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Epidemiology and HBGA-susceptibility investigation of a G9P[8] rotavirus outbreak in a school in Lechang, China

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Abstract

Rotaviruses cause severe gastroenteritis in infants, in which the viruses interact with human histo-blood group antigens (HBGAs) as attachment and host susceptibility factors. While gastroenteritis outbreaks caused by rotaviruses are uncommon in adolescents, we reported here one that occurred in a middle school in China. Rectal swabs and saliva samples were collected from symptomatic and asymptomatic students, and samples were also collected from the environment. Using PCR, followed by DNA sequencing, a single G9P[8] rotavirus strain was identified as the causative agent. The attack rate of the outbreak was 13.5% for boarders, which was significantly higher than that of day students (1.8%). Person-to-person transmission was the most plausible transmission mode. The HBGA phenotypes of the individuals in the study were determined by enzyme immunoassay, using saliva samples, while recombinant VP8* protein of the causative rotavirus strain was produced for HBGA binding assays to evaluate the host susceptibility. Our data showed that secretor individuals had a significantly higher risk of infection than nonsecretors. Accordingly, the VP8* protein bound nearly all secretor saliva samples, but not those of nonsecretors, explaining the observed infection of secretor individuals only. This is the first single-outbreak-based investigation showing that P[8] rotavirus infected only secretors. Our investigation also suggests that health education of school students is an important countermeasure against an outbreak of communicable disease.

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Acknowledgements

We are grateful for the support from the Centers for Disease Control and Prevention of the city of Shaoguan during the investigation of the outbreak. This work was supported by the National Natural Science Foundation of China (31771007, 81773975, and 81473402) and the National Natural Science Foundation of Guangdong Province (2019A1515010951). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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  1. Lun-Ai Guo, Meng Zhang and Yu-zhen Hou contributed equally to this work.

Authors and Affiliations

  1. Department of Epidemiology, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China

    Yu-zhen Hou, Shixing Tang & Ying-Chun Dai

  2. School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China

    Lun-Ai Guo, Wen-Fang Tan & Xu-Fu Zhang

  3. Department of Microbiology and Immunology; Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, 77555, USA

    Haitao Hu

  4. Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China

    Meng Zhang, Ling Fang, Qiong Huang, Hui Li & Li-Mei Sun

  5. Divisions of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, USA

    Ming Tan & Xi Jiang

  6. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Ming Tan & Xi Jiang

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  1. Lun-Ai Guo
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Correspondence to Xu-Fu Zhang or Ying-Chun Dai.

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All authors declare no conflict of interest.

Ethical approval

The study protocol was approved by the ethics committee of Guangdong Center for Disease Control and Prevention (GDCDC-W96-027B-2014.100). As the investigation was an urgent public health response to the outbreak and interviewing and sample collection posed minimal risks, parental/guardian consent and written informed consent were waived by the ethics committee of Guangdong Center Disease Control and Prevention. Instead, all samples were collected with oral informed consent from participants.

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Guo, LA., Zhang, M., Hou, Yz. et al. Epidemiology and HBGA-susceptibility investigation of a G9P[8] rotavirus outbreak in a school in Lechang, China. Arch Virol 165, 1311–1320 (2020). https://doi.org/10.1007/s00705-020-04608-4

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