Comparison of IgG Antibody Seroprevalence to Three Pandemic Strains of GII.4 Norovirus in 1999-2000 and 2003-2004 Öffentlichkeit

Abstract

Norovirus is the leading cause of acute gastroenteritis among all age groups worldwide. More specifically, genogroup II, genotype 4 (GII.4) norovirus strains are responsible for the most illness, with a new pandemic strain emerging every few years. The purpose of this study was to examine antibody seroprevalence to GII.4 GB, GII.4 FH, and GII.4 NO in relation to seroprevalence to prior strains and time of sample collection. The pandemic GII.4 strains used in this study are: GII.4 Grimsby (GB), which emerged in 1995, GII.4 Farmington Hills (FH), which emerged in 2002, and GII.4 New Orleans (NO), which emerged in 2009. NHANES serological data from the 1999-2000 and 2003-2004 cycles (Cycle 1 and Cycle 2, respectively) were analyzed (n=2019). Enzyme-linked immunosorbent assays (ELISA) were used to quantify serum anti-norovirus IgG antibodies, with GII.4 GB, GII.4 FH, and GII.4 NO virus-like particles (VLPs) acting as the antigens. The concentration of serum IgG antibodies for each VLP tested was reported as optical density (OD) values. An OD cutpoint of 1.5 for determining seropositivity was chosen based on data from previous norovirus challenge studies. A multivariable logistic regression model, a linear regression model, and one-way ANOVA tests were then used to complete data analysis. The results 1) suggest that 52.49% of GII.4 GB Cycle 1 samples and 54.98% of GII.4 GB Cycle 2 samples are seropositive, 41.45% of GII.4 FH Cycle 1 samples are not seropositive and 61.19% of GII.4 FH Cycle 2 samples are seropositive, and 45.02% of GII.4 NO Cycle 1 samples and 49.13% of GII.4 NO Cycle 2 samples are not seropositive, and 2) show that there is a statistically significant difference in the antibody levels to GII.4 FH between Cycle 1 and Cycle 2 (p-value<0.0001), consistent with the emergence of this strain in 2002. The findings also justify further research of antibody seroprevalence to various GII.4 strains, since norovirus immunology is not well understood.

Table of Contents

Chapter I: Literature Review...........................................................................................1

Chapter II: Manuscript...................................................................................................13

A. Title, Author, Abstract...............................................................................................13

B. Introduction...............................................................................................................14

C. Methods.....................................................................................................................16

D. Results.......................................................................................................................18

E. Discussion................................................................................................................. 20

1. Strengths and Limitations..........................................................................................22

F. References..................................................................................................................24

G. Tables........................................................................................................................27

H. Figures.......................................................................................................................29

Chapter III: Public Health Implications, Possible Future Directions.............................31

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Stichwort	Norovirus
Committee Chair / Thesis Advisor	Kirby, Amy, Emory University

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