Genetic Diversity and Distribution of Human Norovirus in China (1999-2011)

Noroviruses (NoVs) are a leading cause of epidemic and sporadic acute gastroenteritis worldwide. However, the genetic diversity and geographical distribution of NoV isolates from China have not been well described thus far. In this study, all NoV sequences obtained in China from 1999 to 2011 (n = 983), both partial and complete genomes, were downloaded from GenBank. Genotyping and phylogenetic and recombination analyses were performed in order to gain a better understanding of the distribution and genetic diversity of NoVs in China. The results indicated that approximately 90% of NoV sequences were obtained from the coastal regions of China, and most of the NoV sequences from distinct geographical regions appeared to be closely related. GII. 4 was the most prevalent genotype, accounting for 64.4% of all genotypes, followed by GII. 12 (13.9%) and GII. 3 (7.0%). Over the last decade, the GII. 4 variants were dominated by successive circulation of GII. 4/2002, GII. 4/2004, GII. 4/2006b, and GII. 4/2008, with GII. 4/2006b continuing to date. A relatively high frequency of NoV intergenotype recombinants was identified. The most common ORF1/ORF2 intergenotype recombinant was GII. 12/GII. 4 (n = 11), and the relative frequency was up to 30% among all the recombinant strains (n = 36). These findings may aid in the evaluation and implementation of appropriate measures for monitoring NoV infectious diseases in China.