Epidemiological investigation of norovirus infections in Punjab, Pakistan, through the One Health approach

Ammar Yasir, Yasir Mahmood, Muhammad Arsalan Yaqoob, Ubaid Ur Rehman Zia, Claudia Munoz-Zanzi, Muhammad Masroor Alam, Muhammad Akib Warraich, Muhammad Hassan Mushtaq

Research output: Contribution to journalArticlepeer-review


Introduction: Norovirus, mainly associated with acute gastroenteritis, is very contagious and can affect a vast range of species ranging from cattle, pigs, dogs, mice, cats, sheep, and lions to humans. It is a foodborne pathogen that mainly transmits through the fecal–oral route. Methods: This is the first-ever study conducted in Lahore and Sheikhupura districts of Punjab, Pakistan, to investigate noroviruses through the One Health approach. From January 2020 to September 2021, 200 fecal samples were collected from clinical cases of hospitalized patients and 200 fecal samples from sick animals at veterinary hospitals and local farms. In addition, 500 food and beverage samples were collected from street vendors and retail stores. A predesigned questionnaire was used to assess the risk factors and clinical characteristics of sick people and animals. Results and discussion: Overall, 14% of the human clinical samples were positive by RT-PCR for genogroup GII. All bovine samples were negative. Food and beverage samples were tested in pools, resulting in sugarcane juice samples positive for genogroup GII. Previous contact with acute gastroenteritis patients, sex, and presence of vomiting were found to be significant risk factors (p ≤ 0.05). The substantial number of diarrhea cases associated with noroviruses calls for additional studies to investigate the epidemiology and transmission and to improve surveillance.

Original languageEnglish (US)
Article number1065105
JournalFrontiers in Public Health
StatePublished - 2023

Bibliographical note

Funding Information:
The study was conducted under the research funding provided by the Higher Education Commission (HEC) of Pakistan under the HEC-NRPU program (Grant No. 7032/Punjab/NRPU/R&D/HEC/2017).

Publisher Copyright:
Copyright © 2023 Yasir, Mahmood, Yaqoob, Zia, Munoz-Zanzi, Alam, Warraich and Hassan Mushtaq.


  • One Health
  • Pakistan
  • acute gastroenteritis
  • diarrhea
  • genogroup II and III
  • noroviruses

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't


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