Virological and epidemiological study of Norwalk virus gastroenteritis.

诺瓦克病毒（NV）是引起急性非细菌性胃肠炎（尤其是成人）食源性暴发的最重要的致病病毒。近年来NV基因克隆的成功导致了ELISA、斑点杂交和RT-PCR等新方法的发展。虽然ELISA法未证实NV与人杯状病毒（HCV）、猫杯状病毒和耳福剂相关病毒（OARV）的遗传亲缘关系，但斑点杂交法显示NV与HCV或OARV的某些毒株存在一定的亲缘关系。在儿童（主要是小于10岁的儿童）急性胃肠炎的粪便标本中检测到很少的NV。在日本，重组NV抗体的流行率在整个儿童时期保持在低水平，然后在学龄和成年早期出现急剧上升。在日本和东南亚的健康成人样本中观察到抗体的高流行率。以上结果提示，在日本和东南亚，NV感染在成人中很常见，但在日本的婴儿中可能很少见。其中3例为NV所致，其余15例ELISA检测均为阴性。RT-PCR方法似乎是检测NV的最佳方法，因为PCR产物的敏感性和序列分析的可用性。

Norwalk virus (NV) is the most improtant causative virus of food-borne outbreaks of acute non-bacterial gastroenteritis especially in adults. The recent success of the NV gene cloning has resulted in the development of new methods like the ELISA,the dot blot hybridization and the RT-PCR for NV study.Although genetic relatedness between NV and human calicivirus (HCV), feline calicivirus and Otofuke-agent related virus (OARV) has not demonstrated by the ELISA,some relationships among NV and some strain of HCV or OARV was shown by the dot blot hybridization. Very few NV were detected in the stool specimens obtained from children, mainly younger than 10 years old, with acute gastroenteritis. The prevalence of antibody to recombinant NV remained at a low level throughout childhood and then showed a steep rise during school age and early adulthood in Japan. A high prevalence of antibody was observed in samples collected from healthy adults in Japan and Southeast Asia. These results suggested that NV infection is common in adults in Japan and Southeast Asia but may be rare in infants in Japan. 18 outbreaks of acute gastroenteritis with unknown causative pathogen were examined by the new three methods described above. Three of them were due to NV and the remaining 15 were negative by the ELISA.The RT-PCR method seem to be the best to detect NV because of the sensitivity and the availability of the sequence analysis of the PCR products.