Outbreaks of acute gastroenteritis associated with a re-emerging GII.P16-GII.2 norovirus in the spring of 2017 in Jiangsu, China

Jian Guang Fu, Chao Shi, Cheng Xu, Qin Lin, Jun Zhang, Qian Hua Yi, Jun Zhang, Chang Jun Bao, Xiang Huo, Ye Fei Zhu, Jing Ai, Zheng Xing

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A total of 64 acute gastroenteritis outbreaks with 2,953 patients starting in December of 2016 and occurring mostly in the late spring of 2017 were reported in Jiangsu, China. A recombinant GII.P16-GII.2 norovirus variant was associated with 47 outbreaks (73.4%) for the gastroenteritis epidemic, predominantly occurring in February and March of 2017. Sequence analysis of the RNA-dependent RNA polymerase (RdRp) and capsid protein of the viral isolates from these outbreaks confirmed that this GII.P16-GII.2 strain was the GII. P16-GII.2 variant with the intergenotypic recombination, identified in Taiwan, Hong Kong, and other cities in China in 2016. This GII.P16-GII.2 recombinant variant appeared to a reemerging strain, firstly identified in 2011–2012 from Japan and USA but might be independently originated from other GII.P16-GII.2 variants for sporadic and outbreaks of gastroenteritis in Japan and China before 2016. Further identification of unique amino acid mutations in both VP1 and RdRp of NoV strain as shown in this report may provide insight in explaining its structural and antigenic changes, potentially critical for the variant recombinant to gain its predominance in causing regional and worldwide epidemics.

Original languageEnglish (US)
Article numbere0186090
JournalPloS one
Issue number12
StatePublished - Dec 2017

Bibliographical note

Funding Information:
© This work was supported by the Science & Technology Demonstration Project for Emerging Infectious Diseases Control and Prevention (No. BE2015714) and Jiangsu Province Science and Technology Project of Clinical Medicine (No. BL2014081). We appreciate the help from Drs. Zhiyong Gao and Miao Jin for their guidance in the preliminary data analysis. We also thank Dr. Zhihang Peng for assistance in graphic artwork.

Publisher Copyright:
This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.


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