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Journal of Clinical Microbiology, April 2004, p. 1396-1401, Vol. 42, No. 4
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.4.1396-1401.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Diversity of Noroviruses Cocirculating in the North of England from 1998 to 2001

Chris I. Gallimore,1* Jonathan Green,1,{dagger} David Lewis,2 Alison F. Richards,1 Benjamin A. Lopman,3 Antony D. Hale,2 Roger Eglin,2,{ddagger} Jim J. Gray,1 and David W. G. Brown1

Enteric, Respiratory and Neurological Virus Laboratory, Central Public Health Laboratory, Specialist and Reference Microbiology Division,1 Gastrointestinal Infections Division, Communicable Disease Surveillance Centre, Health Protection Agency, London,3 Leeds Laboratory, Health Protection Agency Yorkshire and Humber, Leeds, United Kingdom2

Received 22 August 2003/ Returned for modification 5 November 2003/ Accepted 22 December 2003

A study was undertaken to investigate the diversity of noroviruses (NVs) in fecal samples from patients from 529 outbreaks and 141 sporadic cases of gastroenteritis in the North of England from September 1998 to August 2001. NV strains were detected by electron microscopy and characterized by a combination of the Grimsby virus antigen enzyme-linked immunosorbent assay, reverse transcriptase PCR, the heteroduplex mobility assay, and DNA sequencing. Twenty-one distinct NV strains, including several novel or variant strains not seen previously, were found circulating in the population studied. Genogroup II NVs were responsible for 83% of the outbreaks. Several strains cocirculated at any one time. The Bristol (Grimsby/Lordsdale) and Hawaii (Girlington) genotypes were the most prevalent among the NVs identified, detected in 49 and 20% of the outbreaks, respectively. A limited number of other genogroup II and I strains were cocirculating. The virus populations detected in hospitals and nursing homes were distinct from those found in community-based outbreaks. Outbreaks in hospitals and nursing homes were more likely to be caused by genogroup II strain Grimsby or Girlington (P < 0.0001) than by other genogroup II or I strains.

* Corresponding author. Mailing address: Enteric, Respiratory and Neurological Virus Laboratory, Central Public Health Laboratory, Specialist and Reference Microbiology Division, Health Protection Agency, 61 Colindale Ave., Colindale, London NW9 5HT, United Kingdom. Phone: 44-208-200-4400. Fax: 44-208-205-8195. E-mail: christopher.gallimore{at}hpa.org.uk.

{dagger} Present address: Genomics, Proteomics and Bioinformatics Laboratory, Central Public Health Laboratory, Specialist and Reference Microbiology Division, Health Protection Agency, London, United Kingdom.

{ddagger} Present address: National Microbiology Transfusion Laboratories, National Blood Service, London, United Kingdom.

Journal of Clinical Microbiology, April 2004, p. 1396-1401, Vol. 42, No. 4
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.4.1396-1401.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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