{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:43:37Z","timestamp":1790934217281,"version":"4.1.0"},"reference-count":63,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Norovirus (NoV) is a leading cause of acute gastroenteritis (AGE) in young children worldwide. Following the introduction of universal rotavirus (RVA) vaccination in Argentina in 2015, the role of NoV in pediatric AGE warrants evaluation. This study aimed to assess the prevalence, clinical characteristics, and molecular diversity of NoV in children under five years of age, comparing the periods before and after RVA vaccine implementation. Methods: A descriptive observational study was conducted in two pediatric hospitals in Argentina. Stool samples were obtained from both outpatient and hospitalized children presenting with acute gastroenteritis (AGE) during two distinct one-year periods: 285 samples from the pre-vaccination period (2011\u20132012) and 212 samples from the post-vaccination period (2019\u20132020). NoV, RVA and other viral enteropathogens were detected by RT-qPCR or immunoassay. Positive NoV samples were genotyped by Sanger sequencing of the ORF1\/ORF2 junction. Results: NoV was detected in 30.1% (86\/285) and 23.5% (50\/212) of cases in the pre- and post-vaccination periods, respectively. Children under two years of age and inpatients had significantly higher NoV detection in both periods. NoV mono-infections were more frequent in post-vaccination period (72% vs. 50%). NoV GII predominated in both periods, with increased genotype diversity observed post-vaccination, including GII.3[P12], GII.4 Sydney[P16], GII.6[P7], and GII.2[P16]. Conclusions: NoV remains a major cause of pediatric AGE in Argentina, particularly in children under two years old. Although NoV prevalence did not increase after RVA vaccine introduction, its clinical relevance persists. Continued molecular surveillance is essential to monitor genotype dynamics and implement prevention strategies.<\/jats:p>","DOI":"10.3390\/vaccines13111080","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T01:14:02Z","timestamp":1761182042000},"page":"1080","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Norovirus in Pediatric Gastroenteritis: A Study in Argentine Hospitals Before and After the Introduction of Universal Rotavirus Vaccination"],"prefix":"10.3390","volume":"13","author":[{"given":"Karina A.","family":"Gomes","sequence":"first","affiliation":[{"name":"Laboratory of Viral Gastroenteritis-National Institute for Infectious Diseases (INEI)-ANLIS \u201cDr. Carlos G. Malbr\u00e1n\u201d Ciudad Aut\u00f3noma de Buenos Aires, Buenos Aires 1281, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina A.","family":"Rivero","sequence":"additional","affiliation":[{"name":"Laboratory of Viral Gastroenteritis-National Institute for Infectious Diseases (INEI)-ANLIS \u201cDr. Carlos G. Malbr\u00e1n\u201d Ciudad Aut\u00f3noma de Buenos Aires, Buenos Aires 1281, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Barrios Mathieur","sequence":"additional","affiliation":[{"name":"Laboratory of Viral Gastroenteritis-National Institute for Infectious Diseases (INEI)-ANLIS \u201cDr. Carlos G. Malbr\u00e1n\u201d Ciudad Aut\u00f3noma de Buenos Aires, Buenos Aires 1281, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2181-7795","authenticated-orcid":false,"given":"Juan I.","family":"Degiuseppe","sequence":"additional","affiliation":[{"name":"Laboratory of Viral Gastroenteritis-National Institute for Infectious Diseases (INEI)-ANLIS \u201cDr. Carlos G. Malbr\u00e1n\u201d Ciudad Aut\u00f3noma de Buenos Aires, Buenos Aires 1281, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo R.","family":"Cortes","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, \u201cDel Ni\u00f1o Jes\u00fas\u201d Children\u2019s Hospital, C\u00f3rdoba X5000HTT, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia A.","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, \u201cDel Ni\u00f1o Jes\u00fas\u201d Children\u2019s Hospital, C\u00f3rdoba X5000HTT, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abel","family":"Zurschmitten","sequence":"additional","affiliation":[{"name":"Laboratory Section, \u201cJun\u00edn de los Andes\u201d Hospital, Neuqu\u00e9n Q8371, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda P.","family":"Castro","sequence":"additional","affiliation":[{"name":"Laboratory Section, \u201cJun\u00edn de los Andes\u201d Hospital, Neuqu\u00e9n Q8371, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0385-5592","authenticated-orcid":false,"given":"Viviana","family":"Parre\u00f1o","sequence":"additional","affiliation":[{"name":"Institute of Virology and Technological Innovations (IVIT), Research Center for Veterinary and Agronomic Sciences (CICVyA), National Institute of Agricultural Technology (INTA), Buenos Aires C1033AAE, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9832-5932","authenticated-orcid":false,"given":"Marina V.","family":"Mozgovoj","sequence":"additional","affiliation":[{"name":"Institute of Food Technology, National Institute of Agricultural Technology (INTA), Buenos Aires C1033AAE, Argentina"},{"name":"Institute of Science and Technology for Sustainable Food Systems (INCUI-NTA), Experimental Unit for Development and Demonstration (UEDD), UEDD INTA-CONICET, Buenos Aires C1033AAE, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan A.","family":"Stupka","sequence":"additional","affiliation":[{"name":"Laboratory of Viral Gastroenteritis-National Institute for Infectious Diseases (INEI)-ANLIS \u201cDr. Carlos G. Malbr\u00e1n\u201d Ciudad Aut\u00f3noma de Buenos Aires, Buenos Aires 1281, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"ref_1","unstructured":"(2025, July 10). Enfermedades Diarreicas. Available online: https:\/\/www.who.int\/es\/news-room\/fact-sheets\/detail\/diarrhoeal-disease."},{"key":"ref_2","first-page":"350","article-title":"Trends in Hospital Discharges for Intestinal Infectious Disease in Infants in Argentina, 2005\u20132013","volume":"115","author":"Degiuseppe","year":"2017","journal-title":"Arch. Argent. de Pediatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/S0140-6736(18)31128-0","article-title":"Viral Gastroenteritis","volume":"392","author":"Estes","year":"2018","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1093\/infdis\/jit254","article-title":"Etiology of Viral Gastroenteritis in Children <5 Years of Age in the United States, 2008\u20132009","volume":"208","author":"Chhabra","year":"2013","journal-title":"J. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2126","DOI":"10.1056\/NEJMra1207742","article-title":"Norovirus Gastroenteritis in Immunocompromised Patients","volume":"367","author":"Bok","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/j.idc.2017.07.012","article-title":"Norovirus Infection in Older Adults Epidemiology, Risk Factors, and Opportunities for Prevention and Control","volume":"31","author":"Cardemil","year":"2017","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1128\/CMR.00075-14","article-title":"Norovirus","volume":"28","author":"Robilotti","year":"2015","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Lucero, Y., Matson, D.O., Ashkenazi, S., George, S., and O\u2019Ryan, M. (2021). Norovirus: Facts and Reflections from Past, Present, and Future. Viruses, 13.","DOI":"10.3390\/v13122399"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Ludwig-Begall, L.F., Mauroy, A., and Thiry, E. (2021). Noroviruses\u2014The State of the Art, Nearly Fifty Years after Their Initial Discovery. Viruses, 13.","DOI":"10.3390\/v13081541"},{"key":"ref_10","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":"Chhabra","year":"2019","journal-title":"J. Gen. Virol."},{"key":"ref_11","first-page":"8","article-title":"Indications for Worldwide Increased Norovirus Activity Associated with Emergence of a New Variant of Genotype II.4, Late 2012","volume":"18","author":"Botteldoorn","year":"2013","journal-title":"Eurosurveillance"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1002\/jmv.2020","article-title":"Surveillance for Rotavirus in Argentina","volume":"65","author":"Bok","year":"2001","journal-title":"J. Med. Virol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1007\/s40121-022-00709-6","article-title":"Rotavirus Vaccine Impact since Its Introduction in the National Immunization Program of Argentina","volume":"12","author":"Marti","year":"2023","journal-title":"Infect. Dis. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1097\/INF.0000000000003775","article-title":"Role of Noroviruses in Sporadic Acute Gastroenteritis Cases from Children Attending a Large Referral Children\u2019s Hospital in Buenos Aires City, Argentina","volume":"42","author":"Gentile","year":"2023","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1093\/cid\/ciaa100","article-title":"The Changing Landscape of Pediatric Viral Enteropathogens in the Post-Rotavirus Vaccine Era","volume":"72","author":"Halasa","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Vel\u00e1zquez, R.F., Linhares, A.C., Mu\u00f1oz, S., Seron, P., Lorca, P., DeAntonio, R., and Ortega-Barria, E. (2017). Efficacy, Safety and Effectiveness of Licensed Rotavirus Vaccines: A Systematic Review and Meta-Analysis for Latin America and the Caribbean. BMC Pediatr., 17.","DOI":"10.1186\/s12887-016-0771-y"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1093\/cid\/cix369","article-title":"Effectiveness of Rotavirus Vaccination: A Systematic Review of the First Decade of Global Postlicensure Data, 2006\u20132016","volume":"65","author":"Jonesteller","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s40272-018-0283-3","article-title":"Rotavirus Vaccines: Effectiveness, Safety, and Future Directions","volume":"20","author":"Burnett","year":"2018","journal-title":"Pediatr. Drugs"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S121","DOI":"10.1093\/cid\/civ1208","article-title":"Effectiveness of Monovalent and Pentavalent Rotavirus Vaccines in Guatemala","volume":"62","author":"Bernart","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_20","unstructured":"(2025, July 10). Ministerio de Salud de la Naci\u00f3n Resoluci\u00f3n 1027\/2014 Programa Nacional de Control de Enfermedades Inmunoprevenibles. Incorporaci\u00f3n. Available online: https:\/\/www.argentina.gob.ar\/."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Bucardo, F., Lindgren, P.-E., Svensson, L., and Nordgren, J. (2011). Low Prevalence of Rotavirus and High Prevalence of Norovirus in Hospital and Community Wastewater after Introduction of Rotavirus Vaccine in Nicaragua. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0025962"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Bucardo, F., Reyes, Y., Svensson, L., and Nordgren, J. (2014). Predominance of Norovirus and Sapovirus in Nicaragua after Implementation of Universal Rotavirus Vaccination. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0098201"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1007\/s00431-013-1945-3","article-title":"Major Reduction of Rotavirus, but Not Norovirus, Gastroenteritis in Children Seen in Hospital after the Introduction of RotaTeq Vaccine into the National Immunization Programme in Finland","volume":"172","author":"Hemming","year":"2013","journal-title":"Eur. J. Pediatr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"397","DOI":"10.14745\/ccdr.v47i10a01","article-title":"Epidemiology of Norovirus and Viral Gastroenteritis in Ontario, Canada, 2009\u20132014","volume":"47","author":"Hughes","year":"2021","journal-title":"Can. Commun. Dis. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Ong, D.S., Harris, M., Hart, J.D., and Russell, F.M. (2025). Indirect Effects of Universal Infant Rotavirus Vaccination: A Narrative Systematic Review. Vaccines, 13.","DOI":"10.3390\/vaccines13050503"},{"key":"ref_26","first-page":"222","article-title":"Molecular characterization of calicivirus strains detected in outbreaks of gastroenteritis occurring in Argentina during 2005 and 2006","volume":"40","author":"Gomes","year":"2008","journal-title":"Rev. Argent. Microbiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1002\/jmv.25684","article-title":"Molecular Epidemiology of Norovirus Outbreaks in Argentina, 2013\u20132018","volume":"92","author":"Degiuseppe","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1002\/jmv.20989","article-title":"Molecular Characterization of Calicivirus Strains Detected in Outbreaks of Gastroenteritis in Argentina","volume":"79","author":"Gomes","year":"2007","journal-title":"J. Med. Virol."},{"key":"ref_29","first-page":"373","article-title":"Norovirus Outbreaks in a Nursery School in Buenos Aires, Argentina","volume":"56","author":"Gomes","year":"2024","journal-title":"Rev. Argent. Microbiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jviromet.2004.08.023","article-title":"Real-Time RT-PCR for Norovirus Screening in Shellfish","volume":"123","author":"Loisy","year":"2005","journal-title":"J. Virol. Methods"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1002\/jmv.20699","article-title":"Detection of Human Sapovirus by Real-Time Reverse Transcription-Polymerase Chain Reaction","volume":"78","author":"Oka","year":"2006","journal-title":"J. Med. Virol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3131","DOI":"10.1128\/AEM.71.6.3131-3136.2005","article-title":"Quantitative Real-Time PCR Assays for Detection of Human Adenoviruses and Identification of Serotypes 40 and 41","volume":"71","author":"Jothikumar","year":"2005","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"114279","DOI":"10.1016\/j.jviromet.2021.114279","article-title":"ROTADIAL: The First Nanobody-Based Immunoassay to Detect Group A Rotavirus","volume":"298","author":"Vega","year":"2021","journal-title":"J. Virol. Methods"},{"key":"ref_34","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":"Chhabra","year":"2021","journal-title":"J. Clin. Virol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1007\/s00705-013-1708-5","article-title":"Proposal for a Unified Norovirus Nomenclature and Genotyping","volume":"158","author":"Kroneman","year":"2013","journal-title":"Arch. Virol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/S0022-2836(05)80360-2","article-title":"Basic Local Alignment Search Tool","volume":"215","author":"Altschul","year":"1990","journal-title":"J. Mol. Biol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3022","DOI":"10.1093\/molbev\/msab120","article-title":"MEGA11: Molecular Evolutionary Genetics Analysis Version 11","volume":"38","author":"Tamura","year":"2021","journal-title":"Mol. Biol. Evol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1128\/CMR.00073-14","article-title":"Practical Guidance for Clinical Microbiology Laboratories: Diagnosis of Bacterial Gastroenteritis","volume":"28","author":"Humphries","year":"2015","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_39","unstructured":"Di Rienzo, J.A., Casanoves, F., Balzarini, M.G., Gonzalez, L., Tablada, M., and Robledo, C.W. (2020). Infostat, Grupo InfoStat, Facultad Ciencias Agropecuarias, Universidad Nacional de C\u00f3rdoba. Available online: https:\/\/www.infostat.com.ar\/."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1097\/INF.0000000000001369","article-title":"Norovirus in Latin America: Systematic Review and Meta-Analysis","volume":"36","author":"Lopman","year":"2017","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.virol.2013.12.005","article-title":"The Emergence and Evolution of the Novel Epidemic Norovirus GII.4 Variant Sydney 2012","volume":"450\u2013451","author":"Eden","year":"2014","journal-title":"Virology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.3201\/eid1908.130458","article-title":"Effects and Clinical Significance of GII.4 Sydney Norovirus, United States, 2012\u20132013","volume":"19","author":"Leshem","year":"2013","journal-title":"Emerg. Infect. Dis."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s12560-021-09482-0","article-title":"Prevalence of GII.4 Sydney Norovirus Strains and Associated Factors of Acute Gastroenteritis in Children: 2019\/2020 Season in Guangzhou, China","volume":"13","author":"Duan","year":"2021","journal-title":"Food Environ. Virol."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Zhang, P., Hao, C., Di, X., Chuizhao, X., Jinsong, L., Guisen, Z., Hui, L., and Zhaojun, D. (2024). Global Prevalence of Norovirus Gastroenteritis after Emergence of the GII.4 Sydney 2012 Variant: A Systematic Review and Meta-Analysis. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1373322"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s13099-022-00506-z","article-title":"Differences in Epidemiology of Enteropathogens in Children Pre- and Post-Rotavirus Vaccine Introduction in Kilifi, Coastal Kenya","volume":"14","author":"Agoti","year":"2022","journal-title":"Gut Pathog."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Lartey, B.L., Quaye, O., Damanka, S.A., Agbemabiese, C.A., Armachie, J., Dennis, F.E., Enweronu-Laryea, C., and Armah, G.E. (2020). Understanding Pediatric Norovirus Epidemiology: A Decade of Study among Ghanaian Children. Viruses, 12.","DOI":"10.3390\/v12111321"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1080\/21645515.2019.1599522","article-title":"No Evidence of an Increase in the Incidence of Norovirus Gastroenteritis Hospitalizations in Young Children after the Introduction of Universal Rotavirus Immunization in Israel","volume":"15","author":"Muhsen","year":"2019","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"212","DOI":"10.4269\/ajtmh.15-0203","article-title":"Burden of Norovirus and Rotavirus in Children after Rotavirus Vaccine Introduction, Cochabamba, Bolivia","volume":"94","author":"McAtee","year":"2016","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Lian, S., Liu, J., Wu, Y., Xia, P., and Zhu, G. (2022). Bacterial and Viral Co-Infection in the Intestine: Competition Scenario and Their Effect on Host Immunity. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23042311"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Tandukar, S., Sherchand, J.B., Karki, S., Malla, B., Shrestha, R.G., Bhandari, D., Thakali, O., and Haramoto, E. (2019). Co-Infection by Waterborne Enteric Viruses in Children with Gastroenteritis in Nepal. Healthcare, 7.","DOI":"10.3390\/healthcare7010009"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1093\/jpids\/piv001","article-title":"High Prevalence and Increased Severity of Norovirus Mixed Infections Among Children 12\u201324 Months of Age Living in the Suburban Areas of Lima, Peru","volume":"5","author":"Zambruni","year":"2016","journal-title":"J. Pediatr. Infect. Dis. Soc."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.4269\/ajtmh.21-0881","article-title":"Clinical Course of Children with Campylobacter Gastroenteritis With and Without Co-Infection in Lima, Peru","volume":"106","author":"Munoz","year":"2022","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Ahmed, S.M., Lopman, B.A., and Levy, K. (2013). A systematic review and meta-analysis of the global seasonality of norovirus. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0075922"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1111\/j.1469-0691.2009.02846.x","article-title":"Norovirus Seasonality and the Potential Impact of Climate Change","volume":"15","author":"Rohayem","year":"2009","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Lopman, B.A., Steele, D., Kirkwood, C.D., and Parashar, U.D. (2016). The Vast and Varied Global Burden of Norovirus: Prospects for Prevention and Control. PLoS Med., 13.","DOI":"10.1371\/journal.pmed.1001999"},{"key":"ref_56","unstructured":"Skansi, M., Barnat\u00e1n, I., Diaz, M., Garay, N., Petino, E., Stella, J., and Veiga, H. (2025). Atlas Clim\u00e1tico de Argentina: Per\u00edodo 1991\u20132020."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Chiu, S.C., Hu, S.C., Liao, L., Chen, Y., and Lin, J. (2022). Norovirus Genogroup II Epidemics and the Potential Effect of Climate Change on Norovirus Transmission in Taiwan. Viruses, 14.","DOI":"10.3390\/v14030641"},{"key":"ref_58","first-page":"21178","article-title":"Emergence of a novel GII.17 norovirus\u2014End of the GII.4 era?","volume":"20","author":"Vennema","year":"2015","journal-title":"Eurosurveillance"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.meegid.2016.11.026","article-title":"Detection of Novel GII.17 Norovirus in Argentina, 2015","volume":"47","author":"Degiuseppe","year":"2017","journal-title":"Infect. Genet. Evol."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Lindesmith, L.C., Donaldson, E.F., Lobue, A.D., Cannon, J.L., Zheng, D.-P., Vinje, J., and Baric, R.S. (2008). Mechanisms of GII.4 Norovirus Persistence in Human Populations. PLoS Med., 5.","DOI":"10.1371\/journal.pmed.0050031"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e2354","DOI":"10.1002\/rmv.2354","article-title":"Global and Regional Circulation Trends of Norovirus Genotypes and Recombinants, 1995\u20132019: A Comprehensive Review of Sequences from Public Databases","volume":"32","author":"Kendra","year":"2022","journal-title":"Rev. Med. Virol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.3201\/eid2705.204756","article-title":"Global Trends in Norovirus Genotype Distribution among Children with Acute Gastroenteritis","volume":"27","author":"Cannon","year":"2021","journal-title":"Emerg. Infect. Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"104248","DOI":"10.1016\/j.jcv.2019.104248","article-title":"Epidemiology and Genotype Diver-sity of Norovirus Infections among Children Aged <5 Years Following Rotavirus Vaccine Introduction in Blantyre, Malawi","volume":"123","author":"Hungerford","year":"2020","journal-title":"J. Clin. Virol."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/13\/11\/1080\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T10:02:45Z","timestamp":1761213765000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/13\/11\/1080"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,22]]},"references-count":63,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["vaccines13111080"],"URL":"https:\/\/doi.org\/10.3390\/vaccines13111080","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,22]]}}}