ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Prospective, Real-time Metagenomic Sequencing During Norovirus Outbreak Reveals Discrete Transmission Clusters.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Healthcare-Associated Gastroenteritis: Outbreak Report and Systematic Review of the Literature.Journal of the Pediatric Infectious Diseases Society · 2025Pooled it
- Using molecular methods to delineate norovirus outbreaks: a systematic review.Archives of virology · 2024Pooled it
- Associations of infection control measures and norovirus outbreak outcomes in healthcare settings: a systematic review and meta-analysis.Expert review of anti-infective therapy · 2022Pooled it
- Small Epidemic Outbreak of Norovirus in the Pediatric Department of Brescia Civic Hospital (Northern Italy): Genomic Characterization and Phylogenetic Analysis.The Pediatric infectious disease journal · 2026Article
- Unraveling the Transmission Dynamics of a Novel Norovirus GII.17[P17] Lineage During Two Consecutive Outbreaks in a Spanish Hospital.Journal of medical virology · 2026Article
- Prediction of genetic relatedness ofAntimicrobial agents and chemotherapy · 2026Article
- Acute Respiratory Infections (ARIs): Current Etiological Perspectives and Advances in Viral Metagenomics-A Review.Viruses · 2025Review
- INTRA- AND INTER-HOST EVOLUTION OF HUMAN NOROVIRUS IN HEALTHY ADULTS.bioRxiv : the preprint server for biology · 2024Article
- Empowering public health: building advanced molecular surveillance in resource-limited settings through collaboration and capacity-building.Frontiers in health services · 2024Article
- Complex norovirus transmission dynamics at hospital wards revealed by deep sequencing.Journal of clinical microbiology · 2023Article
- The clinical value of metagenomic next-generation sequencing for rapid microbial identification of chronic granulation wound infections.Archives of medical science : AMS · 2023Article
- Performance of mNGS in bronchoalveolar lavage fluid for the diagnosis of invasive pulmonary aspergillosis in non-neutropenic patients.Frontiers in cellular and infection microbiology · 2023Article
- An increase in prevalence of recombinant GII.3[P12] norovirus in sporadic acute diarrhea in children in Nizhny Novgorod, Russia, 2018-2021.Virus genes · 2022Article
- NGSocomial Infections: High-Resolution Views of Hospital-Acquired Infections Through Genomic Epidemiology.Journal of the Pediatric Infectious Diseases Society · 2021Review
- Acute Infectious Gastroenteritis: The Causative Agents, Omics-Based Detection of Antigens and Novel Biomarkers.Children (Basel, Switzerland) · 2021Review
- Norovirus Protease Structure and Antivirals Development.Viruses · 2021Review
- Informing antimicrobial management in the context of COVID-19: understanding the longitudinal dynamics of C-reactive protein and procalcitonin.BMC infectious diseases · 2021Article
- Genome-wide analyses of human noroviruses provide insights on evolutionary dynamics and evidence of coexisting viral populations evolving under recombination constraints.PLoS pathogens · 2021Article
- High Throughput Sequencing for the Detection and Characterization of RNA Viruses.Frontiers in microbiology · 2021Review
- Application of metagenomic next-generation sequencing technology for difficult lung lesions in patients with haematological diseases.Translational cancer research · 2020Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundNorovirus outbreaks in hospital settings are a common challenge for infection prevention teams. Given the high burden of norovirus in most communities, it can be difficult to distinguish between ongoing in-hospital transmission of the virus and new introductions from the community, and it is challenging to understand the long-term impacts of outbreak-associated viruses within medical systems using traditional epidemiological approaches alone.
methodsReal-time metagenomic sequencing during an ongoing norovirus outbreak associated with a retrospective cohort study.
resultsWe describe a hospital-associated norovirus outbreak that affected 13 patients over a 27-day period in a large, tertiary, pediatric hospital. The outbreak was chronologically associated with a spike in self-reported gastrointestinal symptoms among staff. Real-time metagenomic next-generation sequencing (mNGS) of norovirus genomes demonstrated that 10 chronologically overlapping, hospital-acquired norovirus cases were partitioned into 3 discrete transmission clusters. Sequencing data also revealed close genetic relationships between some hospital-acquired and some community-acquired cases. Finally, this data was used to demonstrate chronic viral shedding by an immunocompromised, hospital-acquired case patient. An analysis of serial samples from this patient provided novel insights into the evolution of norovirus within an immunocompromised host.
conclusionsThis study documents one of the first applications of real-time mNGS during a hospital-associated viral outbreak. Given its demonstrated ability to detect transmission patterns within outbreaks and elucidate the long-term impacts of outbreak-associated viral strains on patients and medical systems, mNGS constitutes a powerful resource to help infection control teams understand, prevent, and respond to viral outbreaks.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.