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Updated: Jun 19, 2026
15:16
Detection and Genogrouping of Noroviruses from Children's Stools By Taqman One-step RT-PCR
Published on: July 22, 2012
Differences in clinical presentation between norovirus genotypes in nursing homes.
I H M Friesema1, H Vennema, J C M Heijne
1National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands. ingrid.friesema@rivm.nl
Summary
Norovirus (NoV) genotype II.4 (GII.4) outbreaks in nursing homes are linked to more severe symptoms, including increased vomiting and higher resident attack rates. Understanding these genotype-symptom links is crucial for infection control.
Area of Science:
- Infectious Diseases
- Virology
- Epidemiology
Background:
- Norovirus (NoV) outbreaks in healthcare settings are frequently caused by genotype II.4 (GII.4) strains.
- Emerging GII.4 variants periodically lead to increased outbreak incidence.
Purpose of the Study:
- To investigate the association between norovirus (NoV) genotype and clinical symptoms in nursing home residents and staff.
- To compare symptom profiles and attack rates between GII.4 and non-GII.4 norovirus outbreaks.
Main Methods:
- Retrospective analysis of data from 28 norovirus outbreaks in 49 nursing homes during the 2005/2006 and 2006/2007 winter seasons.
- Symptom and illness duration data were collected for 465 residents and 174 staff members.
- Genotyping identified norovirus strains, with GII.4 being predominant.
Main Results:
- Genotype GII.4 caused 21 of 28 outbreaks and was associated with higher resident attack rates.
- Residents in GII.4 outbreaks experienced more frequent vomiting, nausea, abdominal cramps, fever, and mucus in stool compared to other genotypes.
- Specific GII.4 variants (2004 vs. 2006a) showed variations in symptom prevalence, but illness duration did not differ significantly. Staff symptoms showed no clear genotype-specific differences.
Conclusions:
- Norovirus genotype GII.4 is associated with more severe symptomatic illness in nursing home residents.
- Higher attack rates and increased vomiting are key indicators of GII.4 outbreaks.
- Findings highlight the clinical impact of specific norovirus genotypes in institutional settings.
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