Rotavirus Research Articles

Lipid metabolism is involved in the association of rotavirus viroplasms with endoplasmic reticulum membranes.

Rotavirus (RV) replication occurs in cytoplasmic membrane-less, electron-dense inclusions termed viroplasms, composed of viral and cellular elements. These inclusions have been shown to colocalize with components of the lipid droplets (LDs), unique organelles that play an essential role in lipid metabolism. Given the robust LDs-viroplasm association, LDs have been proposed to serve as a scaffold for viroplasm assembly. Interestingly, no evidence has described the participation of lipid metabolism in other RV replication steps. Here, we report that lipid metabolism is essential to maintain the production of the infectious virus through a process independent of viroplasm biogenesis. Disruption of the lipogenesis-lipolysis balance dissociates endoplasmic reticulum membranes from viroplasms, suggesting that lipid metabolism is essential for a continuous flux of lipids to allow the association between viroplasms and ER membranes. LDs could also be relevant as lipid reservoirs for membrane synthesis required to form mature infectious rotavirus particles.

Molecular Detection of Enteric Viruses in Under-Five Children with Diarrhea in Debre Tabor, Northwest Ethiopia.

BackgroundViral gastroenteritis belongs to the major public health problems of infant and children worldwide. The largest proportion of morbidity and mortality occurs in Sub-Saharan Africa.PurposeAimed to assess the burden and genetic diversity of enteric viruses among children with diarrhea.Patients and MethodsA cross-sectional study was undertaken from December 2015 to April 2016 in Debre Tabor. A total of thirty-eight children, who presented with diarrhea at Debre Tabor health centers, were included. Fecal samples were collected and screened for enteric viruses by RT-PCR. Data were analyzed using SPSS software. Descriptive summary techniques were used to display the findings.ResultsOut of thirty-eight children screened, 52.6% were positive for at least one enteric virus. Six (30.0%) of the children had mixed enteric virus infections. Human adenovirus (HAdV) 7 (18.4%) was predominant followed by noroviruses (NoVs) 5 (13.2%), enterovirus (EV) 5 (13.2%), rotavirus A (RVA) 4 (10.5%), human astrovirus (HAstV) 2 (5.3%), and human parechovirus (HPeV) 1 (2.6%). Overall, nineteen different types of enteric virus genotypes were identified. Diverse adenovirus within species A (HAdV-12,-31), B (HAdV-3), C (HAdV-2), and F (HAdV-4) were detected. Norovirus II (GII.4 and GII.6) and norovirus I (GI.2, GI.3, and GI.5) genotypes were found. Sapovirus genotypes within genogroup II (GII.1, GII.5, and GII.6) were identified. Wild-type rotavirus G9 and P[8] genotypes were detected in one of the rotavirus positive samples. Non-polio enteroviruses within species A (coxsackie A virus (CAV) 5, CAV6, and CAV14) and C (enterovirus (EV-C) 99) were also identified. In two of the fecal samples classic HAstV-2 was detected.ConclusionDiverse enteric viruses were detected in fecal samples from under-five children with diarrhea. The detection of heterogeneous enteric viruses in this small data set highlights the need for extended multicenter studies to describe the burden and genetic diversity of enteric virus.

Impact of Vaccination on Rotavirus Genotype Diversity: A Nearly Two-Decade-Long Epidemiological Study before and after Rotavirus Vaccine Introduction in Sicily, Italy.

Sicily was the first Italian region to introduce rotavirus (RV) vaccination with the monovalent G1P[8] vaccine Rotarix® in May 2012. In this study, the seasonal distribution and molecular characterization of RV strains detected over 19 years were compared to understand the effect of Rotarix® on the evolutionary dynamics of human RVs. A total of 7846 stool samples collected from children < 5 years of age, hospitalized with acute gastroenteritis, were tested for RV detection and genotyping. Since 2013, vaccine coverage has progressively increased, while the RV prevalence decreased from 36.1% to 13.3% with a loss of seasonality. The local distribution of RV genotypes changed over the time possibly due to vaccine introduction, with a drastic reduction in G1P[8] strains replaced by common and novel emerging RV strains, such as equine-like G3P[8] in the 2018–2019 season. Comparison of VP7 and VP4 amino acid (aa) sequences with the cognate genes of Rotarix® and RotaTeq® vaccine strains showed specific aa changes in the antigenic epitopes of VP7 and of the VP8* portion of VP4 of the Italian RV strains. Molecular epidemiological surveillance data are required to monitor the emergence of novel RV strains and ascertain if these strains may affect the efficacy of RV vaccines.

Lacticaseibacillus rhamnosus GG Counteracts Rotavirus-Induced Ion Secretion and Enterocyte Damage by Inhibiting Oxidative Stress and Apoptosis Through Specific Effects of Living and Postbiotic Preparations.

BackgroundAdministration of Lacticaseibacillus rhamnosus GG (LGG) to children with gastroenteritis is recommended by universal guidelines. Rotavirus (RV) causes diarrhea through combined cytotoxic and enterotoxic effects. Aim of this study was to evaluate the mechanisms of efficacy of LGG in an in-vitro model of RV diarrhea in its viable form (LGG) and conditioned medium (mLGG).MethodsIon secretion corresponding to the NSP4 enterotoxic effect, was evaluated by short circuit current (Isc) and the cytotoxic effect by transepithelial electrical resistance (TEER) in Ussing chambers, upon exposure to RV in Caco-2 enterocyte monolayers treated or not with living probiotic or its culture supernatant. Mechanisms of enterotoxic and cytotoxic damage were evaluated including oxidative stress measured by reactive oxygen species, apoptosis evaluated by DAPI and nuclear staining, NFkβ immunofluorescence.ResultsRV induced Isc increase and TEER decrease, respectively indicating ion secretion and epithelial damage, the two established pathways of diarrhea. Both probiotic preparations reduced both diarrheal effects, but their potency was different. Live LGG was equally effective on both enterotoxic and cytotoxic effect whereas mLGG was highly effective on ion secretion and showed minimal protective effects on cytoskeleton, apoptosis and NFkβ.ConclusionsLGG counteracts RV-induced diarrhea by inhibiting both cytotoxic and enterotoxic pathogenic mechanisms. Namely, LGG inhibits chloride secretion by specific moieties secreted in the medium with a direct pharmacologic-like action. This is considered a postbiotic effect. Subsequently, live bacteria exert a probiotic effect protecting the enterocyte structure.

Rotavirus-Induced Lipid Droplet Biogenesis Is Critical for Virus Replication.

A variety of pathogens, including viruses, bacteria and parasites, target cellular lipid droplets for their replication. Rotaviruses (RVs) infect the villous epithelium of the small intestine and are a major cause of acute gastroenteritis in infants and young children worldwide. RVs induce and require lipid droplets for the formation of viroplasms, sites of virus genome replication, and nascent particle assembly. Here we review the role of lipid droplets in RV replication. Inhibitors of fatty acid synthesis or chemicals that interfere with lipid droplet homeostasis decrease the number and size of viroplasms and the yield of infectious virus. We used a genetically engineered RV, delayed in viroplasm assembly, to show an early interaction of RV nonstructural protein NSP2 and the lipid droplet-associated protein phospho-PLIN1. The interaction between NSP2 and phospho-PLIN1 suggests that we have identified part of the mechanism of RV-induced lipid droplet formation. These studies demonstrate that RV is an excellent model to dissect the cellular process of lipid droplet formation and to determine how RV induces and usurps lipid droplet biogenesis to form viroplasm/lipid droplets for virus replication.

Acute norovirus gastroenteritis in up to five years children highly rotavirus-vaccinated population in southern Brazil

The acute gastroenteritis remains a problem social, economic and of the public health of the global impact and among the main causative agents are the viruses. This study aimed to show the circulation of rotavirus (RoV) and norovirus (NoV) infections in children under 5 years, vaccinated or not against RoV, enrolled in the health system presented gastroenteritis. From March 2011 to February 2012 a total of 160 stool samples were collected, overall positivity rates were 11.9% (19/160) for NoV and was not found infected patients with RV. The children include had a mean of 2.8 and a median of 3 years of old, and the average of rotavirus vaccination rate was 83.85%. This result shows that this circulating NoV and suggests a reduction in the occurrence of RoV infection in children with high vaccination coverage rate.

Rotavirus VP6: involvement in immunogenicity, adjuvant activity, and use as a vector for heterologous peptides, drug delivery, and production of nano-biomaterials.

The first-generation, live attenuated rotavirus (RV) vaccines, such as RotaTeq and Rotarix, were successful in reducing the number of RV-induced acute gastroenteritis (AGE) and child deaths globally. However, the low efficacy of these first-generation oral vaccines, coupled with safety concerns, required development of improved RV vaccines. The highly conserved structural protein VP6 is highly immunogenic, and it can generate self-assembled nano-sized structures, including tubes and spheres (virus-like particles; VLPs). Amongst the RV proteins, only VP6 shows these features. Interestingly, VP6-assembled structures, in addition to being highly immunogenic, have several other useful characteristics that could allow them to be used as adjuvants, immunological carriers, and drug-delivery vehicles as well as acting a scaffold for production of valuable nano-biomaterials. This review provides an overview of the self-assembled nano-sized structures of VP6-tubes/VLPs and their various functions.

Preventive Effect of a Postbiotic and Prebiotic Mixture in a Rat Model of Early Life Rotavirus Induced-Diarrhea.

Rotavirus (RV) is the main cause of gastroenteritis in children. Prebiotics and, more recently, postbiotics are used for preventing and treating gastrointestinal infections. The aim of this study was to analyze the effects of a LactofidusTM, short-chain galacto-oligosaccharides (scGOS) and long-chain fructo-oligosaccharides (lcFOS) mixture, and their combination on RV infection, in a rat model, for early life diarrhea. Fifteen litters of suckling rats were intragastrically administered daily with the vehicle, the prebiotic mixture, the postbiotic or the combination. The RV was inoculated on day 5 and then fecal samples were clinically evaluated daily. Viral shedding, intestinal permeability assay, in vitro blocking assay, immunoglobulin profiles, and anti-RV response were assessed at day 8 and 16 of life. Cecal microbiota composition, intestinal gene expression, and short chain fatty acids (SCFAs) were analyzed at day 16. The incidence and severity of diarrhea were significantly reduced by all the supplementations. Moreover, they showed blocking activity, changes in the immunoglobulin profiles, in gut microbiota, and in the intestinal gene expression. The prebiotic mixture reduced gut permeability and changed the SCFA profile, whereas the postbiotic enhanced the expression of Toll-like receptors (TLRs). The combination preserved most of the individual observed effects, and furthermore, complementary effects, such as an increase in white blood cells and lymphocytes recruitment, as well as upregulation of TLR7 and TLR9 gene expression.

Rotavirus-Mediated Suppression of miRNA-192 Family and miRNA-181a Activates Wnt/β-Catenin Signaling Pathway: An In Vitro Study.

The significance of the Wnt/β-catenin signaling cascade in Rotavirus (RV) infection has not been elucidated. In this study, we attempt to elucidate the importance of the Wnt/β-catenin pathway in the RV pathogenesis and investigate a miRNA-mediated approach to regulate the pathway to repress the RV infection in the host. The regulation of the Wnt signaling pathway in terms of β-catenin accumulation and activation was analyzed by Western blotting and Confocal imaging analysis. The expression levels of miR-192 family members and miR-181a were enquired into using qPCR assays, whereas their targets in the Wnt pathway were confirmed using the Luciferase Reporter Assays. Members of the miR-192 family and miR-181a, which target the components of the pathway, were also found to be considerably decreased in expression during RV infection. Ectopic expression of these miRNAs could restrict the RV pathogenesis by targeting the intermediates of the Wnt signaling pathway. The miR-192 family and miR-181a were capable of suppressing the RV infection via targeting of the Wnt/β-catenin pathway. The study not only highlights the role of the Wnt signaling cascade in RV infection but also suggests that miRNAs can synergistically decrease RV replication by a significant amount. Thus, the miR-192 family and miR-181a present themselves as prospective antivirals against RV infection.

Microbial aetiology of diarrhea in children less than five years of age at tertiary care hospital of Western Uttar Pradesh, India

Introduction and Aim: Diarrhoeal diseases are one of the major causes of childhood morbidity and mortality globally. Multiple aetiologies and associated risk factors are responsible for diarrhoeal diseases in children. The present study aims to determine the microbial aetiology and possible risk factors of diarrhoea in children less than five years of age at Chhatrapati Shivaji Subharti Hospital, Subharti Medical College, Meerut in Western Uttar Pradesh, India. Materials and Methods: A total of 240 children &lt; 5 years of age with history of acute diarrhoea of less than 7 days duration were included in the study. Microbial etiology of diarrhoea in children were looked for. Bacterial etiology was identified by standard bacteriological technique. Diarrheagenic E. coli (DEC) were identified by gene-specific polymerase chain reaction. Rotavirus (RV) antigen was detected by Enzyme Immunoassay (EIA), parasites were identified by wet mount preparation and fungal etiology was identified by microscopy and culture on Sabouraud’s Dextrose Agar. Results: Out of 240 stool samples, 152 were identified as known aetiology of diarrhea. Microbial etiology could be established in 133/240 (55.41%) stool samples. The most common microbial etiology was bacterial 63(47.36%) followed by rotavirus 35 (17.29 %), parasitic etiology in 22 (16.54%) and least common etiology was fungal in 13 (9.77%) cases. Among other etiology, Lactose intolerance was found in 19/240 (7.91%) cases. Mixed aetiology with two or more pathogen causing diarrhoea was seen in 27% cases. Conclusion: Aetiological agents of diarrhoea could be identified in 63.3% cases. Causes of childhood diarrhoea is polymicrobial and preventable. Awareness and education especially to the mothers regarding the disease, safe drinking water, proper food intake and proper sanitation are key to overcome the burden of the preventable infectious diseases among children less than five years of age.

Detection of adenovirus, rotavirus, and hepatitis E virus in meat cuts marketed in Uruguaiana, Rio Grande do Sul, Brazil

The aim of this study was to investigate the presence of adenovirus (AdV), rotavirus (RV), and hepatitis E virus (HEV) in beef, pork, and chicken meat cuts in retail trade in the city of Uruguaiana, RS, Brazil. A total of 131 meat products were collected (beef, n = 55; chicken, n = 47; pork, n = 29) from 18 commercial establishments (supermarkets, n = 7; butchers, n = 7; markets/grocery stores, n = 4). All samples were evaluated for AdV, RV, and HEV. The genomes of RV and AdV were identified in 29% (n = 38) and 5.34% (n = 7) of the samples, respectively. HEV was not identified in any of the samples. Chicken cuts had a higher frequency of AdV and RV isolates compared to beef and pork (P < 0.05). Among the categories of commercial establishments evaluated, all revealed at least one positive sample for AdV and RV; however, supermarkets showed a higher frequency of RV than others (P < 0.05). The genetic material of AdV and RV was identified simultaneously in 2.29% (n = 3) of samples from supermarkets (n = 2) and grocery stores (n = 1). This is the first report on detection of enteric viruses in meat cuts in the western region of the state of Rio Grande do Sul, Brazil, and the presence of AdV and RV in these products may indicate flaws during the process of handling these foods, especially in places where commercialization provides important public health issues.

Prevalence and diversity of rotavirus A in pigs: Evidence for a possible reservoir in human infection

Rotavirus A (RVA) are a group of diverse viruses causing acute gastroenteritis (AGE) in humans and animals. Zoonotic transmission is an important mechanism for rotavirus evolution and strain diversity in humans, but the extent of pigs as a major reservoir for human infection is not clear. We have surveyed 153 pig farms across Taiwan with a total of 4588 porcine stool samples from three age groups from 2014 to 2017. Nursing piglets (less than one month of age) had higher detection rate for rotavirus than older age groups. Five VP7 (G) genotypes and 5 VP4 (P) genotypes were found in a total of 14 different G/P genotype combinations. In addition, porcine RVA strains had 2 NSP4 (E) genotypes and 3 VP6 (I) genotypes. A P[3]-like genotype was also discovered among strains collected in 2016 and 2017. Most of the genes from Taiwanese porcine strains clustered with each other and the lineages formed by these strains were distinct from the sequences of numerous regional variants or globally circulating porcine strains, suggesting an independent evolutionary history for Taiwanese rotavirus genotypes. The close relationship among porcine RVA strains and some unique porcine-like genotypes detected sporadically among human children in swine farms illustrates that pigs might serve as a reservoir for potential zoonotic transmission and novel genotype evolution in Taiwan's insular environment.

Rotavirus F and G circulating in chickens in Southeastern Brazil.

Rotavirus (RV) infections represent a significant cause of enteritis and diarrhea in avian species and pose a major concern for the poultry industry. However, the prevalence of rotavirus infections among birds is poorly understood. Stool samples were collected from laying and broiler hens from commercial poultry farms in the states of Rio de Janeiro and Espírito Santo, Southwest region of Brazil, for detection of rotavirus species F and G (RVF and RVG, respectively) by reverse transcription polymerase chain reaction. RV was detected in 11.7% (38/325) of samples: 35 samples were positive for RVF and 3 for RVG. RVF was detected in 15 samples from Rio de Janeiro and 23 samples from Espírito Santo. RVG was detected in 3 samples from Espírito Santo. All the positive samples were from asymptomatic broiler chickens. The prevalence of RV infection in these flocks was high, especially considering that the birds had no apparent clinical disease. Silent circulation in the herds signifies the need for a continuous surveillance program to guide measures to control and prevent this viral infection. Continuous monitoring of pathogens is crucial to ensure greater productivity on poultry farms.

A shift in circulating rotaviral genotypes among hospitalized neonates

In neonates, rotavirus (RV) infection is generally nosocomial. The control of rotaviral infection within hospital settings is challenging due to prolonged shedding of the virus and contamination of the surrounding environment. There are few studies that have reported asymptomatic infection within neonates. In this study, neonates were screened for RV infection and possible clinical manifestations that may play a role in RV acquisition were analysed. Stool samples were collected from 523 hospitalized neonates admitted for > 48 h in a low-cost and higher-cost tertiary centre. RV antigen was screened using ELISA and the samples which tested positive were confirmed by semi-nested RT-PCR. RV was detected in 34% of participants and genotypes identified included G12P[11] (44.4%), G10 P[11] (42.6%), G10G12P[11] (10.1%) and G3P[8] (2.9%). ICU admissions were associated with higher viral shedding (p < 0.05). Hospitalization in the low-cost facility ICU was associated with higher RV acquisition risk (p < 0.05). RV was detected in higher rates (36.9%) among neonates with gastrointestinal manifestations. G10P[11] was the predominant genotype for several years (1988–2016) among neonates within India. The preponderance of an emerging G12P[11] genotype and heterotypic distribution was documented. RV surveillance is important to identify emerging strains and establish the road ahead in managing RV infection.

Genomic diversity and intragenic recombination of species C rotaviruses.

Rotavirus C (RVC) is a major cause of diarrhoea in swine, cattle, and humans worldwide. RVC exhibits sequence diversity in all 11 genes, especially in VP4 and VP7, and all segment-based genotyping has been performed similar to rotavirus A. To date, recombination events have been reported in rotavirus A and B. However, there are no reports describing gene recombination of RVC, except for recombination in NSP3 between RVC and rotavirus H. In this study, nine porcine RVC strains identified in Japanese pigs were completely sequenced and analysed together with RVC sequences from the GenBank database. The analyses showed that sequences of the VP4, VP2, and NSP1 of several porcine RVC strains did not branch with any of those of the RVC strains in the GenBank database, suggesting new genotypes. Several homologous recombination events, between or within genotypes, were identified in the VP4, VP7, VP2, NSP1, and NSP3 genes. Of these, nine, one, and one intergenotypic recombination events in the VP4, VP2, and NSP3 genes, respectively, were supported with sufficient statistical values. Although these findings suggest occurrences of the intragenic recombination events in the RVC genome, potential sequence errors and poor sequence assemblies in the databases should be watched with care. The results in this study present data about the important recombination events of the RVCs, which influence evolution of the virus by aiding them to gain genetic diversity and plasticity, although further sequence data will be necessary to obtain more comprehensive understanding of such mechanisms.

Rotavirus A, a significant cause of infant diarrhea in Mozambique

Introduction: Rotavirus A (RVA) is a leading cause of acute infant gastroenteritis in Mozambique, responsible for approximately 13,000 annual infant deaths in peri-urban and other areas. Aim: the present review aimed summarize the most relevant and recent literature regarding RVA infection in Mozambique. Methods: the documents were obtained from electronic databases such as PubMed, Google Scholar, Scinapse, Scilit, and Microsoft Academic to find the leading scientific publications related to Mozambique's RVA.Findings: The search allowed us to find 20 peer-reviewed journal articles, three official reports, eight abstracts from national conferences, one thesis, and other documents to supplement the information. Rotavirus frequency ranged between 24 to 42.4%, 34.8% attributable to Mozambique. Most data are hospital-based from Maputo, Sofala, Zambézia, and Nampula provinces. Nampula province shows the highest number of cases. Thus, there might be some bias on the geographical distribution of the virus. The prevalence is high in children less than one year. Regarding the control, the Expanded Program on Immunization (EPI) introduced a monovalent vaccine in September 2015 (Rotarix), which positively impacted the reduction of RVA cases. After vaccine introduction, a high diversity of RVA genotypes was observed, with the predominance of G1P[8] and the emergence of G9P[4], G9P[6], G3P[4]. However, only the whole genome sequence can confirm if it is due to the natural genotypes fluctuation. RVA infection was detected in swine, and a recent analysis reported an RVA strain from children clustered with different animal strains.Conclusion: The scarce yet highly reliable research resources allowed scientists to detect RVA G1P[8] and other genotypes, potential animal reservoirs, and to find that RVA is more prevalent during the transition dry-rainy season, and the virus becomes more frequent when children approach the 11th month, to then decline as they age. It is essential to develop studies providing a broad view of RVA reservoirs as part of the strategy to control its dissemination.Keywords: Rotavirus infections; Children; Diarrhea; Mozambique

Seroprevalence of Rotavirus among Selected Group of Sudanese Children

Rota virus is the second causes of diarrhea among childrenIn Sudan [2]. The current study was conduct to detect rotavirus gastroenteritis among vaccinated children Methodolgy: A total of59 diarrheal samples was collected from children with acute diarrhea admittedto Mohammed AL Amin Hamid paediatric Hospital throw period from October to November 2019, ELISA was dine to detect Rota virus antigen. Result: Out of 59 samples 84.7% was vaccinated were 15.3% was unvaccinated.in total of 50 vaccinated children 30% is re-infected with rota virus with acute to chronic illness and show positive antigen with ELISA. Conclusions: vaccinated children is infected with rota virus and symptoms is occurs samples for virus antigen was record positive result in ELISA this may related to other genotype or serotype or mutation.

Occurrence of pathogenic microorganisms in small drinking-water systems in Costa Rica

This study describes the quality of drinking water sampled over 2 years (2018 and 2019) from 20 ASADAS (Spanish acronym for Administrative Associations for Water and Sewer Systems) in Costa Rica. The analysis included Rotavirus (RV), somatic coliphages, fecal coliforms, and Escherichia coli. The ASADAS were categorized into three regions as temperate rainy (region 1), tropical rainy (region 2), and tropical rainy and dry (region 3) according to biogeographic classification. The concentrations of fecal coliforms and E. coli were higher in samples from surface water sources from the ASADAS in region 3 compared to regions 1 and 2. RV-positive samples (24/296) were detected in drinking-water samples from regions 2 and 3 during dry and transition seasons, with higher concentrations more frequently in the dry season. In addition, somatic coliphages were detected in samples from the three regions, with higher concentrations in region 2. Furthermore, a statistically significant relationship was found between somatic coliphages and diarrheal cases, classified as outbreaks or alerts in the region. Thus, the results confirmed that somatic coliphages are a good indicator of the presence of diarrhea cases in a specific region.

Rotavirus genotypes and clinical outcome of natural infection based on vaccination status in the post-vaccine era

ABSTRACT Rotavirus (RV) is a leading cause of gastroenteritis in children. In Japan, Rotarix (RV1; GlaxoSmithKline), which is a monovalent vaccine derived from human RV (G1P[8]), has been introduced since November 2011, and RotaTeq (RV5; MSD) which is an pentavalent, human-bovine mono-reassortant vaccine (G1, G2, G3, G4, and P1A[8]), has been introduced since July 2012. Long-term follow-up on vaccine efficacy and RV genotypical change should be carried out in order to control RV infection. The RV gastroenteritis (RVGE) outbreak occurred during the 2018/2019 season in Aichi prefecture, Japan. Therefore, the molecular epidemiology of RV among three different groups of RVGE, which were outpatients who received RV1, those who received RV5, and those without vaccination, was explored. Clinical features of RVGE patients were compared among the three patient groups. Children less than 15 years of age with gastroenteritis who visited any of seven pediatric practices between January and June 2019 were enrolled in the study. G, P, and E genotypes were determined by direct sequencing of reverse transcription–polymerase chain reaction products amplified from stool samples. Among 110 patients, there were 27, 28, and 55 in the RV1-vaccinated, RV5-vaccinated, and unvaccinated groups, respectively. The most frequent genotype was G8P[8] (92/110 patients, 83.6%). Genotype distributions did not significantly differ among the three patient groups (P = .125). Mean Vesikari score was significantly lower among RV1-vaccinated (7.1) and RV5-vaccinated patients (6.4) than among unvaccinated patients (10.2) (P < .001). Even in RVGE patients treated in an outpatient clinic, RV vaccine reduced the severity of the disease in this cohort.

An increasing trend of human sapovirus infection in Japan, 2009 to 2019: An emerging public health concern

BackgroundHuman sapovirus (SaV) is an important etiologic agent of childhood diarrhea. This study aims to investigate the burden of SaV infection in childhood diarrhea in Japan from 2009–2019, to understand the changes in SaV infection after the introduction of rotavirus (RV) vaccination in Japan in 2011. MethodsStool samples were collected from children aged ≤ 12 years old with acute gastroenteritis (AGE) who visited outpatient clinics of six prefectures in Japan. The viral RNA was detected by RT-PCR and genogroups and genotypes were determined through sequence-based analysis. ResultsAmong 5697 stool samples, 318 (5.6%) samples remained SaV-positives showing the highest prevalence in June and 12–24 month aged children. The most predominant genotype was GI.1 (56.8%), followed by GI.2 (19.2%), GII.1 (10.8%), GIV.1 (9.4%), GI.3 (1.7%), GII.2 (1.4%), GII.3 and GII.5 (0.3%). Importantly, an increasing trend (P = 0.016) of SaV infection was observed during this period. In particular, SaV-detection rate was increased significantly (P = 0.033) from 4.3% in pre-rotavirus (RV)-vaccination era to 6.1% in post-RV-vaccination era. We provided evidence that this increase in SaV infection was mainly attributed by coinfections. ConclusionsThe upward trend of SaV infection, particularly after the introduction of RV-vaccination, is an emerging concern. Attention should be paid to control this upward trend of SaV infection to ensure maximum benefits of implementation of RV vaccines towards reducing overall childhood diarrhea worldwide.