<?xml version="1.0" encoding="UTF-8"?><?xml-stylesheet type="text/xsl" href="static/style.xsl"?><OAI-PMH xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/ http://www.openarchives.org/OAI/2.0/OAI-PMH.xsd"><responseDate>2026-04-29T12:24:18Z</responseDate><request verb="GetRecord" identifier="oai:repisalud.isciii.es:20.500.12105/16284" metadataPrefix="marc">https://repisalud.isciii.es/rest/oai/request</request><GetRecord><record><header><identifier>oai:repisalud.isciii.es:20.500.12105/16284</identifier><datestamp>2024-11-29T09:38:24Z</datestamp><setSpec>com_20.500.12105_2052</setSpec><setSpec>com_20.500.12105_2051</setSpec><setSpec>com_20.500.12105_15322</setSpec><setSpec>col_20.500.12105_19609</setSpec><setSpec>col_20.500.12105_16977</setSpec><setSpec>col_20.500.12105_16981</setSpec></header><metadata><record xmlns="http://www.loc.gov/MARC21/slim" xmlns:dcterms="http://purl.org/dc/terms/" xmlns:doc="http://www.lyncode.com/xoai" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.loc.gov/MARC21/slim http://www.loc.gov/standards/marcxml/schema/MARC21slim.xsd">
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      <subfield code="a">Alarcón-Linares, María Ester</subfield>
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      <subfield code="a">Moreno-Docón, Antonio</subfield>
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      <subfield code="a">Pérez-Serna, Lorena</subfield>
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      <subfield code="a">Camacho, Juan</subfield>
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      <subfield code="a">Sánchez Rodriguez, Diego</subfield>
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      <subfield code="a">Gutiérrez-Martín, María Luisa</subfield>
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      <subfield code="a">Broncano-Lavado, Antonio</subfield>
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      <subfield code="a">Echevarria, Juan Emilio</subfield>
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      <subfield code="a">Cabrerizo, Maria</subfield>
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      <subfield code="a">Fernandez-Garcia, Maria Dolores</subfield>
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      <subfield code="c">2023-02-21</subfield>
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      <subfield code="a">Noroviruses are among the most important causes of acute gastroenteritis (AGE). In summer 2021, a large outbreak of norovirus infections affecting 163 patients, including 15 norovirus-confirmed food handlers, occurred in a hotel in Murcia in southeast Spain. A rare GI.5[P4] norovirus strain was identified as the cause of the outbreak. The epidemiological investigation determined that norovirus transmission might have been initiated through an infected food handler. The food safety inspection found that some symptomatic food handlers continued working during illness. Molecular investigation with whole-genome and ORF1 sequencing provided enhanced genetic discrimination over ORF2 sequencing alone and enabled differentiation of the GI.5[P4] strains into separate subclusters, suggesting different chains of transmission. These recombinant viruses have been identified circulating globally over the last 5 years, warranting further global surveillance. IMPORTANCE Due to the large genetic diversity of noroviruses, it is important to enhance the discriminatory power of typing techniques to differentiate strains when investigating outbreaks and elucidating transmission chains. This study highlights the importance of (i) using whole-genome sequencing to ensure genetic differentiation of GI noroviruses to track chains of transmission during outbreak investigations and (ii) the adherence of symptomatic food handlers to work exclusion rules and strict hand hygiene practices. To our knowledge, this study provides the first full-length genome sequences of GI.5[P4] strains apart from the prototype strain.</subfield>
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      <subfield code="a">Microbiol Spectr. 2023 Feb 21;11(2):e0485722.</subfield>
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      <subfield code="a">http://hdl.handle.net/20.500.12105/16284</subfield>
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      <subfield code="a">Genotyping</subfield>
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      <subfield code="a">Rare Recombinant GI.5[P4] Norovirus That Caused a Large Foodborne Outbreak of Gastroenteritis in a Hotel in Spain in 2021</subfield>
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