Rotavirus Infection Research Articles

In Vitro Antiviral Potential of Cucurbitaceae Ecballium elaterium and Its Extract Containing Protease Inhibitors against Bovine Rotavirus

Bovine rotaviruses (BRVs) are significant causative agents of severe diarrhea in newborn calves, resulting in substantial economic losses in the livestock industry. Inhibition of bovine rotavirus using extracts prepared from a Cucurbitaceae plant, which contains trypsin protease inhibitors, might offer a potential anti-rotaviral effect in vitro. Ecballium elaterium (E. elaterium) belongs to the Cucurbitaceae family, indigenous to the Mediterranean, contains E. elaterium trypsin isoinhibitors (EETIso), and has been used in traditional medicine. This study aimed to evaluate the in vitro efficacy of E. elaterium extract against bovine rotavirus infections. Ethanol extracts were prepared from E. elaterium seeds and fruit juice, and their non-toxic concentrations were determined using MA-104 cells. The cells were infected with bovine rotavirus in the presence of E. elaterium extract. The results demonstrated a significant decrease in the rotavirus titer in vitro upon treatment with the E. elaterium extract, suggesting its potential as a therapeutic agent against bovine rotavirus-induced diarrhea in calves. The utilization of E. elaterium extract may contribute to reduced calf mortality, lower medication costs, and improved economic value in cattle farming.

Improving utilization of rotavirus vaccination among children in Kuwait: an intervention study

Vaccination against rotavirus is an effective strategy to overcome the consequences of rotavirus infection. This study aims to raise the knowledge, attitude, and practice (KAP) of both parents or caregivers and healthcare providers towards the rotavirus vaccination. The design of the study was an interventional pre-test and post-test. The type of intervention used in this study is an educational intervention. The intervention consisted of a health education message delivered to the participants including both parents or caregivers and healthcare providers. It included three phases, the first one was carried out to assess the KAP of mothers and caregivers before the intervention, the second phase involved the evaluation of participants’ post-intervention, and the third phase involved the assessment of healthcare providers. The study used a survey to assess the demographics, KAP of the participants. The collected data was analyzed using the SPSS program. The overall KAP among mothers were high (11.6%). After the intervention, the level of KAP of mothers toward the rotavirus vaccine was improved significantly (p=0.0001). Also, after the health education message, the level of KAP of the healthcare providers was significantly improved (p=0.0001). The levels of KAP of mothers and healthcare providers were improved after the educational intervention and the health educational message, reflecting the important role of educational intervention in raising the awareness of both mothers and healthcare providers.

Cost-of-illness of gastroenteritis caused by rotavirus in Chinese children less than 5 years

ABSTRACT Acute gastroenteritis (AGE) caused by rotavirus (RV) remains a public health issue in China. To accelerate the mass rotavirus vaccination, it is important to inform the policy maker, and the public of the economic burden caused by rotavirus infection. A meta-analysis was conducted applying standardized algorithms. Articles published before January 1, 2023, in English and Chinese were searched through PubMed, CNKI, and WanFang Data. Studies with cost analysis of RV AGE were included. A random-effects model was applied to synthesize the total cost of RV AGE from the societal perspective. A prospective survey aimed to measure the cost of RV AGE was conducted in 2021 and 2022 in Shaoxing city, Zhejiang province, that can represent the developed region. The cost data was applied as deviation indicator, in comparison with the pooled estimate generated from meta-analysis. Totally 286 articles were identified, and eventually 12 studies were included. The pooled total social cost of RV AGE was US$282.1 (95%CI: US$213.4–350.7). The pooled private cost of RV AGE was US$206.4 (95%CI: US$155.2–257.5). RV AGE hospitalized and RV AGE incurred in developed regions caused remarkable higher burden (US$631.2 [95%CI: US$512.6–749.8], and US$333.6 [95%CI: US$234.1–433.2] respectively), compared to RV AGE treated at outpatient, and incurred in less developed regions. Our study demonstrates that RV AGE causes a significant economic burden in China. Given the promising effectiveness and highly cost-effective, introduction of rotavirus vaccines in national immunization programs could substantially reduce the economic burden in China.

Oxidative stress enhances rotavirus oncolysis in breast cancer and leukemia, except in melanoma with abundant matrix

ObjectivesThis study aimed to explore the impact of oxidative stress and extracellular matrix integrity on rotavirus infection in various cancer cells, including breast cancer, acute lymphoblastic leukemia, and melanoma. MethodsWe induced oxidative stress using ROS-inducing drugs (cisplatin, metronidazole, melatonin, valproic acid, doxorubicin, losartan, nitrofurantoin, and DHA) and investigated the effects on viral infection in MCF-7, Reh, A375, B16-F1, and SK-MEL-28 cells and the generation of virions from infected cells by harvesting the supernatants every two hours, reinfecting other cells, and analyzing cell viability and DNA fragmentation. FindingsIn MCF-7 and Reh cells, rotavirus Wt1–5 infection led to increased ROS generation, virion production, membrane permeability, mitochondrial dysfunction, DNA damage, and cell death. These effects were amplified by ROS-inducing drugs. Conversely, melanoma cells (SK-MEL-28 and A375) with a robust extracellular matrix network showed limited sensitivity to the drugs. Notably, losartan, which modulates the extracellular matrix, enhanced viral infection in melanoma cells (99 %). ConclusionsOxidative stress promotes oncolytic rotavirus infection in breast cancer and acute lymphoblastic leukemia cells, suggesting potential utility in combination with radiotherapy or chemotherapy due to their shared induction of intracellular oxidative stress.

Distribution of group a Rotavirus circulating in Mashhad, Iran.

Group A Rotavirus (RVA) is the most important causative agent of acute diarrheal disease in pediatrics 5 years and below. This study aimed to determine the distribution of circulating RVA in Mashhad, Iran to develop health improvement strategies and vaccine decision making. A total of 106 fecal specimens were collected from children admitted to Akbar and Dr. Sheikh referral pediatric hospitals of Mashhad City during the December 2020 to March 2021 and December 2021 to March 2022. All specimens were tested for specific bacterial, parasitic, and amoebic infections. Negative samples were analyzed for RVA infections using the RT-PCR method. RVA was detected in 31.3% of the specimens, indicating no statistical significance in gender distribution or between fall and winter positivity rates. The number of RVA-positive specimens increased following age increasing in the range of 1 to 60 months. Today, acute diarrheal disease (ADD) is still caused mostly by Rotavirus infections in pediatrics in Mashhad. Comprehensive studies are needed to determine the genetic diversity of circulating Rotavirus strains in this era.

A 7-Year Survey (2015-2021) in One Pediatric Hospital (Brasov, Romania) on Rotavirus Gastroenteritis Specified as Community- or Hospital-Acquired Infection in Young Children.

This project is an observational, descriptive study evaluating frequencies of rotavirus disease in hospitalized children aged less than 5 years old between 2015 and 2021 in the Pediatric Hospital of Brasov, Central Romania. The study compares socio-demographic (age, sex, place of living and ethnicity), clinical, and treatment aspects between community-acquired rotavirus gastroenteritis (CARG) and hospital-acquired rotavirus gastroenteritis (HARG). During that period, 1913 hospitalized children had a rapid positive immunichromatographic rotavirus test from stool specimens. Among them, 1620 (84.6%) were CARG and 293 (15.4%) were HARG. CARG conditions represented 28.5% of all acute hospitalized gastroenteritis (n = 5673) whereas HARG represented 5.2%. Around the same percentage of urban children were seen in CARG as in HARG (58.5% (n = 948) for CARG and 56.3% (n = 164) for HARG). About 64.9% (n = 1052) of CARG cases were from Roma population, and 66.5% (n = 195) in HARG. The age group with the highest frequency of the disease was 12 to 24 months old for both CARG and HARG. The average hospital duration was 5.09 days for CARG and 7.62 days for HARG. Diarrhea was the principal symptom in both CARG and HARG (92.6% (n = 1500) for CARG and 93.9% (n = 275) for HARG). Most CARG patients (61% (n = 989)) were treated for symptomatic management with iv fluids. Most HARG (60.4% (n = 177)) were treated for symptomatic management with iv fluids and antibiotics. A significant seasonal shift to a later period in the year was observed during the last registration year of 2021, possibly due to the COVID-19 epidemic. The seasonal disease burden of rotavirus infection in children remains high in hospital care in Romania, which may justify the systematic introduction of rotavirus vaccination across the whole country.

660. Pediatric Rotavirus Hospitalization Rates in the Military Health System Before and During the COVID-19 Pandemic

Abstract Background Rotavirus, a vaccine preventable disease, causes significant morbidity and mortality in children < 5 years of age. Globally, the COVID-19 pandemic reduced the rates of pediatric vaccinations, and the Military Health System (MHS) was no different (Figure 1). This gap in immunizations left many children vulnerable to preventable illnesses, including rotavirus. We hypothesized that the reduction in rotavirus vaccine administration during the pandemic would lead to an increase in rotavirus related hospitalizations within the MHS. Methods A repeated monthly cross-sectional study was performed using inpatient data from the MHS to observe differences in rotavirus rates and risk factors before and during the COVID-19 pandemic. Data from March 2018 to February 2020 was considered pre-pandemic, while the following two years (until February 2022), were divided into COVID Year 1 and Year 2. Children included in the study were between 0-59 months of age and those with rotavirus were identified using ICD-10 codes. Poisson regression calculated rate ratios of rotavirus, adjusting for several demographic variables and time period at diagnosis. Monthly counts and rates of rotavirus were also documented. Results Across the cohort of 1.14 million MHS beneficiaries, there were 3,503 unique cases of rotavirus infections in hospitalized children < 5 years old (Table 1). During both Years 1 and 2 of COVID-19, there was a significant decrease in rotavirus related hospitalizations compared to the pre-pandemic period (Figure 2). Younger age was associated with increased risk. Patient sex, parent military rank, and region were not statistically significant (Table 2). Conclusion Despite the reduction in routine immunization administration to children in the MHS after the COVID-19 pandemic started, there was not an increase in rotavirus related hospitalizations. In the two years following the start of the pandemic, there was a statistically significant decrease in hospitalizations related to rotavirus in our cohort. Social distancing to include daycare closures, increased hygiene measures, and catch-up immunizations may explain this finding. Continued research into this topic will help determine if rotavirus related hospitalizations return to pre-pandemic levels. Disclosures All Authors: No reported disclosures

Characterization of Rotavirus Strains Responsible for Breakthrough Diarrheal Diseases among Zambian Children Using Whole Genome Sequencing.

The occurrence of rotavirus (RV) infection among vaccinated children in high-burden settings poses a threat to further disease burden reduction. Genetically altered viruses have the potential to evade both natural infection and vaccine-induced immune responses, leading to diarrheal diseases among vaccinated children. Studies characterizing RV strains responsible for breakthrough infections in resource-limited countries where RV-associated diarrheal diseases are endemic are limited. We aimed to characterize RV strains detected in fully vaccinated children residing in Zambia using next-generation sequencing. We conducted whole genome sequencing on Illumina MiSeq. Whole genome assembly was performed using Geneious Prime 2023.1.2. A total of 76 diarrheal stool specimens were screened for RV, and 4/76 (5.2%) were RV-positive. Whole genome analysis revealed RVA/Human-wt/ZMB/CIDRZ-RV2088/2020/G1P[4]-I2-R2-C2-M2-A2-N2-T2-E2-H2 and RVA/Human-wt/ZMB/CIDRZ-RV2106/2020/G12P[4]-I1-R2-C2-M2-A2-N1-T2-E1-H2 strains were mono and multiple reassortant (exchanged genes in bold) respectively, whilst RVA/Human-wt/ZMB/CIDRZ-RV2150/2020/G12P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1 was a typical Wa-like strain. Comparison of VP7 and VP4 antigenic epitope of breakthrough strains and Rotarix strain revealed several amino acid differences. Variations in amino acids in antigenic epitope suggested they played a role in immune evasion of neutralizing antibodies elicited by vaccination. Findings from this study have the potential to inform national RV vaccination strategies and the design of highly efficacious universal RV vaccines.

Pharmacotherapeutic justification of the hypertonic saline solution usage for the treatment of calves with diarrhea

Among the mass distribution of gastrointestinal diseases in calves with signs of diarrhea, a significant share is occupied by infectious diseases. In the farm, the largest number of sick calves had polyetiological disorders of the gastrointestinal tract, which were caused by causative agents of rotavirus, corona virus infection, and Escherichia Coli K99. The complex etiological nature of the disease with the symptom of diarrhea, the variety of pathogenetic links involves all body systems in the pathological process and requires complex treatment. Treatment should include restoration of hydration and concentration of electrolytes, correction of metabolic acidemia, fight against opportunistic and pathogenic microorganisms, intoxication, and restoration of digestive functions. Treatment of the experimental group of sick calves with diarrhea included antibiotic therapy using Colistin orally at a dose of 0.5 g/50 kg of body weight, twice a day, for 5 days; drinking colostrum in a dose of 30 ml once a day for 3 days; rehydration therapy by drinking energy electrolyte solution "Regidrobust" once a day for 3 days and infusion of 7.5% sodium chloride solution at a dose of 4 ml/kg of body weight, once. Calves of the control group did not receive an infusion of 7.5% sodium chloride solution. The research results showed that in the calves of the research group, complex therapy using a hypertonic 7.5% sodium chloride solution had a stronger therapeutic effect, positively changed the biochemical and morphological indicators of the blood, led to the normalization of metabolic processes, body functions as a whole, and restoration of calf activity. The calves of the experimental group on the 2nd day of treatment showed much more active interest in feed and consumed it and generally had a satisfactory general condition. This did not happen in the calves of the control group, whose condition remained depressed. Disappearance of the symptom of diarrhea in calves of the experimental group was noted on average on the 3rd day of treatment, in calves of the control group on 4-5 days. The proposed treatment scheme contributed to the reduction of the calf disease period by 1,5 times. Key words: diarrhea, gastrointestinal disorders, calves, hypertonic sodium chloride solution, hypertonic saline solution, treatment, rota virus infection, corona virus infection, colibacteriosis.

Prevalence and genetic diversity of rotavirus in Bangladesh during pre-vaccination period, 1973-2023: a meta-analysis.

Rotavirus infection is a major cause of mortality among children under 5 years in Bangladesh. There is lack of integrated studies on rotavirus prevalence and genetic diversity during 1973 to 2023 in Bangladesh. This meta-analysis was conducted to determine the prevalence, genotypic diversity and seasonal distribution of rotavirus during pre-vaccination period in Bangladesh. This study included published articles on rotavirus A, rotavirus B and rotavirus C. We used Medline, Scopus and Google Scholar for published articles. Selected literatures were published between 1973 to 2023. This study detected 12431 research articles published on rotavirus. Based on the inclusion criteria, 29 of 75 (30.2%) studies were selected. Molecular epidemiological data was taken from 29 articles, prevalence data from 29 articles, and clinical symptoms from 19 articles. The pooled prevalence of rotavirus was 30.1% (95% CI: 22%-45%, p = 0.005). Rotavirus G1 (27.1%, 2228 of 8219) was the most prevalent followed by G2 (21.09%, 1733 of 8219), G4 (11.58%, 952 of 8219), G9 (9.37%, 770 of 8219), G12 (8.48%, 697 of 8219), and G3 (2.79%, 229 of 8219), respectively. Genotype P[8] (40.6%, 2548 of 6274) was the most prevalent followed by P[4] (12.4%, 777 of 6274) and P[6] (6.4%, 400 of 6274), respectively. Rotavirus G1P[8] (19%) was the most frequent followed by G2P [4] (9.4%), G12P[8] (7.2%), and G9P[8], respectively. Rotavirus infection had higher odds of occurrence during December and February (aOR: 2.86, 95% CI: 2.43-3.6, p = 0.001). This is the first meta-analysis including all the studies on prevalence, molecular epidemiology, and genetic diversity of rotavirus from 1973 to 2023, pre-vaccination period in Bangladesh. This study will provide overall scenario of rotavirus genetic diversity and seasonality during pre-vaccination period and aids in policy making for rotavirus vaccination program in Bangladesh. This work will add valuable knowledge for vaccination against rotavirus and compare the data after starting vaccination in Bangladesh.

Study of Pathophysiological Aspects of Acute Diarrhea Due to Rotavirus Infection

Rotavirus is a highly contagious virus that enters the body through the consumption of food or water contaminated by the feces of an infected individual. After entering the body, rotavirus infects the epithelial cells lining the small intestine, which is the main site for the absorption of nutrients and water. Rotavirus infects intestinal epithelial cells by attaching to the cell surface and entering the cell. This triggers changes in the epithelial cells, including changes in the receptors present on the surface of the cells. Viruses damage epithelial cells by remodeling the cell's cytoskeleton. This causes epithelial cells to lose their ability to absorb nutrients and water properly. Over time, damage to these epithelial cells causes increased intestinal leakage, allowing fluid to enter the intestines faster than it can be absorbed. The literature search process was carried out on various databases (PubMed, Web of Sciences, EMBASE, Cochrane Libraries, and Google Scholar) regarding studies of the pathophysiology of acute diarrhea due to Rotavirus infection. This study follows the preferred reporting items for systematic reviews and meta-analysis (PRISMA) recommendations. Rotavirus causes damage to intestinal epithelial cells by remodeling the cell cytoskeleton. This results in epithelial cells losing their ability to absorb nutrients and water properly. Rotavirus infection triggers inflammation in the intestines. Infected cells release inflammatory mediators, such as cytokines, which trigger response inflammation. This inflammation causes intestinal irritation, increased bowel movements, and increased mucus production. Fluid loss through diarrhea is a major consequence of rotavirus infection. Babies and children, especially, are especially susceptible to serious dehydration. Dehydration can be life-threatening if not treated quickly and efficiently.

Rotavirus-induced lncRNA SLC7A11-AS1 promotes ferroptosis by targeting cystine/glutamate antiporter xCT (SLC7A11) to facilitate virus infection

Rotavirus (RV) is the primary etiological agent of virus-associated gastroenteritis in infants, causing 200,000 childhood death annually. Despite the availability of vaccines, rotaviral diarrhea continues to be a severe issue in underdeveloped nations in Asia and Africa. The situation demands continual studies on host-rotavirus interactions to understand disease pathogenesis and develop effective antiviral therapeutics. Long non-coding RNAs (lncRNAs), which are a subset of non-coding RNAs of more than 200 nucleotides in length, are reported to play a regulatory function in numerous viral infections. Virus infection often alters the host transcriptome including lncRNA that are differentially expressed either to play an antiviral role or to be advantageous towards virus propagation. In the current study, qPCR array-based expression profiling of host lncRNAs was performed in rotavirus-infected HT-29 cells that identified the lncRNA SLC7A11-AS1 to be upregulated during RV infection. Knockdown of SLC7A11-AS1 conspicuously reduced RV titers implying its pro-viral significance. RV-induced SLC7A11-AS1 downregulates the gene SLC7A11/xCT that encodes the light chain subunit of the system XC− cystine-glutamate exchange transporter, leading to decrease in intracellular glutathione level and increase in lipid peroxidation, which are signature features of ferroptotic pathway. Ectopic expression of xCT also abrogated RV infection by reversing the virus optimized levels of intracellular GSH and lipid ROS levels. Cumulatively, the study reveals that RV infection triggers ferroptotic cell death via SLC7A11-AS1/xCT axis to facilitate its own propagation.

Epidemiology of Rotavirus in Humans, Animals, and the Environment in Africa: A Systematic Review and Meta-analysis.

Globally, rotavirus infections are the most common cause of diarrhea-related deaths, especially among children under 5 years of age. This virus can be transmitted through the fecal-oral route, although zoonotic and environmental contributions to transmission are poorly defined. The purpose of this study is to determine the epidemiology of rotavirus in humans, animals, and the environment in Africa, as well as the impact of vaccination. We searched PubMed, Web of Science, Africa Index Medicus, and African Journal Online, identifying 240 prevalence data points from 224 articles between 2009 and 2022. Human rotavirus prevalence among patients with gastroenteritis was 29.8% (95% confidence interval [CI], 28.1%-31.5%; 238 710 participants), with similar estimates in children under 5 years of age, and an estimated case fatality rate of 1.2% (95% CI, .7%-2.0%; 10 440 participants). Prevalence was estimated to be 15.4% and 6.1% in patients with nongastroenteritis illnesses and apparently healthy individuals, respectively. Among animals, prevalence was 9.3% (95% CI, 5.7%-13.7%; 6115 animals), and in the environmental water sources, prevalence was 31.4% (95% CI, 17.7%-46.9%; 2530 samples). Our findings highlight the significant burden of rotavirus infection in Africa, and underscore the need for a One Health approach to limiting the spread of this disease.

Genomic constellations of RVA detected in Brazil from 1986 to 2016: a temporal and geographical distribution and occurrence of reassortments

Introduction: Species A rotavirus (RVA) infections are a major cause of severe gastroenteritis in children of <5 years worldwide. In Brazil, before vaccination, RVA was associated with 3.5 million episodes of acute diarrheal disease per year. Due to the segmented nature of their genomes, rotaviruses can exchange genes during co-infections, and generate new virus strains and new reinfections. Objective: To evaluate the genomic diversity of RVA isolated in Brazil in 30 years, between 1986 to 2016, to investigate possible changes in the frequency of genotype constellations before and after the implementation of the vaccine. Methods: In total, 4,474 nucleotide sequences were obtained from the Virus Variation Database. Genomic constellation was compared, and the proportion of rotavirus genotypes was analyzed by time and geographic region. Results: Our results showed that major known genotypes were circulating in the country during the period under analysis, with a prevalence of the G1P[8] Wa-like genotype, decreasing only in the period immediately after the introduction of the vaccine. Regarding the geographical distribution, most of our constellations, 62 (39.2%), and 50 (31.6%) were concentrated in the North and Northeast regions. Our analysis also showed the circulation of multiple strains during the periods when the DS-1-like and AU-1-like genotypes were co-circulating with the Wa-like genotype. Conclusion: Therefore, it is likely that inter-genogroup reassortments are still occurring in Brazil and so it is important to establish an efficient surveillance system to follow the emergence of novel reassorted strains that might not be targeted by the vaccine.

Study of the safety and immunogenicity of VLP-based vaccine for the prevention of rotavirus infection in neonatal minipig model

In Russia, almost half of the cases of acute intestinal infections of established etiology in 2022 are due to rotavirus infection (RVI). There is no specific treatment for rotavirus gastroenteritis. There is a need to develop modern, effective and safe vaccines to combat rotavirus infection that are not capable of multiplying (replicating) in the body of the vaccinated person. A promising approach is to create vaccines based on virus-like particles (VLPs). Study of the safety and immunogenicity of a vaccine against rotavirus infection based on virus-like particles of human rotavirus A in newborn minipigs with multiple intramuscular administration. Newborn minipigs were used as an animal model in this study. The safety of the tested vaccine was assessed based on thermometry data, clinical examination, body weight gain, clinical and biochemical blood parameters, as well as necropsy and histological examination. When studying the immunogenic properties of the Gam-VLP-rota vaccine in doses of 30 and 120 µg, the cellular, humoral and secretory immune response was studied. The results of assessing the general condition of animals during the immunization period, data from clinical, laboratory and pathomorphological studies indicate the safety of the vaccine against human rotavirus infection based on VLP (Gam-VLP-rota) when administered three times intramuscularly. Good local tolerance of the tested vaccine was demonstrated. The results of the assessment of humoral immunity indicate the formation of a stable immune response after three-time immunization with Gam-VLP-rota, stimulation of the production of antigen-specific IgG antibodies and their functional activity to neutralize human rotavirus A. It was shown that following the triple immunization with the minimum tested concentration of 30 µg/dose, animals developed a cell-mediated immune response. The results of the IgA titer in blood serum and intestinal lavages indicate the formation of both a systemic immunological response and the formation of specific secretory immunity to human rotavirus A. Thus, three-time intramuscular immunization of minipigs with the Gam-VLP-rota vaccine forms stable protective humoral and cellular immunity in experimental animals. Evaluated vaccine is safe and has good local tolerability.

Amlodipine and Diltiazem Significantly Repress Human Rotavirus Infection In Vitro.

Considering the role of calcium in the replication and morphogenesis of rotaviruses, it is hypothesized that decreased cytosolic calcium levels by using calcium channel blockers can subsequently interfere with rotavirus replication. The present study investigated the effects of two calcium ion channel blockers, amlodipine and diltiazem, against human rotavirus infection. Cytotoxic effects of the drugs on MA-104 cells were evaluated using the neutral red assay. The effects of amlodipine and diltiazem at non-toxic concentrations on human rotavirus were examined using cytopathic effect inhibition, TCID50, and real-time PCR assays. The highest inhibitory effect was obtained at concentrations of 0.5 μg/ml of amlodipine and 3 μg/ml of diltiazem, leading to 4.6 and 5.5 logarithmic reductions in infectious rotavirus titer and four- and a five-fold increase in the Ct values compared to the virus control, respectively (p-value < 0.001). Conversely, infectious rotavirus titers were significantly elevated compared to the virus control at concentrations above 0.9 μg/ml of amlodipine and above 25 μg/ml of diltiazem. Our study suggests that in addition to cardiovascular diseases, calcium channel blockers at their optimal doses may also be used to treat gastroenteritis caused by rotavirus infection.

Ukrainian War Refugee Children With Particularly Severe Viral Infections: A Case Series Report.

The humanitarian crisis in Ukraine in 2022 led to a massive migration of refugees to Poland. Immigrant children, living in overcrowded humanitarian hubs, were exposed to multiple stressful factors likely affecting their immune systems. This case series study aimed to describe a particularly severe course of common viral infections, in Ukrainian refugee children. We present 2 case series of Ukrainian refugee children: 5 hospitalized due to either adenovirus (AdV) and 8 with rotavirus (RV) infection, admitted within 3 months in each case series, recruited retrospectively. Most patients lived in humanitarian hubs and were neglected on admission (dehydrated, with poor hygiene and anxious). All RV infection cases had symptoms of severe gastroenteritis requiring intravenous rehydration. Metabolic acidosis was present in 6 children, and hypoglycemia in 4 participants. None of them were vaccinated against RV. All children with AdV infection had prolonged fever, dyspnea requiring oxygen therapy and hyperinflammation. In 2 AdV infection cases with no clinical improvement and increasing inflammatory markers, intravenous immunoglobulins and glucocorticosteroids were used. The combination of stressful factors and living in overcrowded hubs during the high prevalence of viral infections led to a particularly severe course of viral infections in Ukrainian refugee children.

The success of publicly funded rotavirus vaccine programs for preventing community- and hospital-acquired rotavirus infections in Canadian pediatric hospitals: an observational study.

Canadian immunization programs for rotavirus started in 2011. We sought to determine their effect on the burden of community-acquired admissions and hospital-acquired rotavirus at pediatric hospitals. The Canadian Immunization Monitoring Program Active (IMPACT) network conducted active surveillance for rotavirus-positive hospital admissions between 2005 and 2020 at 12 pediatric hospitals. We used yearly rates of community-acquired rotavirus per 10 000 admissions and hospital-acquired rotavirus infections per 1000 patient-days to determine changes in the pre- and post-vaccine program periods. During the 15-year study period, 5691 rotavirus hospital admissions and hospital-acquired infections were detected, including 4323 (76%) community-acquired infections and 1368 (24%) hospital-acquired infections. The average community-acquired rate in the pre-vaccine period was 60.3 (95% confidence interval [CI] 53.7-68.3) per 10 000 admissions, with a decline to 11.0 (95% CI 7.5-15.1) per 10 000 admissions in the post-vaccine period, resulting in an average reduction of 81.7% (95% CI 74.4%-87.8%). The rate of hospital-acquired rotavirus declined from 0.35 (95% CI 0.29-0.41) per 1000 patient-days in the pre-vaccine period to 0.05 (95% CI 0.03-0.07) per 1000 patient-days in the post-vaccine period, resulting in an 85.3% (95% CI 77.7%-91.9%) average decline. Herd protection was present among children aged 2-16 years. Although start dates of rotavirus vaccine programs across provinces varied, there was around an 80% average decrease in both community-acquired and hospital-acquired rotavirus infections at pediatric hospitals in Canada in the 1- to 9-year interval after implementation of rotavirus vaccine programs. Herd protection is an important aspect of rotavirus vaccines for other children who are not vaccine eligible, and rotavirus vaccines continue to provide important benefits both for children and health care systems.

Microbiota do not restrict rotavirus infection of colon.

Alterations of the gut microbiome can have significant effects on gastrointestinal homeostasis leading to various diseases and symptoms. Increased understanding of rotavirus infection in relation to the microbiota can provide better understanding on how microbiota can be used for clinical prevention as well as treatment strategies. Our volumetric 3D imaging data show that antibiotic treatment and its consequent reduction of the microbial load does not alter the extent of rotavirus infection of enterocytes in the small intestine and that restriction factors other than bacteria limit the infection of colonocytes.

Bocavirus and rotavirus co-infection in children with acute gastroenteritis and associated risk factors

Background: Both Viruses are the leading cause of acute gastroenteritis in infants and young children and are considered an important cause of mortality worldwide. &#x0D; Objective: To estimate the rate of human bocavirus and rotavirus co-infection in children with acute gastroenteritis and determine any association with different risk factors.&#x0D; Patients and Methods: Stool samples were collected from one hundred children suffering from acute gastroenteritis at the Central Teaching Hospital of Pediatrics, Baghdad, Iraq, for the period from December 2021 to April 2022. Samples were stored at -20 °C until they were utilized by PCR and ELISA to identify the human bocavirus (HBoV) DNA and rotavirus antigen (RV-Ag), respectively.&#x0D; Results: This cross-sectional study showed that HBoV DNA was detected in 10 out of 100 samples (10%), while RV-Ag was detected in 22 out of 93 samples (23.66%), and the co-infection rate was 100% (All cases positive for HBoV were also positive for RV). None of the studied demographic data and risk factors showed a significant association with HBoV and/or rotavirus infection (P&gt;0.05).&#x0D; Conclusion: Most NICU deaths resulted from prematurity and respiratory distress syndrome. Enhancing healthcare personnel skills, standardizing protocols, and evidence-based practices for preterm and respiratory distress syndrome management can help reduce neonatal mortality rates in Iraq.