An outbreak of SRSV infection showing vomiting and diarrhea in a primary school, December 1999 - Kanagawa

Vol. 21 No. 2 p. 6 (Page number indicates that of Japanese-version prints.)

On December 2, 1999, 146 of 567 pupils were absent from an primary school S, and among them, 104 presented vomiting. Influenza and other epidemic illness were suspected, then gargling water, blood, stool were collected. Gargling water was inoculated on RD-18S, HeLa, Vero, HEp-2, MDCK, CaCo-2 cells, but no virus was isolated. Polymerase chain reaction (PCR) analysis for enterovirus, influenza virus, and RS virus was conducted using gargling water, but it was negative. Two stool specimens were examined by electron microscope, and small round structured virus (SRSV) was observed. PCR analysis using 35'/36, NV81/82/SM82 primer presented amplification of genes, which was corresponded with these primer band by the first PCR step. Plate hybridization using a probe provided from the National Institute of Public Health revealed that the gene was Norwalk-like virus (NLV) genogroup II (GII).

Because influenza was initially suspected, 21 pairs of sera were obtained. Using these paired sera, anti-NLV antibody was measured by enzyme-linked immunosorbant assay (ELISA). Of 21 specimens, 18 showed elevation of antibody significantly against GII antigens (r47, r76, r104, r7K). Of 21 specimens, only 2 showed elevation of antibody significantly against influenza A(H1). Therefore, it is concluded that NLV is attributed to this outbreak.

Reported by Miyuki Hara, Yumiko Furuya, Takashi Katayama, Sumi Watanabe, Takayuki Saito, Mitsunobu Imai, Dept. of Virology, Kanagawa Prefectural Public Health Laboratory.

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