Cause Of Acute Gastroenteritis Research Articles

Persistence of Norwalk virus, male-specific coliphage, and Escherichia coli on stainless steel coupons and in phosphate-buffered saline.

Human noroviruses (NoVs) are a leading cause of acute gastroenteritis and are frequently transmitted by contaminated food, water, hands, and environmental surfaces. Little is known about their environmental stability and/or which alternative microorganisms can serve as effective surrogates. To examine whether Escherichia coli and male-specific coliphage MS2 can be appropriate surrogates for NoVs, approximately 6.8 log genomic equivalent copies of Norwalk virus (NV), and 6.0 to 6.5 log PFU or CFU of MS2 and E. coli, respectively, were inoculated onto stainless steel coupons and held at 4°C, room temperature (RT), or 37°C over a period of 75 min (E. coli and MS2) to 4 weeks. These three microorganisms were also seeded into phosphate-buffered saline (PBS) and sampled at different time intervals for up to 6 weeks. MS2 and E. coli survived approximately 15 min at 37°C, 45 min at RT, and 60 min at 4°C on the stainless steel surfaces. In contrast, NV RNA titers were reduced by only 2.4 log at 37°C, 1.5 log at RT, and 0.9 log at 4°C after 4 weeks. MS2 and E. coli were able to survive at least 5 weeks in PBS at 4°C and RT, and NV was stable in PBS at 4°C and RT for at least 6 weeks. However, E. coli, MS2, and NV were completely inactivated after 1-, 4-, and 5-week incubations in PBS at 37°C, respectively. These findings indicate that NoVs are highly persistent on environmental surfaces and in PBS solution at different temperatures. While E. coli does not appear to be an appropriate surrogate for NoVs, MS2 could be more relevant for modeling the environmental persistence of NoVs under wet conditions, but not under dry conditions.

Antiviral activity of Ecasol against feline calicivirus, a surrogate of human norovirus

Human norovirus (NoV) is a major cause of acute gastroenteritis in closed settings such as hospitals, hotels and cruise ships. The virus survives on inanimate surfaces for extended periods of time, and environmental contamination has been implicated in its transmission. The disinfection of contaminated areas is important in controlling the spread of NoV infections. Neutral solutions of electrochemically activated (ECA)-anolyte have been shown to be powerful disinfectants against a broad range of bacterial pathogens. The active chemical ingredient is hypochlorous acid (HOCl), which is registered as an approved food contact surface sanitizer in the United States by the Environmental Protection Agency, pursuant to 40 CFR 180.940. We evaluated the antiviral activity of Ecasol (an ECA-anolyte) against feline calicivirus (FCV), a surrogate of NoV. FCV dried on plastic surfaces was exposed to Ecasol for 1, 2, or 5min. After exposure to Ecasol, the virus titers were compared with untreated controls to determine the virus inactivation efficacy after different contact times. Ecasol was found to decrease the FCV titer by >5log(10) within 1min of contact, indicating its suitability for inactivation of NoV on surfaces.

Two Rotavirus Outbreaks Caused by Genotype G2P[4] at Large Retirement Communities

Outbreaks of rotavirus gastroenteritis in elderly adults are reported infrequently but are often caused by G2P[4] strains. In 2011, outbreaks were reported in 2 Illinois retirement facilities. To implement control measures, determine the extent and severity of illness, and assess risk factors for disease among residents and employees. Cohort studies using surveys and medical chart abstraction. Two large retirement facilities in Cook County, Illinois. Residents and employees at both facilities and community residents with rotavirus disease. Attack rates, hospitalization rates, and rotavirus genotype. At facility A, 84 of 324 residents (26%) were identified with clinical or laboratory-confirmed rotavirus gastroenteritis (median age, 84 years) and 11 (13%) were hospitalized. The outbreak lasted 7 weeks. At facility B, 90 case patients among 855 residents (11%) were identified (median age, 88 years) and 19 (21%) were hospitalized. The facility B outbreak lasted 9.3 weeks. Ill employees were identified at both locations. In each facility, attack rates seemed to differ by residential setting, with the lowest rates among those in more separated settings or with high baseline level of infection control measures. The causative genotype for both outbreaks was G2P[4]. Some individuals shed virus detected by enzyme immunoassay or genotyping reverse transcription polymerase chain reaction for at least 35 days. G2P[4] was also identified in 17 of 19 (89%) samples from the older adult community but only 15 of 40 (38%) pediatric samples. Medical or cognitive impairment among residents limited the success of some interviews. Rotavirus outbreaks can occur among elderly adults in residential facilities and can result in considerable morbidity. Among older adults, G2P[4] may be of unique importance. Health professionals should consider rotavirus as a cause of acute gastroenteritis in adults. None.

Role of Cytolethal Distending Toxin in Altered Stool Form and Bowel Phenotypes in a Rat Model of Post-infectious Irritable Bowel Syndrome.

Background/AimsCampylobacter jejuni infection is a leading cause of acute gastroenteritis, which is a trigger for post-infectious irritable bowel syndrome (PI-IBS). Cytolethal distending toxin (CDT) is expressed by enteric pathogens that cause PI-IBS. We used a rat model of PI-IBS to investigate the role of CDT in long-term altered stool form and bowel phenotypes.MethodsAdult Sprague-Dawley rats were gavaged with wildtype C. jejuni (C+), a C. jejuni cdtB knockout (CDT-) or saline vehicle (controls). Four months after gavage, stool from 3 consecutive days was assessed for stool form and percent wet weight. Rectal tissue was analyzed for intraepithelial lymphocytes, and small intestinal tissue was stained with anti-c-kit for deep muscular plexus interstitial cells of Cajal (DMP-ICC).ResultsAll 3 groups showed similar colonization and clearance parameters. Average 3-day stool dry weights were similar in all 3 groups, but day-to-day variability in stool form and stool dry weight were significantly different in the C+ group vs both controls (P < 0.01) and the CDT- roup (P < 0.01), but were not different in the CDT- vs controls. Similarly, rectal lymphocytes were significantly higher after C. jejuni (C+) infection vs both controls (P < 0.01) and CDT-exposed rats (P < 0.05). The counts in the latter 2 groups were not significantly different. Finally, c-kit staining revealed that DMP-ICC were reduced only in rats exposed to wildtype C. jejuni.ConclusionsIn this rat model of PI-IBS, CDT appears to play a role in the development of chronic altered bowel patterns, mild chronic rectal inflammation and reduction in DMP-ICC.

871 Frequency of Norovirus Infection in Children with Acute Gastroenteritis

Background and AimsNoroviruses are one of the common causes of acute gastroenteritis and have a great impact on child health. The aim of this study was to determine the prevalence...

Norovirus vaccine development: next steps

Noroviruses (NoVs) are a common cause of acute gastroenteritis in humans, with an estimated 21 million cases occurring in the USA annually [1]. Although the disease is often self limited and recove...

Identification of RNA-Protein Interaction Networks Involved in the Norovirus Life Cycle

Human noroviruses are one of the major causes of acute gastroenteritis in the developed world, yet our understanding of their molecular mechanisms of genome translation and replication lags behind that for many RNA viruses. Due to the nonculturable nature of human noroviruses, many related members of the Caliciviridae family of small RNA viruses are often used as model systems to dissect the finer details of the norovirus life cycle. Murine norovirus (MNV) has provided one such system with which to study the basic mechanisms of norovirus translation and replication in cell culture. In this report we describe the use of riboproteomics to identify host factors that interact with the extremities of the MNV genome. This network of RNA-protein interactions contains many well-characterized host factors, including PTB, La, and DDX3, which have been shown to play a role in the life cycle of other RNA viruses. By using RNA coimmunoprecipitation, we confirmed that a number of the factors identified using riboproteomics are associated with the viral RNA during virus replication in cell culture. We further demonstrated that RNA inhibition-mediated knockdown of the intracellular levels of a number of these factors inhibits or slows norovirus replication in cell culture, allowing identification of new intracellular targets for this important group of pathogens.

Complete Genome of the Human Norovirus GIV.1 Strain Lake Macquarie Virus

Norovirus is an important human pathogen that is now recognized as the leading cause of acute gastroenteritis globally. Six viral genogroups have been described, although only genogroups GI, GII, and GIV are known to infect humans, with the GII viruses most commonly identified in both outbreak and sporadic settings. In contrast, infections by GIV viruses are rarely reported, and their overall prevalence in the community is unknown. Here, we report the complete genome sequence of the human GIV.1 strain Lake Macquarie virus, which caused two linked outbreaks of acute gastroenteritis in aged-care facilities in the Hunter region of New South Wales, Australia. The Lake Macquarie virus genome was 7,527 nucleotides (nt) in length and shared highest identity (70%) with the recently completed feline GIV.2 virus genome.

Detection and molecular characterization of adenoviruses in Korean children hospitalized with acute gastroenteritis

Human adenoviruses (HAdVs) are an important cause of acute gastroenteritis in children. However, few studies on the epidemiology or types of HAdVs associated with acute gastroenteritis have been conducted in Korea. Therefore, in the present study, the incidence of HAdV in 2064 stool samples from Korean children hospitalized with acute gastroenteritis (2004-2006) was assessed and the types of viruses present determined. Polymerase chain reaction, sequencing, and phylogenic analyses revealed that 113 samples (5.5%) were HAdV-positive. While HAdVs were mainly detected during July to October, no seasonal difference between the enteric and non-enteric viruses in the incidence of HAdV was observed. HAdV-41 and HAdV-40 were found in 54 (47.8%) and 3 (2.6%) HAdV-positive samples, respectively. HAdV-3, HAdV-7, HAdV-2, HAdV-31, HAdV-4, and HAdV-37 were detected in 11 (9.7%), 5 (4.4%), 2 (1.7%), 2 (1.7%), 1 (0.8%), and 1 (0.8%) of sample(s), respectively. Thus, not only enteric, but also non-enteric, HAdVs may play an important role in acute gastroenteritis in Korean children.

Prevalence of six Campylobacter species in a New Zealand dairy goat herd

The occurrence of Campylobacter, a common cause of acute gastroenteritis in humans, was investigated on five occasions over 9 months at a housed dairy goat farm in New Zealand. Six Campylobacter species were sought in 249 fresh faecal samples of adults does using a combination of culture and molecular identification. Seventy-four (30%) samples were positive for Campylobacter. Four species were detected: C. jejuni (20%), C. coli (7%), C. lari (2%) and C. hyointestinalis (2%). These species have known association with human infection. C. fetus and C. upsaliensis were not detected. There were significant differences among samplings in the prevalence of C. jejuni (P < 0.001), C. coli (P < 0.001) and C. lari (P < 0.01). These findings highlight the importance of good farm hygiene to prevent risk to workers handling the goats and disposing of bedding material, and to consumers of goat milk or meat.

Influence of chemical and physical conditions on the production of bacteriocin by Aeromonas hydrophila

Aeromonas hydrophila have been isolated as a cause of a cute gastroenteritis in 23 (5.6%) of 410 patients. Other bacterial enteropathogens have been isolated from 387 patients with diarrhea, were 19 different strains. A. hydrophila occurred more commonly in children with acute diarrhea, the results showed that 18(78.26%) isolates of A. hydrophila found in children under 10 years old ,distributed to 10(43.47%) in male and 8(34.78%) in female ,and in adults with diarrhea 5 (21.73%). In the other hand, we noticed frequency of isolation was higher in male 14(60.86%) when compared with 9(39.14%) in female. Six strains of A. hydrophila have been observed to have bacteriocin activity against 12 of 23 different A. hydrophila ,as well as Staphylococcus aureas, Pseudomonas aeruginosa, Escherichia coli, Enterobacter cloacea and Shigella dysenteria. The results showed Bacteriocin-like substances (BLS11) had isoinhibitory activity on 10 same A. hydrophila species and heteroinhibitory activity effects on all pathogenic bacterial strains used, while BLS5 showed isoinhibitory activity on 2 same A. hydrophila species and heteroinhibitory activity by effecting on gram negative only, and BLS3&amp; BLS12 showed activity on E. coli isolates only, and none of BLS1&amp; BLS10(isoinhibitory activity on 1 A.hydrophila respectively) had effect on all pathogenic bacteria. Among the standard laboratory media used Brain Heart Infusion broth (BHI) showed the maximum production and poor yields resulted from growth in Peptone Glyserol (PG) and Nutrient broth. We selected BLS11 to their wide range effect on same species and enteric pathogenic strains, to study the Influence of chemical and physical conditions on the production of BLS by A.hydrophila. The BLS11 preparations from A.hydrophila11 strains of A. hydrophila were tolerant to all three treatments of surfactant. In the other hand, effect of organic acid on BLS production BLS11 has been studied and showed no remarkable difference in zone of inhibition when used acetone as affecter element, while both of isopropanol and ethanol have narrow inhibition zone range when compared with control strain. These results indicated that most A. hydrophila might be harboring plasmid mediated bacteriocin like substance, and there are no relation between BLS production and number of plasmid bands present in bacteria.

Influence of chemical and physical conditions on the production of bacteriocin by Aeromonas hydrophila

Aeromonas hydrophila have been isolated as a cause of a cute gastroenteritis in 23 (5.6%) of 410 patients. Other bacterial enteropathogens have been isolated from 387 patients with diarrhea, were 19 different strains. A. hydrophila occurred more commonly in children with acute diarrhea, the results showed that 18(78.26%) isolates of A. hydrophila found in children under 10 years old ,distributed to 10(43.47%) in male and 8(34.78%) in female ,and in adults with diarrhea 5 (21.73%). In the other hand, we noticed frequency of isolation was higher in male 14(60.86%) when compared with 9(39.14%) in female. Six strains of A. hydrophila have been observed to have bacteriocin activity against 12 of 23 different A. hydrophila ,as well as Staphylococcus aureas, Pseudomonas aeruginosa, Escherichia coli, Enterobacter cloacea and Shigella dysenteria. The results showed Bacteriocin-like substances (BLS11) had isoinhibitory activity on 10 same A. hydrophila species and heteroinhibitory activity effects on all pathogenic bacterial strains used, while BLS5 showed isoinhibitory activity on 2 same A. hydrophila species and heteroinhibitory activity by effecting on gram negative only, and BLS3&amp; BLS12 showed activity on E. coli isolates only, and none of BLS1&amp; BLS10(isoinhibitory activity on 1 A.hydrophila respectively) had effect on all pathogenic bacteria. Among the standard laboratory media used Brain Heart Infusion broth (BHI) showed the maximum production and poor yields resulted from growth in Peptone Glyserol (PG) and Nutrient broth. We selected BLS11 to their wide range effect on same species and enteric pathogenic strains, to study the Influence of chemical and physical conditions on the production of BLS by A.hydrophila. The BLS11 preparations from A.hydrophila11 strains of A. hydrophila were tolerant to all three treatments of surfactant. In the other hand, effect of organic acid on BLS production BLS11 has been studied and showed no remarkable difference in zone of inhibition when used acetone as affecter element, while both of isopropanol and ethanol have narrow inhibition zone range when compared with control strain. These results indicated that most A. hydrophila might be harboring plasmid mediated bacteriocin like substance, and there are no relation between BLS production and number of plasmid bands present in bacteria.

The impact of childhood acute rotavirus gastroenteritis on the parents’ quality of life: prospective observational study in European primary care medical practices

BackgroundRotavirus (RV) is the commonest cause of acute gastroenteritis in infants and young children worldwide. A Quality of Life study was conducted in primary care in three European countries as part of a larger epidemiological study (SPRIK) to investigate the impact of paediatric rotavirus gastroenteritis (RVGE) on affected children and their parents.MethodsA self-administered questionnaire was linguistically validated in Spanish, Italian and Polish. The questionnaire was included in an observational multicentre prospective study of 302 children aged <5 years presenting to a general practitioner or paediatrician for RVGE at centres in Spain, Italy or Poland. RV infection was confirmed by polymerase chain reaction (PCR) testing (n = 264). The questionnaire was validated and used to assess the emotional impact of paediatric RVGE on the parents.ResultsQuestionnaire responses showed that acute RVGE in a child adversely affects the parents’ daily life as well as the child. Parents of children with RVGE experience worry, distress and impact on their daily activities. RVGE of greater clinical severity (assessed by the Vesikari scale) was associated with higher parental worries due to symptoms and greater changes in the child’s behaviour, and a trend to higher impact on parents’ daily activities and higher parental distress, together with a higher score on the symptom severity scale of the questionnaire.ConclusionsParents of a child with acute RVGE presenting to primary care experience worry, distress and disruptions to daily life as a result of the child’s illness. Prevention of this disease through prophylactic vaccination will improve the daily lives of parents and children.

Intranasal vaccination with an adjuvanted Norwalk virus-like particle vaccine elicits antigen-specific B memory responses in human adult volunteers

Noroviruses are the most frequent cause of acute gastroenteritis in humans of all ages. No vaccines are currently available. An intranasally delivered Norwalk (NV) virus-like particle (VLP) vaccine was recently shown to be well tolerated, immunogenic and to protect against infection in Phase 1 studies. Here, we examined B memory (B(M)) responses in volunteers who received the highest dosage levels of the NV-VLP vaccine (50 μg and 100 μg). We measured the frequency of NV-specific IgG and IgA-secreting B(M) cells in peripheral blood and the level of antibodies produced by these cells in culture. All subjects immunized with 100 μg of the NV-VLP vaccine and 90% of those who received 50 μg had significant IgA or IgG B(M) responses. The B(M) cell frequencies correlated with serum antibody levels and mucosally-primed antibody-secreting cell responses. This is the first demonstration of dose-dependent, functional B(M) responses in humans immunized intranasally with a NV-VLP vaccine.

The estimated disease burden of norovirus in The Netherlands

Noroviruses are an important cause of acute gastroenteritis in humans. We incorporated new insights gained over the past decade in an updated estimate of the disease burden of (foodborne) norovirus illness in The Netherlands in 2009. The disease outcomes - non-consulting cases, visiting a general practitioner, hospitalization and mortality - and the foodborne proportion were derived from cohort studies, surveillance data and literature. Age-specific incidence estimates were applied to the population age distribution in The Netherlands in 2009. The general population incidence was 3800/100 000 (95% CI 2670–5460), including 0.4 fatal cases/100 000,resulting in 1622 (95% CI 966–2650) disability-adjusted life-years in a population of 16.5 million [corrected].The updated burden of norovirus is over twofold higher than previously estimated, due in particular to the new insights in case-fatality ratios. Results suggest that the burden of norovirus institutional outbreaks is relatively small compared to the burden of community-acquired norovirus infections.

Selection and evolutionary analysis in the nonstructural protein NSP2 of rotavirus A

Rotavirus A is the leading cause of acute gastroenteritis in infants and young children worldwide. The nonstructural protein 2 (NSP2) plays essential roles in the replication cycle of rotavirus and may play a role in protective immunity against rotavirus disease. Using a Bayesian approach, we measured the mutation rate of genotype N1 NSP2 gene sequences. The N1 genotype is the main NSP2 genotype associated with rotavirus strains causing severe disease, and was found to have a high mutation rate (8.7×10−4 substitutions/site/year) in comparison to the rotavirus VP4 gene and rates of mutation in other RNA viruses. NSP2 has traditionally been considered as a conserved rotavirus protein and selection analysis indicated that the NSP2 protein was under strong negative selection, suggesting that most nucleotide substitutions were synonymous. This conservation is likely a result of functional constraints of NSP2 in the rotavirus replication cycle. Four sites of positive selection were identified; two of these (positions 249 and 255) were located in a previously characterised antibody binding epitope. The remaining sites were not located in known functional regions, and the reason for variation at these sites remains to be elucidated.

Impact of rotavirus vaccines on rotavirus disease

Rotaviruses are the most common cause of acute gastroenteritis in young children worldwide. Both licensed rotavirus vaccines (Rotarix™ [RV1] and RotaTeq™ [RV5]) are effective and safe. Studies from countries that have included RV1 or RV5 in the national immunization programs have demonstrated their safety and sustained efficacy under real-life circumstances. A significant decline in acute gastroenteritis-related deaths among Latin American children was observed after the introduction of RV1 and RV5 vaccines. Both vaccines were able to decrease the number of cases of rotavirus acute gastroenteritis and of severe rotavirus diseases. Vaccination was also associated with a dramatic reduction in hospitalizations and outpatient visits for all-cause acute gastroenteritis. Indirect protection after infant mass vaccination has been strongly suggested. Moreover, postlicensure safety studies assessed rare adverse events (rates <1 in 50,000), such as intussusception.

Prevalence and Molecular Genotyping of Group A Rotaviruses in Iranian Children

Rotavirus is the leading cause of acute gastroenteritis in worldwide young children. Effective vaccines to prevent rotavirus infection are currently available, although their clinical use is still limited, and rotavirus still causes many episodes of infantile gastroenteritis, mainly during the winter season. The aim of this study was to evaluate the prevalence of rotavirus infection in children aged <5-years-old who were hospitalised for gastroenteritis. One hundred and sixty-three stool samples from hospitalised children (<5-years-old) complicated with severe diarrhoea, in two hospitals in Jahrom City, Iran were collected from 2009 to 2010. Antigenic prevalence of rotavirus group A was distinguished by enzyme immunoassay. The antigen of group A rotavirus was diagnosed by EIA in 75 of 163 collected samples. The genotype of EIA-positive samples was determined by nested RT-PCR. The frequency of rotavirus genotypes G1, G2, G3, G4 and G9 was 17.33, 13.34, 2.67, 30.66 and 2.67 %, respectively. Also, the frequency of mixed and non-typable genotypes was detected in 2.67 and 30.66 %, respectively. G1/G8 mixed infection was the first of these rotavirus genotypes to be reported in Iran. Detection of high prevalence of group A rotavirus infection in hospitalised children with diarrhoea, and determination of circulating rotavirus genotypes in this region of Iran, provide useful data for formulating effective vaccines; especially for infants less than 5-years-old.

Group A rotavirus genotypes circulating prior to implementation of a National Immunization Program in Estonia

Group A rotaviruses (RVA) are a major cause of acute gastroenteritis in children ≤ 5 y worldwide which could be prevented with two recently introduced vaccines – monovalent Rotarix (live-attenuated G1P[8] strain) and pentavalent RotaTeq (human-bovine reassortant containing serotypes G1, G2, G3, G4 and P[8]). Prior to implementation of vaccines into national immunization program we aimed to describe RVA genotype distribution in hospitalized children aged < 5 y in Estonia during 2007–2008. A total of 671 children with confirmed RVA gastroenteritis from three major pediatric hospitals were prospectively enrolled. G- and P-genotypes were detected from 124 stool samples by semi-nested reverse transcription-PCR. Severity of disease was assessed using Clark scoring system. The majority of cases (65%) occurred in infants aged 7 to 24 mo and were of moderate severity (mean Clark score 12.1 (SD 3.2)). The prevailing strain was G2P[4] (34.7%), causing significantly more cases than G4P[8] (12.9%), G1P[8] or G9P[8] (both 4.0%), G3P[8] (1.6%). Yearly differences in genotype distribution occurred, as G2P[4] (52.8%) dominated in 2007, but G4P[8] (26.9%) in 2008. One third of strains remained non-typeable. The distribution of RVA genotypes in Estonia differs from that seen in other Central and Eastern European countries, although one should bear in mind the large proportion of P-untypeable strains and natural fluctuations of dominating RVA genotypes. Nevertheless, considering the high genotype-independent efficacy of the vaccines, introduction of national immunization should be considered.

Assessment of a rapid immunochromatographic test for the diagnosis of norovirus gastroenteritis

Noroviruses are the leading cause of acute gastroenteritis in people of all ages. Since the viruses are highly infectious, rapid and early diagnosis is important to prevent and control the disease. The present study aimed to evaluate the commercial immunochromatographic test RIDA® QUICK Norovirus for the detection of norovirus in stool samples from patients with acute gastroenteritis in Thailand. As compared with reference RT-PCR results, the RIDA® QUICK Norovirus assay provided a sensitivity of 48.2 and 83.3% with a specificity of 87.5%. False positive results were observed in 12.5% of norovirus-negative stool samples. Based on commercial quantitative real-time RT-PCR, the RIDA® QUICK Norovirus assay revealed a highly significant association, p-value <0.001, and good agreement (kappa = 0.6). The assay could detect norovirus in stool samples ranging from 3.22 × 10(6) to 3.26 × 10(8) copies/ml. False negative results occurred in the stool samples containing 5.9 × 10(6) copies/ml of norovirus GI or 1.85 × 10(4) - 4.28 × 10(5) copies/ml of GII. The immunochromatographic RIDA® QUICK Norovirus assay may be useful for rapid screening of norovirus infections in patients with acute gastroenteritis in both developed and developing countries where the RT-PCR method has not been established for routine diagnosis.