Viral gastroenteritis and genetic characterization of recombinant norovirus circulating in Eastern Russia.

From November 2003 to March 2004 a total of 100 fecal specimens from infants and children with acute gastroenteritis in the city of Birobidzhan, Eastern Russia were tested for the presence of diarrheal viruses by RT-multiplex PCR. Of these, 74 fecal specimens were positive for diarrheal viruses and this represented 74%. Among the diarrheal viruses detected, group A rotavirus was the most prevalent (67%; 67 of 100), followed by norovirus (4%; 4 of 100), group C rotavirus (1%, 1 of 100), sapovirus (1%; 1 of 100), and hepatitis A virus (1%; 1 of 100). It was found that 86.6% (58 of 67) of group A rotavirus were serotyped as G3. Sapovirus and hepatitis A virus were genetically determined to belong to GI/1 and subgenotype 1A, respectively. Interestingly, all norovirus isolates in the study turned out to make a novel cluster when polymerase-based grouping was performed. It is noteworthy to point out that these norovirus isolates were further genetically characterized as naturally occurring recombinants, which were firstly found circulating in the Russian population studied. Breakpoint analysis of recombinant norovirus showed that the recombination site was at the open reading frame (ORF)1/ORF2 overlap. This is the first report of the existence of acute gastroenteritis caused by recombinant norovirus in Eastern Russia.