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Journal of Clinical Microbiology, March 2005, p. 1112-1117, Vol. 43, No. 3
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.3.1112-1117.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Prevalence of Norovirus among Visitors from the United States to Mexico and Guatemala Who Experience Traveler's Diarrhea

Amy R. Chapin,1 Colleen M. Carpenter,2 William C. Dudley,2 Lucy C. Gibson,2 Rafael Pratdesaba,3 Olga Torres,3 Domingo Sanchez,4 Jaime Belkind-Gerson,4 Irene Nyquist,5 Anders Kärnell,5 Bjorn Gustafsson,5 Jane L. Halpern,2 A. Louis Bourgeois,2 and Kellogg J. Schwab1*

Department of Environmental Health Sciences,1 Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland,2 Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala,3 Hospital del Nino de Morelense, Cuernavaca, Mexico,4 SBL Vaccin, Stockholm, Sweden5

Received 22 April 2004/ Returned for modification 20 August 2004/ Accepted 28 October 2004

Traveler's diarrhea (TD) is the most common infectious illness acquired by visitors to developing nations. The purpose of this study was to utilize molecular diagnostic techniques to determine the prevalence of norovirus (NoV) in TD occurring among visitors from the United States to Guatemala and Mexico. Stool samples (n = 54) were collected from 34 TD cases and analyzed for NoV by reverse transcription-PCR and oligoprobe confirmation. The overall prevalence of NoV was 65%. Interestingly, all NoV-positive stool samples were identified as genogroup I NoVs, and time spent at travel destinations was found to be an important factor in determining the frequency of infection (P = 0.003). Eleven NoV-positive stool samples also tested positive for enterotoxigenic Escherichia coli, indicating that dual infections with this leading bacterial cause of TD were very common. Results of this study suggest that NoV infection is a frequent occurrence among travelers to Mexico and Guatemala who experience episodes of TD. In addition, the simple molecular detection method utilized here will serve to facilitate more in-depth epidemiological studies of this emergent viral pathogen in travelers and other at-risk populations.

* Corresponding author. Mailing address: Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St., Room E6620, Baltimore, MD 21205. Phone: (410) 614-5753. Fax: (410) 955-9334. E-mail: kschwab{at}jhsph.edu.

Journal of Clinical Microbiology, March 2005, p. 1112-1117, Vol. 43, No. 3
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.3.1112-1117.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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