Call to Action for Dengue Vaccine Failure

the strain CRI41435, sharing 99% sequence identity. AstV-MLB1 and AstVMLB2 are phylogenetically related to the rat astroviruses RS118 and RS126. The remaining novel astroviruses, 10322603 and 10621246, clustered closely with human, mink, and ovine astrovirus strain NI-295 (Figure). This study documented that multiple novel astroviruses circulated simultaneously with common human astrovirus types in China. The detection rates of novel astroviruses, especially Ast-MLB1, were higher than in 2 previous reports (3,4), although lower than in a study from Egypt (9). These results indicate that multiple novel astroviruses are spread worldwide. The differences in prevalence may have been caused by the geographic and/or study cohort differences. The phylogeny of astroviruses determined in our study basically agrees with previous analyses (5), supporting the idea that the novel astroviruses are related to other animal astroviruses. Additional studies using full-genome sequencing should be done to clarify the origin of the novel astroviruses. One limitation of this study was that no asymptomatic control was included. A recent case–control study has suggested that AstV-MLB1 was not associated with diarrhea (10). However, other novel astroviruses were not assessed. Further study, especially with a large case–control cohort, should be initiated to determine the correlation of unique astroviruses with gastrointestinal and extraintestinal diseases.