Key result
Pediatric norovirus prevalence in Shanghai drops ~47% in 2020 versus 2018-2019.
Why the study?
Norovirus is a major pathogen causing acute gastroenteritis, especially in children, prompting investigation into its molecular epidemiological characteristics in Shanghai from 2018 to 2021.
Observational (n=1,545)
Absolute Event Rate: 5.8% vs 10.9%
p-value: p=0.023
The study demonstrates a shift in the predominant norovirus strains causing acute gastroenteritis in children in Shanghai before and during the COVID-19 pandemic.
Norovirus prevalence fell during 2020 measures; hypothesis-generating for nonpharmaceutical effects on pediatric gastroenteritis but should not change practice.
Norovirus (NoV) is a major pathogen that causes acute gastroenteritis (AGE) in people of all ages, especially in children. In this study, we investigated the molecular epidemiological characteristics of NoV in children with AGE in Shanghai from 2018 to 2021. The overall detection rate of NoV was 11.9% (181/1545), with annual detection rates of 9.4% (36/381), 13.6% (29/213), 5.8% (13/226) and 14.2% (103/725), respectively. Of note, the prevalence of NoV in 2020 was significantly lower than that in 2018-2019 (10.9%, 65/594) (P = 0.023) and 2021 (14.2%, 103/725) (P = 0.000). The 181 NoV strains identified in this study were classified into the GI group (1.1%, 2/181), GII group (98.3%, 178/181) and GIX group (0.6%, 1/181) according to the VP1 gene. The most common NoV VP1 genotype was GII.4 Sydney_2012 (63.5%, 115/181), followed by GII.3 (19.9%, 36/181) and GII.2 (9.4%, 17/181). For P genotypes, 174 strains were sequenced successfully according to the RdRp gene, and the predominant genotype was GII.P16 (44.8%, 78/174), followed by GII.P31 (25.9%, 45/174) and GII.P12 (21.3%, 37/174). Among the 174 cases, GII.4 Sydney_2012[P16] (36.8%, 64/174) was the dominant genotype, followed by GII.4 Sydney_2012[P31] (25.3%, 44/174), GII.3[P12] (20.1%, 35/174) and GII.2[P16] (8.0%, 14/174). In particular, the dominant genotypes in Shanghai changed from GII.4 Sydney_2012[P31] in 2018-2019 to GII.4 Sydney_2012[P16] in 2020-2021. This is the first report to describe the epidemiological changes in NoV infection before and during the COVID-19 pandemic in Shanghai. These data highlight the importance of continuous surveillance for NoV in children with AGE in Shanghai.
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Lu et al. (2023) conducted an observational in Acute gastroenteritis (n=1,545). Year 2020 (COVID-19 pandemic onset) vs. Years 2018-2019 was evaluated on Norovirus prevalence (p=0.023). The prevalence of norovirus in children with acute gastroenteritis in Shanghai was significantly lower in 2020 (5.8%) compared to 2018-2019 (10.9%, P=0.023) and 2021 (14.2%, P=0.000).
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