International Research Journal of Biochemistry and Bioinformatics (ISSN-2250-9941) Vol. 1(6) pp. 131-138, July, 2011 Available online http://www.interesjournals.org/IRJBB Copyright © 2011 International Research Journals Full length Research Paper Molecular isolation of human norovirus and astrovirus in tap water by RT- PCR Julius Tieroyaare Dongdem 1*, Susan Damanka 2 and Richard Asmah 3 1Department of Medical Biochemistry, School of Medicine and Health Sciences. University for Development Studies, Tamale. Ghana 2Department of Electron Microscopy and Histopathology. Noguchi Memorial Institute for Medical Research, Legon, Ghana 3 School of Allied Health Science, Korle Bu Teaching Hospital. Accra, Ghana Accepted 7 July, 2011 Viral gastroenteritis is responsible for pediatric morbidity and mortality, time loss and also an economic burden in developing countries. Norovirus is known to cause 90% of all epidemic non- bacterial outbreaks worldwide. Astroviruses are second only to rotavirus as cause of viral gastroenteritis worldwide. Nevertheless, in most diarrheal cases, neither norovirus nor astrovirus is routinely screened for in stool or environmental samples, thus, data on health impact of waterborne disease is lacking in developing countries like Ghana. Since the presence of these viruses in drinking water are potential health threats, the aim of this study was to collect water samples within the distribution network of the Weija Water Works and test for norovirus and astrovirus contamination using molecular methods. Two litres of each sample was concentrated 4,000 fold. Viral ssRNA was extracted from all concentrates by the phenol /chloroform method and purified with the RNaid ® kit. Ten samples which had previously tested positive for rotaviruses were selected for norovirus and astrovirus detection. Each sample was reverse transcribed, amplified by PCR and analyzed by gel electrophoresis. Norovirus GII type was not detected. Four and three out of the ten samples tested positive for GI norovirus and astrovirus respectively. By virtue of molecular weight, we isolated different strains of norovirus and one strain type of astrovirus. The level of viral contamination increased particularly at the region furthest from the treatment plant. Keywords: Detection, norovirus, astrovirus, Diarrhea, Ghana, Tap water, RT-PCR INTRODUCTION Acute viral gastroenteritis is a very common illness that is Clinical manifestation of acute viral gastroenteritis is not only responsible for particularly pediatric morbidity variable. Generally, it is self limiting, has an explosive and mortality, but also a great deal of time loss from onset and is manifested by varying combinations of school and work. Though less harmful to adults, diarrhea, nausea, vomiting, low grade fever, abdominal gastroenteritis also represents an economic burden in cramps, headache, anorexia, myalgia and malaise (Khan developing countries. Over a billion diarrheal cases occur et al., 1992). Other symptoms include loss of taste, each year among children below five years resulting in general lethargy, weakness, muscle aches, dehydration approximately 2.5 million deaths (O'Ryan et al., 2005). and Loss of weight. Viral gastroenteritis however, affects all age groups Both human norovirus and astrovirus have also been worldwide and occurs in both endemic and epidermic implicated in the aetiology of viral gastroenteritis aside forms (Blacklow et al., 1981). rotavirus and adenovirus. Norovirus is an RNA virus and belongs to the family Caliciviridae which causes approximately 90% of epidemic non-bacterial outbreaks *Corresponding author E-mail: [email protected]; Tel: of gastroenteritis worldwide (Lindesmith et al., 2003). 0233-20-4442691, 0233-24-4718710 Norovirus is responsible for 50% of all foodborne 132 Int. Res. J. Biochem. Bioinform. outbreaks of gastroenteritis in the U.S (Widdowson et al., According to Branswell (2008), the waterborne outbreaks 2005). Noroviruses are now considered to be the most of norovirus that occur are typically due to drinking water common cause of outbreaks of acute gastroenteritis sources in which chlorination or other disinfection worldwide (Lindesmith, 2003). Most outbreaks are systems have broken down, or in recreational situations triggered by contamination of food by an infected food in which either disinfection breaks down or chlorination handler. Norovirus outbreaks can affect persons of all breaks down in the case of a swimming pool. ages and occur in a wide variety of settings e.g., nursing The genus astrovirus on the other hand, has been homes, hospitals, restaurants, communities, schools, day classified within the newly established Astroviridae family. care centers, military barracks, cruise ships, etc. Even though several studies have revealed the public (Widdowson et al, 2005). Although waterborne outbreaks health significance of human astrovirus (HAstV), very are far less common than foodborne outbreaks, little is understood about the epidemiology of this virus. gastroenteritis outbreaks attributable to norovirus Astroviruses were first observed by electron microscopy infections have been reliably linked to sources of in stool specimens from infants with gastroenteritis contaminated water including municipal water, well water, (Appleton and Higgins, 1975). Like noroviruses, stream water, commercial ice, lake water and swimming astroviruses are now recognized as important aetiological pool water which has not been investigated in most sub agents of viral gastroenteritis in all age groups. In fact, Saharan African countries like Ghana. One such study the development of RT-PCR has revealed that looked for patterns that might explain norovirus outbreaks astroviruses are second only to rotavirus as the most in Toronto. It was found that winter flare ups of the highly common cause of viral gastroenteritis in children contagious condition were more likely to happen in the worldwide (Cruz et al., 1992; Glass et al., 1996; week after water temperatures in Lake Ontario dipped Herrmann et al, 1991; Lew et al., 1991). Also, the below 4 ⁰C or flow from the Don river into Lake Ontario impending licensing of a rotavirus vaccine (Tucker et al., was high (Branswell, 2008). The findings suggested that 1998) may lead to astrovirus becoming the primary cause under certain environmental conditions, noroviruses from of viral gastroenteritis among young children in the near human sewage may proliferate in bodies of water that are future. However, in most diarrheal cases, astrovirus is used both as municipal water sources and sewage neither routinely screened for in stool samples nor in treatment outlets, eventually finding their way back into environmental samples. Also, data on the health impact the human gastrointestinal tracts through drinking water of waterborne astrovirus is lacking especially in (Branswell, 2008). Other waterborne outbreaks were developing countries like Ghana. investigated in Finland for viruses. The diagnostic Large outbreaks of astrovirus diarrhea are described procedure included analysis of patients' stool samples by with increasing incidence (Oishi et al, 1994). In July 2001, electron microscopy and RT-PCR for noroviruses and an outbreak of gastroenteritis occurred in Helsinki among astroviruses. Epidemiological studies discovered that, of children and adults after bathing in an outdoor wading the 41 waterborne outbreaks reported during the pool. Epidemiological survey revealed that at least 242 observation period (1998 - 2003), samples from 28 persons were affected. Microbiological testing of both outbreaks which were available for analysis showed that patient stool samples and of the pool water revealed the noroviruses caused 18 outbreaks (CDC, 2001). During presence of two different gastroenteritis viruses: a fall 2008, 3 norovirus outbreaks occurring on college norovirus and an astrovirus (Maunula et al., 2004). campuses in California, Michigan and Wisconsin were Mitchell et al.(1995) evaluated astrovirus as a cause of reported by Roberts et al., 2009. Public health diarrheal outbreaks among infants and toddlers in day investigations led by the respective state and local health care centers. Astrovirus was detected in 6 (7%) of the 81 departments to characterize the extent of the outbreaks outbreaks investigated and concluded that astrovirus is resulted in approximately 1,000 cases of reported illness an important cause of outbreaks of diarrhea among including at least 10 hospitalizations and prompted children attending day care centers, more frequently closure of one of the 3 campuses (Roberts et al., 2009). infecting younger children and often produced The number of deaths from norovirus in the U.S is asymptomatic infections. estimated to be about 300 yearly, most of which occur in Current analytic methods do not authorize direct young children, elderly and persons with weakened monitoring of norovirus and astrovirus in treated drinking immune systems. Severe illness is rare however, water nor are they enforced by quality monitoring bodies. symptoms may become life-threatening in these groups if Indicator organisms e.g. coliform bacteria, have been dehydration is ignored or untreated (Goodgame, 2006). used as proxy indicators of fecal contamination. In most cases, contamination occurs almost exclusively However, the size, physiology and susceptibility of by sewage that contains enteric pathogens. Enteric bacterial indicators to physical treatment and disinfection viruses that affect humans are mostly species-specific. differ