recombinant capsid antigens of three NVs (rNorwalk, rMxV, and rVA387). Of 588 serum samples tested, the antibody prevalence was 88.9, 54.1, or 90.0% for the three antigens, respectively. There were significant differences in the prevalence of antibody to rMxV between blood types (P < 0.05); the prevalence for type O was the highest (62.5%), and the prevalence for type B was the lowest (49.1%). The average optical density values for antibody to rNorwalk and rMxV were lowest among students with type B. The number of students who did not have antibody to any of the three antigens was the highest for blood type B (6.9%) compared to other blood types (0.8 to 3.4% [P < 0.006]). The antibody prevalence also varied with the hometown residencies of the students before joining the military, with the highest rates for students from rural areas, lower rates for students from small towns or villages, and the lowest rates for students from large cities. The numbers of students who did not have antibody to any of the three antigens were highest for students from the large cities, lower for students from small towns or villages, and lowest for students from rural areas. The distribution of ABO blood types did not differ among the three groups. These data suggest that NVs are prevalent in China and that both genetic and environmental factors play a role in NV infection.

Surveillance and risk factors of norovirus gastroenteritis among children in a southern city of China in the fall–winter seasons of 2003–2006

Aim:  Noroviruses (NoVs) are an important cause of acute gastroenteritis but knowledge on the disease burden and epidemiology in children in the developing countries remains limited. In this study, we performed a surveillance of NoV gastroenteritis in children of China to address some of the questions.

P[8] and P[4] Rotavirus Infection Associated with Secretor Phenotypes Among Children in South China.

Rotaviruses are known to recognize human histo-blood group antigens (HBGAs) as a host ligand that is believed to play an important role in rotavirus host susceptibility and host range. In this study, paired fecal and saliva samples collected from children with viral gastroenteritis, as well as paired serum and saliva samples collected from the general population in south China were studied to evaluate potential association between rotavirus infections and human HBGA phenotypes. Rotavirus was detected in 75 (28%) of 266 fecal samples and P[8] rotaviruses were found to be the predominant genotype. The HBGA phenotypes of the rotavirus-infected children were determined through their saliva samples. Secretor statuses were found to correlate with the risk of rotavirus infection and all P[8]/P[4] rotavirus infected children were secretors. Accordingly, recombinant VP8* proteins of the P[8]/P[4] rotaviruses bound saliva samples from secretor individuals. Furthermore, correlation between serum P[8]/P[4]-specific IgG and host Lewis and secretor phenotypes has been found among 206 studied serum samples. Our study supported the association between rotavirus infection and the host HBGA phenotypes, which would help further understanding of rotavirus host range and epidemiology.