Detection of antibody to recombinant Norwalk virus antigen in specimens from outbreaks of gastroenteritis

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Abstract
Norwalk virus and other small round-structured viruses are commonly associated with outbreaks of gastroenteritis. We used a recently described recombinant-expressed Norwalk virus (rNV) capsid protein in enzyme immunoassays to quantitatively measure immunoglobulin G (IgG) and IgA to Norwalk virus in serum pairs from patients involved in outbreaks of gastroenteritis. The outbreaks previously were classified, on the basis of the results of a blocking antibody assay, as Norwalk virus negative, serologically intermediate, or Norwalk virus positive. The rNV IgG assay was more sensitive than the blocking assay for detecting IgG to Norwalk virus in serum from patients in all outbreak classes. There was 79% concordance between seroconversions detected by the blocking antibody assay and those detected by the rNV IgG assay. The rNV IgA assay detected seroconversions to Norwalk virus primarily in patients involved in outbreaks previously classified as Norwalk virus positive.