{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:43:35Z","timestamp":1790934215604,"version":"4.1.0"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Human norovirus is a major cause of acute gastroenteritis across all age groups. This study investigated the prevalence, genotypes, and viral loads of noroviruses in adult patients with acute gastroenteritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A hospital-based cross-sectional study was conducted between December 2021 and March 2023 in Thailand. The presence of noroviruses GI and GII in stool samples from patients with acute gastroenteritis were tested using RT-nested PCR and DNA sequencing. All norovirus GII-positive samples were further characterized by polymerase-capsid typing assay and semi-nested RT-PCR. Norovirus GII concentrations were determined by RT-qPCR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Norovirus GII was detected in 11.2% (28\/250) of stool samples. Genotyping of the VP1 and RdRp genes identified GII.4 Sydney 2012[P31], GII.17[P17], and GII.17[P16], with GII.17[P16] being the most frequently detected. Of 28 norovirus GII-positive samples, the most common genotype was GII.17 (35.7%), followed by GII.17[P16] (32.1%), GII.17[P17] (14.3%), GII.4 Den Haag (7.1%), and GII.4 Sydney 2012[P31], GII.3 and GII.2 (3.6% each). GII.4 Sydney[P31] infections had the highest viral load (8.3\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      genome copies\/g), followed by GII.17[P17] (8.9\u2009\u00d7\u200910\n                      <jats:sup>5\u2009<\/jats:sup>\n                      \u2212\u20094.5\u2009\u00d7\u200910\n                      <jats:sup>8<\/jats:sup>\n                      genome copies\/g) and GII.17[P16] (3.7\u2009\u00d7\u200910\n                      <jats:sup>4\u2009<\/jats:sup>\n                      \u2212\u20091.6\u2009\u00d7\u200910\n                      <jats:sup>7<\/jats:sup>\n                      genome copies\/g). GII.3 (2.4\u2009\u00d7\u200910\n                      <jats:sup>4<\/jats:sup>\n                      genome copies\/g), GII.4 Den Haag (1.7\u2009\u00d7\u200910\u2074 and 3.8\u2009\u00d7\u200910\u2074 genome copies\/g) and GII.17 (2.4\u2009\u00d7\u200910\u00b3\u20137.4\u2009\u00d7\u200910\u2074 genome copies\/g) exhibited lower viral concentrations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings provide important epidemiological insights into norovirus circulation, highlighting the emergence of GII.17[P16] and informing future outbreak preparedness and vaccine development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0337513","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T18:26:57Z","timestamp":1764008817000},"page":"e0337513","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Emergence of norovirus GII.17[P16] in adult patients with acute gastroenteritis in Thailand during 2021\u22122023"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3519-7862","authenticated-orcid":true,"given":"Leera","family":"Kittigul","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thongthiw","family":"Pairoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kitwadee","family":"Rupprom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuwanda","family":"Thongpanich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukhontha","family":"Siri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"issue":"12","key":"pone.0337513.ref001","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0142927","article-title":"Aetiology-specific estimates of the global and regional incidence and mortality of diarrhoeal diseases commonly transmitted through food","volume":"10","author":"SM Pires","year":"2015","journal-title":"PLoS One"},{"issue":"1","key":"pone.0337513.ref002","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1038\/s41541-024-00884-2","article-title":"A narrative review of norovirus epidemiology, biology, and challenges to vaccine development","volume":"9","author":"KB Carlson","year":"2024","journal-title":"NPJ Vaccines"},{"issue":"10","key":"pone.0337513.ref003","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1099\/jgv.0.001318","article-title":"Updated classification of norovirus genogroups and genotypes","volume":"100","author":"P Chhabra","year":"2019","journal-title":"J Gen Virol"},{"issue":"1","key":"pone.0337513.ref004","doi-asserted-by":"crossref","DOI":"10.1002\/rmv.2237","article-title":"Global prevalence and genotype distribution of norovirus infection in children with gastroenteritis: a meta-analysis on 6 years of research from 2015 to 2020","volume":"32","author":"M Farahmand","year":"2022","journal-title":"Rev Med Virol"},{"key":"pone.0337513.ref005","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1186\/s12879-015-1315-z","article-title":"Increased norovirus activity was associated with a novel norovirus GII.17 variant in Beijing, China during winter 2014-2015","volume":"15","author":"Z Gao","year":"2015","journal-title":"BMC Infect Dis"},{"issue":"39","key":"pone.0337513.ref006","doi-asserted-by":"crossref","first-page":"2400625","DOI":"10.2807\/1560-7917.ES.2024.29.39.2400625","article-title":"Increased circulation of GII.17 noroviruses, six European countries and the United States, 2023 to 2024","volume":"29","author":"P Chhabra","year":"2024","journal-title":"Euro Surveill"},{"issue":"8","key":"pone.0337513.ref007","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.3390\/v15081682","article-title":"Prevalence of human norovirus GII.4 Sydney 2012 [P31] between 2019 and 2021 among young children from rural communities in South Africa","volume":"15","author":"R Khumela","year":"2023","journal-title":"Viruses"},{"issue":"1","key":"pone.0337513.ref008","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3390\/pathogens13010003","article-title":"Norovirus epidemiology and genotype circulation during the COVID-19 Pandemic in Brazil, 2019-2022","volume":"13","author":"SK Sarmento","year":"2023","journal-title":"Pathogens"},{"issue":"26","key":"pone.0337513.ref009","doi-asserted-by":"crossref","first-page":"21178","DOI":"10.2807\/1560-7917.ES2015.20.26.21178","article-title":"Emergence of a novel GII.17 norovirus \u2013 End of the GII.4 era?","volume":"20","author":"M de Graaf","year":"2015","journal-title":"Euro Surveill"},{"issue":"8","key":"pone.0337513.ref010","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.3201\/eid2308.161138","article-title":"Global spread of norovirus GII.17 Kawasaki 308, 2014-2016","volume":"23","author":"MCW Chan","year":"2017","journal-title":"Emerg Infect Dis"},{"issue":"6","key":"pone.0337513.ref011","doi-asserted-by":"crossref","first-page":"535","DOI":"10.3390\/v11060535","article-title":"Emerging novel GII.P16 noroviruses associated with multiple capsid genotypes","volume":"11","author":"L Barclay","year":"2019","journal-title":"Viruses"},{"issue":"7","key":"pone.0337513.ref012","first-page":"378","article-title":"Norovirus GII.17 gastroenteritis outbreak in a nursing home","volume":"43","author":"P Mart\u00edn Bazarra","year":"2025","journal-title":"Enferm Infecc Microbiol Clin (Engl Ed)"},{"issue":"2","key":"pone.0337513.ref013","doi-asserted-by":"crossref","first-page":"223","DOI":"10.3390\/v17020223","article-title":"Multi-province outbreak of acute gastroenteritis linked to potential novel lineage of GII.17 norovirus in Argentina in 2024","volume":"17","author":"KA Gomes","year":"2025","journal-title":"Viruses"},{"issue":"9","key":"pone.0337513.ref014","doi-asserted-by":"crossref","first-page":"102499","DOI":"10.1016\/j.jiph.2024.102499","article-title":"Epidemics and diversity of norovirus variants with acute gastroenteritis outbreak in Hongshan District, Wuhan City, China, 2021-2023","volume":"17","author":"D Xu","year":"2024","journal-title":"J Infect Public Health"},{"issue":"4","key":"pone.0337513.ref015","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1007\/s00705-023-05741-6","article-title":"Genome characterisation of norovirus GII.P17-GII.17 detected during a large gastroenteritis outbreak in Romania in 2021","volume":"168","author":"S Dinu","year":"2023","journal-title":"Arch Virol"},{"issue":"8","key":"pone.0337513.ref016","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s00705-025-06356-9","article-title":"Appearance and spread of norovirus genotype GII.17 subcluster C2 (Romania-2021 like) in Nizhny Novgorod, Russia, 2021-2023","volume":"170","author":"NV Epifanova","year":"2025","journal-title":"Arch Virol"},{"issue":"8","key":"pone.0337513.ref017","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.3201\/eid2508.190365","article-title":"Recombinant GII.Pe-GII.4 Norovirus, Thailand, 2017-2018","volume":"25","author":"W Chuchaona","year":"2019","journal-title":"Emerg Infect Dis"},{"issue":"3","key":"pone.0337513.ref018","doi-asserted-by":"crossref","DOI":"10.1128\/spectrum.00448-22","article-title":"Changing predominance of norovirus recombinant strains GII.2[P16] to GII.4[P16] and GII.4[P31] in Thailand, 2017 to 2018","volume":"10","author":"P Khamrin","year":"2022","journal-title":"Microbiol Spectr"},{"issue":"9","key":"pone.0337513.ref019","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/j.jiph.2022.08.006","article-title":"Molecular epidemiology and characterization of norovirus and sapovirus in pediatric patients with acute diarrhea in Thailand, 2019-2020","volume":"15","author":"P Phengma","year":"2022","journal-title":"J Infect Public Health"},{"issue":"4","key":"pone.0337513.ref020","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/j.virs.2024.05.010","article-title":"Diverse genotypes of norovirus genogroup I and II contamination in environmental water in Thailand during the COVID-19 outbreak from 2020 to 2022","volume":"39","author":"K Kumthip","year":"2024","journal-title":"Virol Sin"},{"issue":"1","key":"pone.0337513.ref021","doi-asserted-by":"crossref","first-page":"22240","DOI":"10.1038\/s41598-024-73369-w","article-title":"Surveillance of norovirus, SARS-CoV-2, and bocavirus in air samples collected from a tertiary care hospital in Thailand","volume":"14","author":"K Rupprom","year":"2024","journal-title":"Sci Rep"},{"issue":"1","key":"pone.0337513.ref022","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s12560-022-09508-1","article-title":"Detection of norovirus recombinant GII.2[P16] strains in oysters in Thailand","volume":"14","author":"L Kittigul","year":"2022","journal-title":"Food Environ Virol"},{"key":"pone.0337513.ref023","doi-asserted-by":"crossref","first-page":"104689","DOI":"10.1016\/j.jcv.2020.104689","article-title":"Single-step RT-PCR assay for dual genotyping of GI and GII norovirus strains","volume":"134","author":"P Chhabra","year":"2021","journal-title":"J Clin Virol"},{"key":"pone.0337513.ref024","doi-asserted-by":"crossref","first-page":"1373322","DOI":"10.3389\/fpubh.2024.1373322","article-title":"Global prevalence of norovirus gastroenteritis after emergence of the GII.4 Sydney 2012 variant: a systematic review and meta-analysis","volume":"12","author":"P Zhang","year":"2024","journal-title":"Front Public Health"},{"issue":"2","key":"pone.0337513.ref025","first-page":"78","article-title":"Norovirus infections in the Czech Republic in 2008-2020","volume":"71","author":"P Pazdiora","year":"2022","journal-title":"Epidemiol Mikrobiol Imunol"},{"key":"pone.0337513.ref026","article-title":"Norovirus disease among older adults","volume":"9","author":"H Tsai","year":"2022","journal-title":"Ther Adv Infect Dis"},{"issue":"1","key":"pone.0337513.ref027","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1186\/s12985-024-02498-5","article-title":"Prevalence and genotype distribution of norovirus in Ningxia Hui Autonomous Region, China, from 2011 to 2022","volume":"21","author":"J Ma","year":"2024","journal-title":"Virol J"},{"issue":"4","key":"pone.0337513.ref028","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1111\/jam.14201","article-title":"Occurrence of noroviruses in recycled water and sewage sludge: emergence of recombinant norovirus strains","volume":"126","author":"L Kittigul","year":"2019","journal-title":"J Appl Microbiol"},{"issue":"6","key":"pone.0337513.ref029","doi-asserted-by":"crossref","first-page":"002118","DOI":"10.1099\/jgv.0.002118","article-title":"The saga to monitor and control norovirus: the rise of GII.17","volume":"106","author":"GI Parra","year":"2025","journal-title":"J Gen Virol"},{"issue":"2","key":"pone.0337513.ref030","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1093\/cid\/ciy438","article-title":"Norovirus transmission dynamics in a pediatric hospital using full genome sequences","volume":"68","author":"JR Brown","year":"2019","journal-title":"Clin Infect Dis"},{"issue":"8","key":"pone.0337513.ref031","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1080\/23744235.2025.2479133","article-title":"Molecular epidemiology and evolution of norovirus in Australia and New Zealand, 2018 to 2020","volume":"57","author":"GJH Yan","year":"2025","journal-title":"Infect Dis (Lond)"},{"issue":"11","key":"pone.0337513.ref032","doi-asserted-by":"crossref","first-page":"4553","DOI":"10.1080\/21645515.2021.1961465","article-title":"Epidemiology and evolution of Norovirus in China","volume":"17","author":"N Wei","year":"2021","journal-title":"Hum Vaccin Immunother"},{"issue":"4","key":"pone.0337513.ref033","doi-asserted-by":"crossref","first-page":"654","DOI":"10.3390\/v16040654","article-title":"Epidemiological features of human norovirus genotypes before and after COVID-19 countermeasures in Osaka, Japan","volume":"16","author":"T Shirai","year":"2024","journal-title":"Viruses"},{"issue":"12","key":"pone.0337513.ref034","article-title":"Viral shedding in gastroenteritis in children caused by variants and novel recombinant norovirus infections","volume":"100","author":"H-Y Cheng","year":"2021","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"pone.0337513.ref035","doi-asserted-by":"crossref","first-page":"119","DOI":"10.3201\/eid2501.180395","article-title":"Higher viral load of emerging norovirus GII.P16-GII.2 than pandemic GII.4 and epidemic GII.17, Hong Kong, China","volume":"25","author":"SKC Cheung","year":"2019","journal-title":"Emerg Infect Dis"},{"issue":"7","key":"pone.0337513.ref036","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.3201\/eid2307.170034","article-title":"Norovirus GII.P16\/GII.2-associated gastroenteritis, China, 2016","volume":"23","author":"Y Ao","year":"2017","journal-title":"Emerg Infect Dis"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0337513","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T18:27:01Z","timestamp":1764008821000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0337513"}},"subtitle":[],"editor":[{"given":"Pierre","family":"Roques","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,11,24]]},"references-count":36,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0337513","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,24]]}}}