the dynamics of norovirus outbreak epidemics recent insights诺瓦克病毒暴发流行的动态最新见解.pdfVIP

Int. J. Environ. Res. Public Health 2011, 8, 1141-1149; doi:10.3390/ijerph804 1141 OPEN ACCESS International Journal of Environmental Research and Public Health ISSN 1660-4601 /journal/ijerph Review The Dynamics of Norovirus Outbreak Epidemics: Recent Insights John A. Marshall * and Leesa D. Bruggink Victorian Infectious Diseases Reference Laboratory, 10 Wreckyn Street, North Melbourne, Victoria 3051, Australia; E-Mail: leesa.bruggink@.au * Author to whom correspondence should be addressed; E-Mail: john.marshall@.au ; Tel.: +61-3-9342-2678; Fax: +61-3-9342-2660. Received: 23 February 2011; in revised form: 11 April 2011 / Accepted: 13 April 2011 / Published: 15 April 2011 Abstract: Noroviruses are a major cause of gastroenteritis outbreaks worldwide. Norovirus outbreaks frequently occur as epidemics which appear to be related to both genetic and environmental factors. This review considers recent progress in understanding these factors. The norovirus genome undergoes continuous change and this appears to be important in the persistence of the virus in the community. Studies on the common GII.4 genotype have shown that some norovirus outbreak epidemics involving this genotype are correlated with specific changes in the genome. In contrast to the growing understanding of the role of genetic fact