J Korean Med Sci.  2020 Aug;35(34):e281. 10.3346/jkms.2020.35.e281.

An Outbreak Associated with Sapovirus GI.3 in an Elementary School in Gyeonggi-do, Korea

• Cho SR
• Yun SJ
• Chae SJ
• Jung S
• Kim JH
• Yong KC
• Cho EH
• Choi W
• Lee DY

• KMID: 2505721
• DOI: http://doi.org/10.3346/jkms.2020.35.e281

Abstract

On October 4, 2018, an outbreak of gastroenteritis associated with sapovirus occurred among elementary school students in Gyeonggi-do, Korea. Epidemiologic studies were conducted in a retrospective cohort approach. Using self-administered questionnaires, we collected information on symptoms and food items consumed. Of the 999 subjects, 17 developed patients that met the case definition. The main symptom was vomiting (100%), and the symptomatic age was 6-12 years. Positive samples were identified by conventional reverse transcription polymerase chain reaction for sequencing. They were classified into genotype GI.3 by phylogenetic analysis. This is the first report of an outbreak associated with sapovirus GI.3 in Korea.

Keyword

Sapovirus; Acute Gastroenteritis; GI.3 Genotype

Figure

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  Fig. 1 Epidemic curve of the outbreak. Clinical symptoms began on October 4 and terminated on October 5. Individual cases experienced general clinical symptoms, which included vomiting, abdominal pain, and diarrhea.

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  Fig. 2 Phylogenetic analysis of sapovirus detected in the outbreak, based on 720 bp of the capsid region (ORF1) sequences. The phylogenetic tree was generated using the neighbor-joining method with distance calculation by Kimura-2-parameter correction implemented in the MEGA6 software. The numbers in the branches indicate the bootstrap of 1,000 replicated values. Reference strains of sapovirus genotype were registered in GenBank under the accession number indicated in the text. Outbreak samples are marked with black circles (●).

Reference

1. Hansman GS, Oka T, Katayama K, Takeda N. Human sapoviruses: genetic diversity, recombination, and classification. Rev Med Virol. 2007; 17(2):133–141. PMID: 17340567.

2. Oka T, Wang Q, Katayama K, Saif LJ. Comprehensive review of human sapoviruses. Clin Microbiol Rev. 2015; 28(1):32–53. PMID: 25567221.

3. Hall AJ, Lopman BA, Payne DC, Patel MM, Gastañaduy PA, Vinjé J, et al. Norovirus disease in the United States. Emerg Infect Dis. 2013; 19(8):1198–1205. PMID: 23876403.

4. Nakata S, Honma S, Numata KK, Kogawa K, Ukae S, Morita Y, et al. Members of the family caliciviridae (Norwalk virus and Sapporo virus) are the most prevalent cause of gastroenteritis outbreaks among infants in Japan. J Infect Dis. 2000; 181(6):2029–2032. PMID: 10837186.

5. Hansman GS, Saito H, Shibata C, Ishizuka S, Oseto M, Oka T, et al. Outbreak of gastroenteritis due to sapovirus. J Clin Microbiol. 2007; 45(4):1347–1349. PMID: 17267629.

6. Phan TG, Trinh QD, Yagyu F, Okitsu S, Ushijima H. Emergence of rare sapovirus genotype among infants and children with acute gastroenteritis in Japan. Eur J Clin Microbiol Infect Dis. 2007; 26(1):21–27. PMID: 17200841.

7. Usuku S, Kumazaki M, Kitamura K, Tochikubo O, Noguchi Y. An outbreak of food-borne gastroenteritis due to sapovirus among junior high school students. Jpn J Infect Dis. 2008; 61(6):438–441. PMID: 19050349.

8. Johansson PJ, Bergentoft K, Larsson PA, Magnusson G, Widell A, Thorhagen M, et al. A nosocomial sapovirus-associated outbreak of gastroenteritis in adults. Scand J Infect Dis. 2005; 37(3):200–204. PMID: 15849053.

9. Kirby AE, Streby A, Moe CL. Vomiting as a symptom and transmission risk in norovirus illness: evidence from human challenge studies. PLoS One. 2016; 11(4):e0143759. PMID: 27116105.

10. Gallimore CI, Iturriza-Gomara M, Lewis D, Cubitt D, Cotterill H, Gray JJ. Characterization of sapoviruses collected in the United Kingdom from 1989 to 2004. J Med Virol. 2006; 78(5):673–682. PMID: 16555276.

11. Svraka S, Vennema H, van der Veer B, Hedlund KO, Thorhagen M, Siebenga J, et al. Epidemiology and genotype analysis of emerging sapovirus-associated infections across Europe. J Clin Microbiol. 2010; 48(6):2191–2198. PMID: 20392905.

12. Varela MF, Ouardani I, Kato T, Kadoya S, Aouni M, Sano D, et al. Sapovirus in Wastewater Treatment Plants in Tunisia: Prevalence, Removal, and Genetic Characterization. Appl Environ Microbiol. 2018; 84(6):e02093-17. PMID: 29305515.