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Application of a multiplex salivary immunoassay to detect sporadic incident norovirus infections in a prospective community study
Citation:
Wade, Tim, S. Griffin, A. Egorov, E. Sams, E. Hudgens, S. Deflorio-Barker, T. Plunkett, A. Dufour, J. Styles, AND K. Oshima. Application of a multiplex salivary immunoassay to detect sporadic incident norovirus infections in a prospective community study. Society for Epidemiologic Research, Baltimore, Maryland, June 19 - 22, 2018.
Impact/Purpose:
Salivary immuonassays are a cost-effective, feasible approach to study norovirus infection in large cohorts.
Description:
Norovirus is one of the most common causes of gastroenteritis. Following infection, anti-norovirus salivary immunoglobulin G (IgG) rises steeply within 2 weeks and remains elevated for several months; this immunoconversion can serve as an indicator of infection. We used a multiplex salivary immunoassay to detect incident norovirus infections in a cohort of 484 visitors to a beach on Lake Michigan in 2015. Saliva was collected on the day of the beach visit (S1); after 10-12 days (S2); and after 3-5 weeks (S3). Luminex microspheres were coupled to recombinant antigens of genogroup I (GI) and II (GII) noroviruses and incubated with saliva. Immunoconversion was defined as at least 4-fold increase in anti-norovirus IgG antibody response (median fluorescence intensity, MFI) from S1 to S2 and a 3-fold increase from S1 to S3 with a minimum S2 MFI above the 75th percentile prediction interval of a cubic spline regression of MFI on age. Ten participants (2.1%) immunoconverted: 5 to GI norovirus (1%); 8 to GII (1.7%); and 3 to both. Four of the 10 participants (40%) reported at least one gastrointestinal symptom; diarrhea was the symptom most strongly associated with immunoconversion (OR=5.4, 95% CI 1.3-22.5). Participants 10-18 years old had the highest incidence of immunoconversion (5%). White race and greater household size were moderately (p<0.1) associated with immunoconversion; however, swimming during the beach visit was not (aOR=1.4, 95% CI 0.15-12.3). Although the sample size was insufficient to fully examine risk factors, this study demonstrated that the salivary immunoassay can be used to study norovirus epidemiology in a community. Furthermore, because saliva is simple, painless and inexpensive to collect, this approach is an efficient and novel way to study infectious agents in large cohorts. This abstract does not reflect EPA policy.