The role of human caliciviruses in epidemic gastroenteritis

  • K. Y. Green


Members of the Caliciviridae family of small, positive-sense RNA viruses exhibit a broad host range. The Norwalk and Norwalk-like caliciviruses in this family are major etiologic agents of epidemic gastroenteritis in humans. This illness characteristically lasts 24–48 h and often occurs in group settings such as families, schools, institutions, or communities. The spread of the human caliciviruses is considered to be predominantly by person-to-person contact via the fecal-oral-route. However, the ingestion of calicivirus-contaminated food or water can result in large-scale common-source outbreaks. Many basic features concerning the biology and replication of the human caliciviruses are not known because they have not yet been grown in cell culture and the virus does not appear to replicate in animal models other than the chimpanzee. Sequence analysis of RT-PCR-generated DNA fragments derived from serotypically distinct reference strains (such as the Norwalk, Hawaii, and Snow Mountain viruses) and other circulating strains associated with gastroenteritis has provided evidence for marked genetic diversity among these viruses. Moreover, analysis of the antigenic relationships among these viruses using paired sera from individuals infected with well-characterized reference strains or from animals immunized with recombinant “virus-like particles” (VLPs) suggests that several serotypes of these viruses are circulating worldwide. The availability of molecular techniques for the detection of these fastidious viruses has enabled epidemiologic studies that have strengthened the association of human caliciviruses with acute gastroenteritis and has demonstrated a potential role for antigenic diversity in the natural history of these pathogens.


Rabbit Hemorrhagic Disease Virus Norwalk Virus Feline Calicivirus Immune Electron Microscopy Human Caliciviruses 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Ando T, Monroe S, Gentsch JR, Jin Q, Lewis DC, Glass, RI (1995) Detection and differentiation of antigenically distinct small-round structured viruses (Norwalk-like viruses) by reverse transcription-PCR and southern hybridization. J Clin Microbiol 33: 67–71Google Scholar
  2. 2.
    Centers for Disease Control (1990) Viral agents of gastroenteritis: public health importance and outbreak management. Morbid Mortal Weekly Rep 39 (RR-5): 1–24Google Scholar
  3. 3.
    Chadwick PR, Walker M, Rees AE (1994) Airborne transmission of a small round structured virus. Lancet 343: 171PubMedCrossRefGoogle Scholar
  4. 4.
    Devereux J, Haeberli P, Smithies O (1984) A comprehensive set of sequence analysis programs for the VAX. Nucleic Acids Res 12: 387–395PubMedCrossRefGoogle Scholar
  5. 5.
    Dingle KE, Lambden PR, Caul EO, Clarke IN (1995) Human enteric Caliciviridae: the complete genome sequence and expression of virus-like particles from a genetic II small round structured virus. J Gen Virol 76: 2349–2355PubMedCrossRefGoogle Scholar
  6. 6.
    Gangarosa RE, Glass RI, Lew JF, Boring JR (1992) Hospitalizations involving gastroenteritis in the United States, 1985: the special burden of the disease among the elderly. Am J Epidemiol 135: 280–290Google Scholar
  7. 7.
    Geliert GA, Waterman SH, Ewert D, Oshiro L, Giles MP, Monroe SS, Gorelkin L, Glass RI (1990) An outbreak of acute gastroenteritis caused by a small round structured virus in a geriatric convalescent facility. Infect Control Hosp Epidemiol 11: 459CrossRefGoogle Scholar
  8. 8.
    Green J, Norcott JP, Lewis D, Arnold C, Brown DW (1993) Norwalk-like viruses: demonstration of genomic diversity by polymerase chain reaction. J Clin Microbiol 31: 3007–3012PubMedGoogle Scholar
  9. 9.
    Green KY, Lew JF, Jiang X, Kapikian AZ, Estes MK (1993) Comparison of the reactivities of baculovirus-expressed recombinant Norwalk virus capsid antigen with those of the native Norwalk virus antigen in serologic assays and some epidemiologic observations. J Clin Microbiol 31: 2185–2191PubMedGoogle Scholar
  10. 10.
    Green KY, Kapikian AZ, Valdesuso J, Sosnovtsev S, Lew JF (1997) Expression and self-assembly of recombinant capsid protein from the antigenically distinct Hawaii human calicivirus. J Clin Microbiol 35: 1909–1914PubMedGoogle Scholar
  11. 11.
    Green KY, Taylor JL, Valdesuso J, Lew JF, Kapikian AZ, Lin F-L (1997) Identification of Norwalk-like caliciviruses as an important cause of epidemic gastroentertitis in nursing homes for the elderly (submitted)Google Scholar
  12. 12.
    Green SM, Lambden PR, Caul EO, Ashley CR, Clarke IN (1995) Capsid diversity in small round-structured viruses: molecular characterization of an antigenically distinct human enteric calicivirus. Virus Res 37: 271–283PubMedCrossRefGoogle Scholar
  13. 13.
    Greenberg HB, Valdesuso J, Yolken RH, Gangarosa E, Gary W, Wyatt RG, Konno T, Suzuki H, Chanock RM, Kapikian AZ (1979) Role of Norwalk virus in outbreaks of nonbacterial gastroenteritis. J Infect Dis 139: 564–568PubMedCrossRefGoogle Scholar
  14. 14.
    Greenberg HB, Wyatt RG, Kalica AR, Yolken RH, Black R, Kapikian AZ, Chanock RM (1981) New insights in viral gastroenteritis. Persp Virol 11: 163–187Google Scholar
  15. 15.
    Hyams KC, Malone JD, Kapikian AZ, Estes MK, Jiang X, Bourgeios AL, Paparello S, Hawkins RD, Green KY (1993) Norwalk virus infection among Desert Storm troops. J Infect Dis 167: 986–987PubMedCrossRefGoogle Scholar
  16. 16.
    Jiang X, Graham DY, Wang K, Estes MK (1990) Norwalk virus genome: cloning and characterization. Science 250: 1580–1583.CrossRefGoogle Scholar
  17. 17.
    Jiang X, Matson DO, Ruiz-Palacios GM, Hu J, Treanor J, Pickering LK (1995) Expression, self-assembly, and antigenicity of a Snow Mountain agent-like calicivirus capsid protein. J Clin Microbiol 33: 1452–1455PubMedGoogle Scholar
  18. 18.
    Jiang X, Maison DO, Velazquez FR, Calva JJ, Zhong WM, Hu J, Ruiz-Palacious GM, Pickering LK (1995) Study of Norwalk-related viruses in Mexican children. J Med Virol 47: 309–316PubMedCrossRefGoogle Scholar
  19. 19.
    Jiang X, Wang M, Graham DY, Estes MK (1992) Expression, self-assembly, and antigenicity of the Norwalk virus capsid protein. J Virol 66: 6527–6532PubMedGoogle Scholar
  20. 20.
    Jiang X, Wang M, Wang K, Estes MK (1993) Sequence and genomic organization of Norwalk virus. Virology 195: 51–61PubMedCrossRefGoogle Scholar
  21. 21.
    Kapikian AZ (1993) Viral gastroenteritis. JAMA 269: 627–630PubMedCrossRefGoogle Scholar
  22. 22.
    Kapikian AZ (1994) Norwalk and Norwalk-like viruses. In: Kapikian AZ (ed) Viral infections of the gastrointestinal tract. Marcel Dekker, New York, pp 471–518Google Scholar
  23. 23.
    Kapikian AZ, Wyatt RG, Dolin R, Thornhill TS, Kalica AR, Chanock RM (1972) Visualization by immune electron microscopy of a 27 nm particle associated with acute infectious non-bacterial gastroenteritis. J Virol 10: 1075–1081PubMedGoogle Scholar
  24. 24.
    Kapikian AZ, Feinstone SM, Purcell RH, Wyatt RG, Thornhill TS, Kalica AR, Chanock RM (1975) Detection and identification by immune electron microscopy of fastidious agents associated with respiratory illness, acute nonbacterial gastroenteritis, and hepatitis A. Persp Virol 9: 9–47Google Scholar
  25. 25.
    Kapikian AZ, Estes MK, Chanock RM (1996) Norwalk group of viruses. In: Fields BN, Knipe DM, Howley PM (eds) Virology. Lippincott-Raven, Philadelphia, pp 783–810Google Scholar
  26. 26.
    Kaplan JE, Gary GW, Baron RC, Singh N, Schonberger LB, Feldman R, Greenberg HB (1982) Epidemiology of Norwalk gastroenteritis and the role of Norwalk virus in outbreaks of acute nonbacterial gastroenteritis. Ann Int Med 96: 756–761PubMedGoogle Scholar
  27. 27.
    Kreutz LC, Seal BS, Mengeling WL (1994) Early interaction of feline calicivirus with cells in culture. Arch Virol 136: 19–34PubMedCrossRefGoogle Scholar
  28. 28.
    Lambden PR, Caul EO, Ashley CR, Clark IN (1993) Sequence and genome organization of a human small round-structured (Norwalk-like) virus. Science 259: 516–519PubMedCrossRefGoogle Scholar
  29. 29.
    Lambden PR, Caul EO, Ashley CR, Clarke IN (1994) Human enteric caliciviruses are genetically distinct from small round structured viruses. Lancet 343: 666–667PubMedCrossRefGoogle Scholar
  30. 30.
    Lambden PR, Clark IN (1995) Genome organization in the Caliciviridae. Trends Microbiol 3: 261–265PubMedCrossRefGoogle Scholar
  31. 31.
    Lee KM, Kniazeff AJ, Fabricant CG, Gillespie JH (1969) Utilization of various cell culture systems for propagation of certain feline viruses and canine herpesvirus. Cornell Vet 59: 539–547Google Scholar
  32. 32.
    Lew JF, Glass RI, Gangarosa RE, Cohen IP, Bern C, Moe CL (1991) Diarrheal deaths in the United States, 1979–1987. JAMA 265: 3280–3284PubMedCrossRefGoogle Scholar
  33. 33.
    Lew JF, Kapikian AZ, Jiang X, Estes M, Green KY (1994) Molecular characterization and expression of the capsid protein of a Norwalk-like virus recovered from a desert shield troop with gastroenteritis. Virology 200: 319–325PubMedCrossRefGoogle Scholar
  34. 34.
    Lew JF, Petric M, Kapikian AZ, Jiang X, Estes M, Green KY (1994) Identification of minireovirus as a Norwalk-like virus in pediatric patients with gastroenteritis. J Virol 68: 3391–3396PubMedGoogle Scholar
  35. 35.
    Lew JF, Kapikian AZ, Valdesuso J, Green KY (1994) Molecular characterization of Hawaii virus and other Norwalk-like viruses: evidence for genetic polymorphism among human caliciviruses. J Infect Dis 170: 535–542PubMedCrossRefGoogle Scholar
  36. 36.
    Lew JF, Valdesuso J, Vesikari T, Kapikian AZ, Jiang X, Estes MK, Green KY (1994) Detection of Norwalk virus or Norwalk-like virus infections in Finnish infants and young children. J Infect Dis 169: 1364–1367PubMedCrossRefGoogle Scholar
  37. 37.
    Lewis D (1990) Three serotypes of Norwalk-like virus demonstrated by solid-phase immune electron microscopy. J Med Virol 30: 78–81CrossRefGoogle Scholar
  38. 38.
    Liete JPG, Ando T, Noel JS, Jiang B, Humphrey C, Lew JF, Green KY, Glass RI, Monroe SS (1996) Characterization of Toronto virus capsid protein expressed in baculovirus. Arch Virol 141: 865–875CrossRefGoogle Scholar
  39. 39.
    Liu BL, Clarke IN, Caul EO, Lambden PR (1995) Human enteric caliciviruses have a unique genome structure and are distinct from the Norwalklike viruses. Arch Virol 140: 1345–1356PubMedCrossRefGoogle Scholar
  40. 40.
    Madely CR, Cosgrove BP (1976) Caliciviruses in man. Lancet i: 199–200CrossRefGoogle Scholar
  41. 41.
    Maison DO, Zhong W-M, Nakata S, Numata K, Jiang X, Pickering LK, Chiba S, Estes MK (1995) Molecular characterization of a human calicivirus with sequence relationships closer to animal caliciviruses than other known human caliciviruses. J Med Virol 45: 215–222CrossRefGoogle Scholar
  42. 42.
    Matsui SM, Kim JP, Greenberg HB, Su W, Sun Q, Johnson PC, Dupont HL, Oshiro LS, Reyes GR (1991) The isolation and characterisation of a Norwalk virus-specific cDNA. J Clin Invest 87: 1456–1461PubMedCrossRefGoogle Scholar
  43. 43.
    Moe CL, Gentsch J, Ando T, Grohmann G, Monroe SS, Jiang X, Wang J, Estes MK, Seto Y, Humphrey C, Stine S, Glass RI (1994) Application of PCR to detect Norwalk virus in fecal specimens from outbreaks of gastroenteritis. J Clin Microbiol 32: 642–648PubMedGoogle Scholar
  44. 44.
    Numata K, Nakata S, Jiang X, Estes MK, Chiba S (1994) Epidemiological study of Norwalk virus infections in Japan and Southeast Asia by enzyme-linked immunosorbent assays with Norwalk virus capsid protein produced by the baculovirus expression system. J Clin Microbiol 32: 121–126PubMedGoogle Scholar
  45. 45.
    Okada S, Sekine S, Ando T, Hayeshi Y, Murao M, Yabuuchi K, Miki T, Ohashi M (1990) Antigenic characterization of small, round, structured viruses by immune electron microscopy. J Clin Microbiol 28: 1244–1248PubMedGoogle Scholar
  46. 46.
    Parker S, Cubitt D, Jiang JX, Estes M (1993) Efficacy of a recombinant Norwalk virus protein enzyme immunoassay for the diagnosis of infections with Norwalk virus and other human ‘candidate’ caliciviruses: J Med Virol 41: 179–184PubMedCrossRefGoogle Scholar
  47. 47.
    Parker SP, Cubitt WD, Jiang X (1995) Enzyme immunoassay using baculovirus-expressed human calicivirus (Mexico) for the measurement of IgG responses and determining its seroprevalence in London, UK. J Med Virol 46: 194–200PubMedCrossRefGoogle Scholar
  48. 48.
    Parker SP, Cubitt WD, Jiang X, Estes MK (1993) Efficacy of a recombinant Norwalk virus protein enzyme immunoassay for the diagnosis of infection with Norwalk virus and other “candidate” caliciviruses. J Med Virol 41: 108–118CrossRefGoogle Scholar
  49. 49.
    Parker SP, Cubitt WD, Jiang XJ, Estes MK (1994) Seroprevalence studies using a recombinant Norwalk virus protein enzyme immunoassay. J Med Virol 42: 146–150PubMedCrossRefGoogle Scholar
  50. 50.
    Sosnovtsev S, Green KY (1995) RNA transcripts derived from a cloned full-length copy of the feline calicivirus genome do not require VPg for infectivity. Virology 210: 383–390PubMedCrossRefGoogle Scholar
  51. 51.
    Studdert MJ, Martin MC, Peterson JE (1970) Viral diseases of the respiratory tract of cats: Isolation and properties of viruses tentatively classified as picornaviruses. Am J Vet Res 31: 1723–1732PubMedGoogle Scholar
  52. 52.
    Thornhill TS, Wyatt RG, Kalica AR, Dolin R, Chanock RM, Kapikian AZ (1977) Detection by immune electron microscopy of 26–27 mm virus-like particles associated with two family outbreaks of gastroenteritis. J Infect Dis 135: 20–27PubMedCrossRefGoogle Scholar
  53. 53.
    Viral Gastroenteritis Sub-committee of the PHLS Virology Committee (1993) Outbreaks of gastroenteritis associated with SRSVs. PHLS Microbiol Dig 10: 2–8Google Scholar
  54. 54.
    Wang J, Jiang X, Madore P, Gray J, Desselberger U, Ando T, Seto Y, Oishi I, Lew J, Green K, Estes M (1994) Sequence diversity of small, round-structured viruses in the Norwalk virus group. J Virol 68: 5982–5990PubMedGoogle Scholar
  55. 55.
    Wyatt RG, Dolin R, Blacklow NR (1974) Comparison of three agents of acute infectious nonbacterial gastroenteritis by cross-challenge in volunteers. J Infect Dis 129: 709–714PubMedCrossRefGoogle Scholar
  56. 56.
    Wyatt RG, Greenberg HB, Dalgard DW, Allen WP, Sly DL, Thornhill TS, Chanock RM, Kapikian AZ (1978) Experimental infection of chimpanzees with the Norwalk agent of epidemic viral gastroenteritis. J Med Virol 2: 89–96PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 1997

Authors and Affiliations

  • K. Y. Green
    • 1
    • 2
  1. 1.Laboratory of Infectious DiseasesNational Institute of Allergy and Infectious Diseases, National Institutes of HealthBethesdaUSA
  2. 2.National Institutes of HealthBethesdaUSA

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