Detection of norovirus in mouthwash samples from patients with acute gastroenteritis.

Abstract

BACKGROUND:

Norovirus infection is characteristically associated with vomiting which is known to contain a high concentration of viral particles. The oral cavity is therefore likely to become contaminated with norovirus during episodes of gastroenteritis.

OBJECTIVE:

To investigate the oral detection of norovirus in patients with norovirus gastroenteritis.

STUDY DESIGN:

Faecal and oral mouthwash samples were collected in two separate settings. In the first setting, samples were collected repeatedly over a 3-week period from six family members experiencing a domestic outbreak of norovirus gastroenteritis. Secondly, samples were collected at a single time point following disease onset from 59 patients hospitalised with norovirus gastroenteritis. Norovirus detection in oral and faecal samples was undertaken by RT-PCR.

RESULTS:

In the family study, norovirus was detected in early morning mouthwash samples for 10-15 days following disease onset from each of six family members. In the hospital study, 14/59 hospitalised adults with norovirus infection had norovirus detected in mouthwashes (24%; 14-37% 95% C.I.). For the hospitalised adults, the detection of norovirus in mouthwash samples was associated with the presence of vomiting (p=0.1); and in those patients with norovirus infection whose mouthwash samples were collected within 24h of the onset of vomiting, 59% (10/17) had norovirus detected.

CONCLUSIONS:

Oral mouthwashes may provide an adjunct to faecal sampling to support the diagnosis of norovirus infection. The detection of norovirus in orally-derived material raises the possibility of oral-to-oral norovirus transmission, and that this potential for transmission may extend beyond the immediate symptomatic period.

• Authors: Andrew Kirby, Winifred Dove, Lynne Ashton, Mark Hopkins, Nigel A Cunliffe
• Journal: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology (J Clin Virol) Vol. 48 Issue 4 Pg. 285-7 (Aug 2010) ISSN: 1873-5967 [Electronic] Netherlands
• PMID: 20637439 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2010 Elsevier B.V. All rights reserved.

Chemical References

• RNA, Viral

Topics

• Adult
• Aged
• Aged, 80 and over
• Caliciviridae Infections (virology)
• Feces (virology)
• Gastroenteritis (virology)
• Humans
• Middle Aged
• Mouth (virology)
• Norovirus (genetics, isolation & purification)
• RNA, Viral (genetics, isolation & purification)
• Reverse Transcriptase Polymerase Chain Reaction
• Therapeutic Irrigation