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Open AccessArticle

Detection of Norovirus in Saliva Samples from Acute Gastroenteritis Cases and Asymptomatic Subjects: Association with Age and Higher Shedding in Stool

1
Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, University of Barcelona, 08028 Barcelona, Spain
2
Nutrition and Food Safety Research Institute (INSA·UB), University of Barcelona, 08921 Barcelona, Spain
3
Laboratori de l’Agència de Salut Pública de Barcelona, 08001 Barcelona, Spain
4
Vall d’Hebron University Hospital, 08035 Barcelona, Spain
5
Department of Health, Generalitat of Catalonia, 08005 Barcelona, Spain
6
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
7
Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
*
Author to whom correspondence should be addressed.
The Working Group for the Study of Outbreaks of Acute Gastroenteritis in Catalonia (PI16/02005) is composed by: Miquel Alsedà, Josep Álvarez, Irene Barrabeig, Anna Isabel Belver, Neus Camps, Sofia Minguell, Monica Carol, Pere Godoy, Conchita Izquierdo, Mireia Jané, Ana Martínez, Ignacio Parrón, Cristina Pérez, Ariadna Rovira, Maria Sabaté, Maria Rosa Sala, Núria Torner, Rosa Maria Vileu (Agència de Salut Pública de Catalunya; CIBERESP); Anna de Andrés, Javier de Benito, Esteve Camprubí, Montse Cunillé, M Lluïsa Forns, A Moreno-Martínez, Efrén Razquin, Cristina Rius, Sara Sabaté, Mercé de Simón (Agència Salut Pública de Barcelona; CIBERESP); Rosa Bartolomé, Thais Cornejo (Hospital Vall d’Hebron); Susana Guix (Laboratori de Virus Entèrics, Universitat de Barcelona); Lorena Coronas, Àngela Domínguez, Núria Soldevila (Departament de Medicina, Universitat de Barcelona; CIBERESP).
Academic Editor: Kim Y. Green
Viruses 2020, 12(12), 1369; https://doi.org/10.3390/v12121369
Received: 11 November 2020 / Revised: 26 November 2020 / Accepted: 28 November 2020 / Published: 30 November 2020
(This article belongs to the Special Issue Gastroenteritis Viruses)
Norovirus infections are a leading cause of acute gastroenteritis outbreaks worldwide and across all age groups, with two main genogroups (GI and GII) infecting humans. The aim of our study was to investigate the occurrence of norovirus in saliva samples from individuals involved in outbreaks of acute gastroenteritis in closed and semiclosed institutions, and its relationship with the virus strain, virus shedding in stool, the occurrence of symptoms, age, and the secretor status of the individual. Epidemiological and clinical information was gathered from norovirus outbreaks occurring in Catalonia, Spain during 2017–2018, and stool and saliva samples were collected from affected and exposed resident individuals and workers. A total of 347 saliva specimens from 25 outbreaks were analyzed. Further, 84% of individuals also provided a paired stool sample. For GII infections, norovirus was detected in 17.9% of saliva samples from symptomatic cases and 5.2% of asymptomatic individuals. Positivity in saliva occurred in both secretors and nonsecretors. None of the individuals infected by norovirus GI was positive for the virus in saliva. Saliva positivity did not correlate with any of the studied symptoms but did correlate with age ≥ 65 years old. Individuals who were positive in saliva showed higher levels of virus shedding in stool. Mean viral load in positive saliva was 3.16 ± 1.08 log10 genome copies/mL, and the predominance of encapsidated genomes was confirmed by propidium monoazide (PMA)xx-viability RTqPCR assay. The detection of norovirus in saliva raises the possibility of oral-to-oral norovirus transmission during the symptomatic phase and, although to a lesser extent, even in cases of asymptomatic infections. View Full-Text
Keywords: human norovirus; saliva; acute gastroenteritis; PMAxx-viability RTqPCR; asymptomatic infection; FUT2 genotyping human norovirus; saliva; acute gastroenteritis; PMAxx-viability RTqPCR; asymptomatic infection; FUT2 genotyping
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MDPI and ACS Style

Anfruns-Estrada, E.; Sabrià, A.; Fuentes, C.; Sabaté, S.; Razquin, E.; Cornejo, T.; Bartolomé, R.; Torner, N.; Izquierdo, C.; Soldevila, N.; Coronas, L.; Dominguez, A.; Pintó, R.M.; Bosch, A.; Guix, S.; on behalf of the Working Group for the Study of Outbreaks of Acute Gastroenteritis in Catalonia. Detection of Norovirus in Saliva Samples from Acute Gastroenteritis Cases and Asymptomatic Subjects: Association with Age and Higher Shedding in Stool. Viruses 2020, 12, 1369. https://doi.org/10.3390/v12121369

AMA Style

Anfruns-Estrada E, Sabrià A, Fuentes C, Sabaté S, Razquin E, Cornejo T, Bartolomé R, Torner N, Izquierdo C, Soldevila N, Coronas L, Dominguez A, Pintó RM, Bosch A, Guix S, on behalf of the Working Group for the Study of Outbreaks of Acute Gastroenteritis in Catalonia. Detection of Norovirus in Saliva Samples from Acute Gastroenteritis Cases and Asymptomatic Subjects: Association with Age and Higher Shedding in Stool. Viruses. 2020; 12(12):1369. https://doi.org/10.3390/v12121369

Chicago/Turabian Style

Anfruns-Estrada, Eduard; Sabrià, Aurora; Fuentes, Cristina; Sabaté, Sara; Razquin, Efrén; Cornejo, Thais; Bartolomé, Rosa; Torner, Nuria; Izquierdo, Conchita; Soldevila, Nuria; Coronas, Lorena; Dominguez, Angela; Pintó, Rosa M.; Bosch, Albert; Guix, Susana; on behalf of the Working Group for the Study of Outbreaks of Acute Gastroenteritis in Catalonia. 2020. "Detection of Norovirus in Saliva Samples from Acute Gastroenteritis Cases and Asymptomatic Subjects: Association with Age and Higher Shedding in Stool" Viruses 12, no. 12: 1369. https://doi.org/10.3390/v12121369

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