Abstract
This 15-year study aimed to determine the role of the main viruses responsible for acute infantile gastroenteritis cases in a day care center in the city of Rio de Janeiro, Brazil. From 1994 to 2008, 539 fecal samples were obtained from 23 outbreaks as well as sporadic cases that occurred in this period. The detection of Rotavirus group A (RVA), norovirus (NoV) and astrovirus (AstV) was investigated both by classical and molecular methods of viral detection. RVA was detected by enzymatic immune assay and/or polyacrylamide gel electrophoresis and genotyped by using semi-nested multiplex PCR. NoV and AstV were subsequently tested by real time PCR in all RVA-negative samples and genotyped throughout genome sequencing. Three protocols for molecular characterization of NoV nucleotide sequencing were performed with the partial nucleotide sequencing of genomic regions known as region B (polymerase gen), C and D (capsid gen).Viruses were identified in 47.7% (257/539) of the cases, and the detection rates of RVA, NoV and AstV in16.1% (87/539), 33.4% (151/452), and 6.3% (19/301), respectively. Most gastroenteritis cases were reported in autumn and winter, although NoV presented a broader monthly distribution. Viruses' detection rates were significantly higher among children aged less than 24 months old, although NoV cases were detected in all age groups. RVA genotypes as G1P[8], G9P[8], G2P[4], G3P[8] and G1+G3P[8] and RVA was no longer detected after 2005. NoV characterization revealed genotypes variability circulating in the period as GI.2, GI.3, GI.8 GII.2, GII.3, GII.4, GII.4 variants 2001 and 2006b, GII.6, GII.7, GII.12 and GII.17. AstV genotypes 1, 2, 4 and 5 were also characterized. Those data demonstrate the impact of NoV infection in cases of infantile gastroenteritis, surpassing RVA infection responsible for high morbidity rate in children under five years old.
Highlights
Acute gastroenteritis (AGE) is an important health concern and can be caused by a wide array of viruses many of which identified in the 70’s [1,2,3]
This study aims to assess the impact of those viruses in cases of infantile AGE that occurred in a day care center in the city of Rio de Janeiro, Brazil, between 1994 and 2008
Collection of faecal samples and study design Bertha Lutz day care center is located at the campus of the Oswaldo Cruz Foundation, Rio de Janeiro, Brazil and caters for children ranging from four months of age, who can remains at an average of eight hours per day in periods that can last up to five years
Summary
Acute gastroenteritis (AGE) is an important health concern and can be caused by a wide array of viruses many of which identified in the 70’s [1,2,3]. After RVA, norovirus (NoV) and astrovirus (AstV) are the most important etiologic agents of infantile AGE worldwide [8,9,10, 11,12] associated with sporadic cases and outbreaks in indoor settings such as schools, cruise chips, restaurants, hospitals, homes for the elderly and military recruits [13]. Incidence rates of those viruses among children aged less than 5 years-old, represent a particular concern in infants attending nurseries [14,15,16]
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