Norovirus is commonly associated with food and waterborne outbreaks. Genetic susceptibility to norovirus is largely dependent on presence of histo-blood group antigens (HBGA), specifically ABO, secretor, and Lewis phenotypes. The aim of the study was to determine the association between HBGAs to norovirus susceptibility during a large norovirus foodborne outbreak linked to genotype GII.6 in an office-based company in Stockholm, Sweden, 2015. A two-episode outbreak with symptoms of diarrhea and vomiting occurred in 2015. An online questionnaire was sent to all 1109 employees that had worked during the first outbreak episode. Food and water samples were collected from in-house restaurant and tested for bacterial and viral pathogens. In addition, fecal samples were collected from 8 employees that had diarrhea. To investigate genetic susceptibility during the outbreak, 98 saliva samples were analyzed for ABO, secretor, and Lewis phenotypes using ELISA. A total of 542 of 1109 (49%) employees reported gastrointestinal symptoms. All 8 fecal samples tested positive for GII norovirus, which was also detected in coleslaw collected from the in-house restaurant. Eating at the in-house restaurant was significantly associated with risk of symptom development. Nucleotide sequencing was successful for 5/8 fecal samples and all belonged to the GII.6 genotype. HBGA characterization showed a strong secretor association to norovirus-related symptoms (P = 0.014). No association between norovirus disease and ABO phenotypes was observed. The result of this study shows that non-secretors were significantly less likely to report symptoms in a large foodborne outbreak linked to the emerging GII.6 norovirus strain.

中文翻译：

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在大型GII.6诺如病毒食源性暴发中，分泌者的地位与疾病的易感性有关。

诺如病毒通常与食物和水传播疾病有关。诺如病毒的遗传易感性在很大程度上取决于组织血型抗原（HBGA）的存在，特别是ABO，分泌物和Lewis表型。该研究的目的是确定与基因型GII.6相关的大型诺如病毒食源性暴发期间HBGA与诺如病毒易感性之间的关联。这是一家总部设在瑞典斯德哥尔摩的办公室公司，2015年。两次发作的腹泻和腹泻症状呕吐发生在2015年。在线问卷已发送给在第一次疫情发作期间工作的所有1109名员工。从内部餐厅收集食物和水样本，并测试细菌和病毒病原体。此外，还从8名有腹泻的雇员那里收集了粪便样本。为了调查暴发期间的遗传易感性，使用ELISA分析了98个唾液样本的ABO，分泌物和Lewis表型。1109名员工中有542名（49％）员工报告了胃肠道症状。所有8个粪便样品均检测出GII诺如病毒呈阳性，这也从从内部餐厅收集的凉拌卷心菜中检测到。在室内餐厅进餐与症状发展的风险显着相关。核苷酸测序成功用于5/8粪便样品，并且都属于GII.6基因型。HBGA表征显示出与诺如病毒相关症状的强烈分泌物关联（所有8个粪便样品均检测出GII诺如病毒呈阳性，这也从从内部餐厅收集的凉拌卷心菜中检测到。在室内餐厅进餐与症状发展的风险显着相关。核苷酸测序成功用于5/8粪便样品，并且都属于GII.6基因型。HBGA表征显示出与诺如病毒相关症状的强烈分泌物关联（所有8个粪便样品均检测出GII诺如病毒呈阳性，这也从从内部餐厅收集的凉拌卷心菜中检测到。在室内餐厅进餐与症状发展的风险显着相关。核苷酸测序成功用于5/8粪便样品，并且都属于GII.6基因型。HBGA表征显示出与诺如病毒相关症状的强烈分泌物关联（P  = 0.014）。没有观察到诺如病毒疾病和ABO表型之间的关联。这项研究的结果表明，在与新出现的GII.6诺如病毒株有关的大规模食源性疾病暴发中，非分泌者报告症状的可能性大大降低。