Laboratory Evidence of Norwalk Virus Contamination on the Hands of Infected Individuals

• Type of Material: Article
• Authors: Pengbo Liu, Emory University; Blanca Escudero, North Carolina State University; Lee-Ann Jaykus, North Carolina State University; Julia Montes, Emory University; Rebecca M. Goulter, North Carolina State University; Meredith Lichtenstein, Emory University; Marina Fernandez, Emory University; Joong-Chul Lee, Emory University; Elizabeth De Nardo, Gojo Industries Inc.; Amy Kirby, Emory University; James W. Arbogast, Gojo Industries Inc.; Christine L Moe, Emory University
• Language: English
• Date: 2013-12
• Publisher: American Society for Microbiology
• Publication Version: Final Published Version
• Copyright Statement: © 2013, American Society for Microbiology. The authors have paid a fee to allow immediate free access to this article.
• Final Published Version (URL): http://aem.asm.org/content/79/24/7875
• Title of Journal or Parent Work: Applied and Environmental Microbiology
• ISSN: 0099-2240
• Volume: 79
• Issue: 24
• Start Page: 7875
• End Page: 7881
• Grant/Funding Information: Partial funding was also provided by a Food Virology Collaborative grant (no. 1111-2011-0494) from the National Institute of Food and Agriculture (NIFA) at the U.S. Department of Agriculture (USDA).; This work was supported by Gojo Industries, Inc.
• Research Categories: Environmental Sciences; Health Sciences, Public Health

Abstract

Human norovirus (NoV) outbreak investigations suggest that the hands of infected individuals play an important role in NoV transmission. However, there is no experimental evidence documenting the likelihood and degree of NoV contamination on hands. As part of a clinical trial designed to evaluate the efficacy of high-pressure processing for Norwalk virus (NV) inactivation in oysters, 159 hand rinse samples were collected from 6 infected and 6 uninfected subjects. NV was concentrated from the samples by polyethylene glycol precipitation, followed by RNA extraction using an automated guanidinium isothiocyanate-silica method. NV RNA was detected and quantified using multiple NV-specific reverse transcription-quantitative PCR (RT-qPCR) assays. A total of 25.4% (18/71) of the hand rinse samples collected from 6 infected volunteers were presumptively positive for NV, with an average of 3.86 log10 genomic equivalent copies (GEC) per hand. Dot blot hybridization of PCR products obtained using a different primer set, and DNA sequencing of selected amplicons, provided further confirmation of the presence of NV in the hand rinses. NV contamination was also detected in two hand rinse samples obtained from one uninfected subject. These findings provide definitive evidence of NV contamination on the hands of infected subjects observed under controlled clinical research conditions. Such data support the need for better hand hygiene strategies to prevent NoV transmission.