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Journal of Clinical Microbiology, February 2009, p. 421-429, Vol. 47, No. 2
0095-1137/09/$08.00+0     doi:10.1128/JCM.01852-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Molecular Epidemiology of Norovirus Gastroenteritis Investigated Using Samples Collected from Children in Tunisia during a Four-Year Period: Detection of the Norovirus Variant GGII.4 Hunter as Early as January 2003 {triangledown}

Khira Sdiri-Loulizi,1,2 Katia Ambert-Balay,2* Hakima Gharbi-Khelifi,1 Nabil Sakly,3 Mouna Hassine,1 Slaheddine Chouchane,4 Mohamed Neji Guediche,4 Pierre Pothier,2 and Mahjoub Aouni1

Laboratory of Infectious Diseases and Biological Agents, Faculty of Pharmacy, TU-5000 Monastir, Tunisia,1 National Reference Center for Enteric Viruses, Laboratory of Virology, University Hospital of Dijon, F-21070 Dijon, France,2 Laboratory of Immunology, University Hospital Fattouma Bourguiba, TU-5000 Monastir, Tunisia,3 Pediatric Department, University Hospital Fattouma Bourguiba, TU-5000 Monastir, Tunisia4

Received 25 September 2008/ Returned for modification 15 November 2008/ Accepted 12 December 2008

Human noroviruses (NoVs) cause epidemic and endemic acute gastroenteritis in children and adults. To study the prevalence and genetic diversity of NoV in children in Tunisia, a total of 788 fecal samples were collected during a 4-year period in the region of Monastir, from children 12 years of age or younger, hospitalized or presenting in dispensaries with symptoms of acute gastroenteritis. NoV was detected by reverse transcription-PCR and confirmed by sequence analysis. This is the first report that describes the molecular epidemiology of NoV in Tunisian children: NoVs were characterized as the causative agent in 128 (16.2%) of the samples. Fourteen samples contained a mixture of two NoVs, and 33 samples were coinfected with additional enteric viruses. Eight distinct NoV genotypes were detected (GGI.2, GGI.4, GGII.1, GGII.4, GGII.8, GGII.14, GGIIb/GGII.2, and GGIIb/GGII.3). GGII.4 was the most prevalent genotype, accounting for 83 (64.8%) cases. Interestingly the GGII.4 variant Hunter, described as spreading all over the world in 2004, was found in Tunisia as early as January 2003. The delay of 1 year between the isolation in Tunisia and the worldwide emergence is somewhat surprising, considering the importance of the contacts between North Africa and Europe particularly. Nevertheless, this illustrates the idea that sporadic gastroenteritis cases may be a reservoir for emerging epidemic NoV strains.

* Corresponding author. Mailing address: Centre National de Référence des Virus Entériques, Laboratoire de Virologie, Centre Hospitalier Universitaire de Dijon, Plateau Technique de Biologie, 2 Rue Angélique Ducoudray, BP 37013, 21070 Dijon, France. Phone: 33 (0) 380 293 437. Fax: 33 (0) 380 293 280. E-mail: katia.balay{at}chu-dijon.fr

{triangledown} Published ahead of print on 24 December 2008.

Journal of Clinical Microbiology, February 2009, p. 421-429, Vol. 47, No. 2
0095-1137/09/$08.00+0     doi:10.1128/JCM.01852-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Sdiri-Loulizi, K., Hassine, M., Gharbi-Khelifi, H., Sakly, N., Chouchane, S., Guediche, M. N., Pothier, P., Aouni, M., Ambert-Balay, K. (2009). Detection and Genomic Characterization of Aichi Viruses in Stool Samples from Children in Monastir, Tunisia. J. Clin. Microbiol. 47: 2275-2278 [Abstract] [Full Text]  


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