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Rotaviruses cause severe gastroenteritis in infants, in which the viruses interact with human histo-blood group antigens (HBGAs) as attachment and host susceptibility factors. While gastroenteritis outbreaks caused by rotaviruses are uncommon in adolescents, we reported here one that occurred in a middle school in China. Rectal swabs and saliva samples were collected from symptomatic and asymptomatic students, and samples were also collected from the environment. Using PCR, followed by DNA sequencing, a single G9P[8] rotavirus strain was identified as the causative agent. The attack rate of the outbreak was 13.5% for boarders, which was significantly higher than that of day students (1.8%). Person-to-person transmission was the most plausible transmission mode. The HBGA phenotypes of the individuals in the study were determined by enzyme immunoassay, using saliva samples, while recombinant VP8* protein of the causative rotavirus strain was produced for HBGA binding assays to evaluate the host susceptibility. Our data showed that secretor individuals had a significantly higher risk of infection than nonsecretors. Accordingly, the VP8* protein bound nearly all secretor saliva samples, but not those of nonsecretors, explaining the observed infection of secretor individuals only. This is the first single-outbreak-based investigation showing that P[8] rotavirus infected only secretors. Our investigation also suggests that health education of school students is an important countermeasure against an outbreak of communicable disease.

Human noroviruses (NoVs) are an important cause of epidemic acute gastroenteritis. Their role in sporadic cases, however, is less clear. In this study, we performed a two-year surveillance (September 2005 to August 2007) of NoV gastroenteritis in outpatient clinics in a southern city of China, Jiangmen City. NoVs were detected in 115 patients (115/881, 13.1%) with 30 (26.1%) co-infections with rotaviruses. Sequence analysis showed that all 115 NoVs belonged to genogroup II, with GII.4 being the most predominant (87.8%). NoV-associated infection can be seen year-around, with autumn and winter peaks. This study provides basic information on sporadic cases of major NoV gastroenteritis in children in different seasons, which is valuable for future disease control and prevention.