Prevalence of GII.4 Sydney 2012 and Recombinant GII.3P[12] Noroviruses Associated with Acute Gastroenteritis in Hospitalized Children in Thailand, 2015-2017

Abstract

Norovirus (NoV) is an important pathogen causing acute gastroenteritis worldwide. The purpose of the present study was the molecular characterization of NoV. A total of 408 stool specimens collected from hospitalized children associated with acute gastroenteritis in Chiang Rai, Thailand, 2015-2017 were investigated for the presence of NoVs by RT-PCR. NoV GII was detected in 32 samples (7.8%). Five distinct genotypes were identified, including GII.4 (13/32, 40.6%), GII.3 (11/32, 34.3%), GII.17 (4/32, 12.5%), GII.2 (2/32, 6.3%), and GII.14 (2/32, 6.3%). NoV infection occurred mostly in young children under 3 years of age (31/32, 96.9%) and showed the main peak in summer months from March to April (18/32, 56.3%). Phylogenetic analysis revealed that all 13 GII.4 strains clustered with GII.4 Sydney 2012 variant. Representative GII.3 strains were analyzed as a recombinant GII.3P[12] strain. Several amino acid differences were found in the antigenic epitopes and antibody binding sites of the VP1 capsid of the GII.3P[12]. Homology modeling of the P domain of the GII.3P[12] strain demonstrated that 10/13 amino acid differences were predicted to be located on the surface-exposed area of the capsid structure. These amino acid changes might affect the infectivity and the antigenicity of the recombinant GII.3P[12]. The prevalence of GII.4 Sydney 2012 and recombinant GII.3P[12] strains indicates the genetic diversity of circulating NoVs in Thailand, emphazing the importance of continuous surveillance to mornitor newly emerging NoV strains in the future.