Evidence of the etiological predominance of norovirus in gastroenteritis outbreaks - Emerging new-variant and recombinant noroviruses in Hungary

Gábor Reuter, Katalin Krisztalovics, Harry Vennema, Marion Koopmans, György Szucs

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73 Citations (Scopus)


Between January 2001 and December 2003, stool specimens from 262 (45%) of 581 reported outbreaks of gastroenteritis were investigated for noroviruses in Hungary. Specimens collected from outbreaks of non-bacterial gastroenteritis were examined by reverse-transcription polymerase chain reaction and enzyme immunoassay. In 253 (97%) of 262 outbreaks, norovirus was detected and confirmed by sequencing in 211 (81%). Hospitals (35%), day care centers (30%), and elderly homes (27%) were the most common settings. Diversity and frequency of the genotypes changed over time but with predominance (95%) of genogroup (GG) II strains. Strains grouped into 11 genotypes including an epidemic spread of new-variant GGII4 (Lordsdale virus) and a recently emerged group of natural recombinant strains (GGIIb/Hilversum polymerase) with four capsid types (Hawaii, Mexico, Snow Mountain, and Lordsdale). Clusters of epidemics including food-borne outbreaks were detected. According to this study, noroviruses are the predominant etiological agents causing gastroenteritis outbreaks in Hungary.

Original languageEnglish
Pages (from-to)598-607
Number of pages10
JournalJournal of Medical Virology
Issue number4
Publication statusPublished - aug. 1 2005


ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

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