Molecular Epidemiology of Norovirus Outbreaks in Food-Catering Facilities in Busan,  2021–2024

Hee-Soo Koo; Hyeon-Jin Kim; Seon-Young Kim; Jung-Hye Choi; Byung-Jun Kim

doi:10.4167/jbv.2025.55.4.360

All Issue

2025 Vol.55, Issue 4 Preview Page Next Page

Original Article

Molecular Epidemiology of Norovirus Outbreaks in Food-Catering Facilities in Busan, 2021–2024

31 December 2025. pp. 360-369

PDF XML

Abstract

Norovirus is the leading cause of foodborne illness outbreaks worldwide and represents a significant public health concern. Highly contagious and responsible for acute gastroenteritis, norovirus spreads rapidly through contaminated food, water, and direct person-to-person contact. Owing to extensive genetic diversity, individuals may experience repeated infections, with limited cross-protection across genotypes. This study investigated the molecular epidemiology of norovirus outbreaks in food-catering facilities in Busan, Korea, from 2021 to 2024. Among 1,546 stool specimens analyzed, 394 (25.5%) tested positive, comprising 19 genogroup I (4.8%) and 375 genogroup II (95.2%) strains, which represented 12 genotypes (5 GI and 7 GII). Outbreaks occurred most frequently in childcare centers, elementary schools, and kindergartens. Although annual variation in genotype prevalence was observed, GII.4 remained the predominant strain throughout the study period. In 2024, GII.7 was identified for the first time, consistent with strains detected in patients with acute diarrhea in Busan, and GII.17—previously responsible for large outbreaks more than a decade earlier—also re-emerged. These findings underscore the dynamic circulation of norovirus genotypes in community settings and highlight the importance of continuous molecular surveillance. Such efforts are essential for the early detection of emerging variants, improved outbreak prevention, and the development of effective vaccines targeting persistent and high-burden genotypes such as GII.4.

Keywords

Norovirus

Foodborne outbreaks

Genotype surveillance

GII.7

References

Patel MM, Hall AJ, Vinje J, Parashar UD. Noroviruses a comprehensive review. J Clin Virol. 2009;44:1-8.

10.1016/j.jcv.2008.10.009

Pires SM, Fischer‐Walker CL, Lanata CF, Devleesschauwer B, Hall AJ, Kirk MD, et al. Aetiology‐specific estimates of the global and regional incidence and mortality of diarrhoeal diseases commonly transmitted through food. PLoS One. 2015;10(12):e0142927.

10.1371/journal.pone.014292726632843PMC4668836

Jiang X, Wang M, Wang K, Estes MK. Sequence and genomic organization of Norwalk virus, Virology. 1993;195(1):51-61.

10.1006/viro.1993.1345

Lee SG, Cho HG, Paik SY. Molecular epidemiology of norovirus in South Korea. BMB Rep. 2015;48(2):61-67.

10.5483/BMBRep.2015.48.2.25425441425PMC4352615

Chhabra P, de Graaf M, Parra GI, Chan MC, Green K, Martella V, et al. Updated classification of norovirus genogroups and genotypes, J Gen Virol. 2019;100(10):1393-1406.

10.1099/jgv.0.00131831483239PMC7011714

Atmar RL, Ramani S, Estes MK. Human noroviruses: recent advances in a 50-year history. Curr Opin Infect Dis. 2018;31(5):422-432.

10.1097/QCO.0000000000000476

Yu F, Jiang B, Guo X, Hou L, Tian Y, Zhang J, et al. Norovirus outbreaks in China, 2000-2018: A systematic review. Rev Med Virol. 2022;32(6):e2382.

10.1002/rmv.2382

van Beek J, de Graaf M, Al-Hello H, Allen DJ, Ambert-Balay K, Botteldoorn N, et al. Molecular surveillance of norovirus, 2005-16: an epidemiological analysis of data collected from the NoroNet network. Lancet Infect Dis. 2018;18(5):545-553.

10.1016/S1473-3099(18)30059-8

Dinu S, Nagy M, Negru DG, Popovici ED, Zota L, Oprișan G. Molecular identification of emergent GII.P17-GII.17 norovirus genotype, Romania, 2015. Euro Surveill. 2016;21(7):30141.

10.2807/1560-7917.ES.2016.21.7.30141

Koo HS, Lee MO, Ku PT, Hwang SJ, Park DJ, Baik HS. Molecular epidemiology of norovirus in asymptomatic food handlers in Busan, Korea, and emergence of genotype GII.17. J Microbiol. 2016;54(10):686-694.

10.1007/s12275-016-6312-4

Dey SK, Nguyen TA, Phan TG, Nishio O, Salim AF, Rahman M, et al. Molecular and epidemiological trend of norovirus associated gastroenteritis in Dhaka City, Bangladesh. J Clin Virol. 2007;40(3):218-223.

10.1016/j.jcv.2007.08.005

Guntapong R, Hansman GS, Oka T, Ogawa S, Kageyama T, Pongsuwanna Y, et al. Norovirus and sapovirus infections in Thailand. Jpn J Infect Dis. 2004;57(6):276-278.

10.7883/yoken.JJID.2004.276

Green KY. Caliciviridae: The Noroviruses, In: Fields Virology. 5th ed. Lippincott Williams & Wilkins, Philadelphia, 2007. p.949-980.

Park Y, Jang H, Jang J, Park JH. Person-to-Person Transmission During a Norovirus Outbreak in a Korean Kindergarten: A Retrospective Cohort Study. Children (Basel). 2025;12(8):1027.

10.3390/children1208102740868479PMC12384608

Cho SR, Chae SJ, Jung SY, Choi WY, Han MG, Yoo CK, et al. Trends in acute viral gastroenteritis among children aged ≤5 years through the national surveillance system in South Korea, 2013–2019. J Med Virol. 2021;93(8):4875-4882.

10.1002/jmv.2668533219526PMC8360024

Kumar S, Stecher G, Suleski M, Sanderford M, Sharma S, Tamura K. MEGA12: Molecular Evolutionary Genetic Analysis Version 12 for Adaptive and Green Computing. Mol Biol Evol. 202441(12):msae263.

Hur ES, Jeong IH, Kwon SM, Kang MS, Park SJ, Lee YH, et al. Trends in Norovirus Distribution among the Children of Childcare Center. J Bacteriol Virol. 2023;53(1):11-18.

10.4167/jbv.2023.53.1.011

Cannon JL, Bonifacio J, Bucardo F, Buesa J, Bruggink L, Chan MC, et al. Global Trends in Norovirus Genotype Distribution among Children with Acute Gastroenteritis. Emerg Infect Dis. 2021;27(5):1438-1445.

10.3201/eid2705.20475633900173PMC8084493

Matsushima Y, Ishikawa M, Shimizu T, Komane A, Kasuo S, Shinohara M, et al. Genetic analyses of GII.17 norovirus strains in diarrheal disease outbreaks from December 2014 to March 2015 in Japan reveal a novel polymerase sequence and amino acid substitutions in the capsid region. Euro Surveill. 2015;20(26):21173.

10.2807/1560-7917.ES2015.20.26.21173

Available at https://www.cdc.gov/norovirus/php/reporting/calicinet-data.html [accessed on 28 October 2025].

Kim SY. Surveillance report of waterborne and foodborne pathogens in Korea, 2024. The Annual Report of Busan Metropolitan City Institute of Health & Environment. 2025. p.12-17

Yin X, Xiao S, Zhang X, Ruan F. Social network analysis of a norovirus outbreak at a primary school—Zhuhai City, Guangdong Province, China, 2023. China CDC Wkly. 2024;6(44):1142-1146.

10.46234/ccdcw2024.23239553343PMC11561375

Barclay L, Vinjé J. Increasing Predominance of Norovirus GII.17 over GII.4, United States, 2022-2025. Emerg Infect Dis. 2025;31(7):1471-1473.

10.3201/eid3107.25052440456181PMC12205451

Novazzi F, Lai A, Boi M, Ceriani MP, Castillo GD, Villa S, et al. Large norovirus GII.17 outbreak in a school in northern Italy: a novel emerging sublineage within an emerging genotype? Int J Infect Dis. 2025:108185.

10.1016/j.ijid.2025.108185

Carlson KB, Dilley A, O’Grady T, Johnson JA, Lopman B, Viscidi E. A narrative review of norovirus epidemiology, biology, and challenges to vaccine development. NPJ Vaccines. 2024;9(1):94.

10.1038/s41541-024-00884-238811605PMC11137017

Havumaki J, Eisenberg JNS, Mattison CP, Lopman BA, Ortega-Sanchez IR, Hall AJ, et al. Immunologic and epidemiologic drivers of norovirus transmission in daycare and school outbreaks. Epidemiology. 2021;32(3):351-359.

10.1097/EDE.000000000000132233652444PMC11457302

Information

Publisher :The Korean Society for Microbiology and The Korean Society of Virology
Publisher(Ko) :대한미생물학회‧대한바이러스학회
Journal Title :JOURNAL OF BACTERIOLOGY AND VIROLOGY
Volume : 55
No :4
Pages :360-369
Received Date : 2025-09-11
Revised Date : 2025-10-29
Accepted Date : 2025-11-13
DOI :https://doi.org/10.4167/jbv.2025.55.4.360

JOURNAL OF BACTERIOLOGY AND VIROLOGY ISSN:1598-2467(Print) 2093-0429(Online)

All Issue