Abstract
IntroductionGroup A rotaviruses (RVA) are the leading cause of acute gastroenteritis (AGE) in young children, causing ca 250,000 deaths worldwide, mainly in low-income countries. Two proteins, VP7 (glycoprotein, G genotype) and VP4 (protease-sensitive protein, P genotype), are the basis for the binary RVA nomenclature. Although 36 G types and 51 P types are presently known, most RVA infections in humans worldwide are related to five G/P combinations: G1P[8], G2P[4], G3P[8], G4P[8], G9P[8].AimThis study aimed to characterise the RVA strains circulating in Italy in the pre-vaccination era, to define the trends of circulation of genotypes in the Italian paediatric population.MethodsBetween September 2014 and August 2017, after routine screening in hospital by commercial antigen detection kit, 2,202 rotavirus-positive samples were collected in Italy from children hospitalised with AGE; the viruses were genotyped following standard European protocols.ResultsThis 3-year study revealed an overall predominance of the G12P[8] genotype (544 of 2,202 cases; 24.70%), followed by G9P[8] (535/2,202; 24.30%), G1P[8] (459/2,202; 20.84%) and G4P[8] (371/2,202; 16.85%). G2P[4] and G3P[8] genotypes were detected at low rates (3.32% and 3.09%, respectively). Mixed infections accounted for 6.49% of cases (143/2,202), uncommon RVA strains for 0.41% of cases (9/2,202).ConclusionsThe emergence of G12P[8] rotavirus in Italy, as in other countries, marks this genotype as the sixth most common human genotype. Continuous surveillance of RVA strains and monitoring of circulating genotypes are important for a better understanding of rotavirus evolution and genotype distribution, particularly regarding strains that may emerge from reassortment events.
Highlights
Group A rotaviruses (RVA) are the leading cause of acute gastroenteritis (AGE) in young children, causing ca 250,000 deaths worldwide, mainly in lowincome countries
Between September 2014 and August 2017, across three consecutive surveillance seasons, a total of 2,202 RVA-positive samples (775 samples in 2014/15; 712 samples in 2015/16; 715 samples in 2016/17) from patients with AGE were collected throughout Italy and analysed by molecular methods, in order to assign the G/P genotypes
Sampling was performed in 13 Italian regions, taking into account the population size of the regions involved in the surveillance, grouped as three major geographical areas: those located in northern Italy, in central Italy and in southern Italy [33]
Summary
Group A rotaviruses (RVA) are the leading cause of acute gastroenteritis (AGE) in young children, causing ca 250,000 deaths worldwide, mainly in lowincome countries. 36 G types and 51 P types are presently known, most RVA infections in humans worldwide are related to five G/P combinations: G1P[8], G2P[4], G3P[8], G4P[8], G9P[8]. Conclusions: The emergence of G12P[8] rotavirus in Italy, as in other countries, marks this genotype as the sixth most common human genotype. Group A rotaviruses (RVA) are the leading cause of acute gastroenteritis (AGE) in young children worldwide, and are estimated to cause 250,000 deaths every year among children aged 0–5 years, mainly in low-income countries of sub-Saharan Africa and South East Asia [1]. The only exception is Africa, where a different epidemiology from the rest of the world has been observed, with a greater genotype diversity among RVA affecting humans [10]
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