title: Virus diversity in a winter epidemic of acute diarrhea in France.
abstract: In France, an epidemic peak of acute diarrhea is observed each winter. Previous results suggested a viral etiology for these winter epidemics. We investigated the role of enteric viruses in acute diarrhea and their molecular diversity. One hundred sixty-one patients with acute diarrhea and 45 healthy patients (controls) from the general population were given a standardized questionnaire between December 1998 and May 1999. Stool specimens were screened for group A and C rotaviruses, human caliciviruses, astroviruses, and adenovirus types 40 and 41 by reverse transcription-PCR and/or enzyme immunoassay. Virologic analysis was positive for 63 cases (39%). Caliciviruses and group A rotaviruses were the most frequent (19 and 17% of cases, respectively). Two control stool specimens were found positive for group A rotavirus, and one was found positive for astrovirus. Molecular characterization of the strains disclosed a cocirculation of P[8],G1, P[8],G4, and P[4],G2 rotaviruses; type 1, 2, 3, 4, and 8 astroviruses; and Sapporo-like and Norwalk-like human caliciviruses. These four types of viruses accounted for an attributable risk of acute diarrhea of 34.7% for the general population, under the assumption of a causal role of these viruses.
authors.affiliation: Institut National de la Santé et de la Recherche Médicale Unité 444, Epidémiologie et Sciences de l'Information, Faculté de Médecine Saint-Antoine, 75571 Paris, France. roxane.brachet@u444.jussieu.fr
authors.forename: Roxane
authors.initials: R
authors.lastname: Chikhi-Brachet
authors.forename: Fabienne
authors.initials: F
authors.lastname: Bon
authors.forename: Laurent
authors.initials: L
authors.lastname: Toubiana
authors.forename: Pierre
authors.initials: P
authors.lastname: Pothier
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Nicolas
authors.forename: Antoine
authors.initials: A
authors.lastname: Flahault
authors.forename: Evelyne
authors.initials: E
authors.lastname: Kohli
mesh_terms: D000208:Acute Disease; D000260:Adenoviruses, Human / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D000293:Adolescent; D000328:Adult; D000368:Aged; D002139:Caliciviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000821:virology*; D004196:Disease Outbreaks; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D001257:Mamastrovirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D008875:Middle Aged; D012401:Rotavirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D012621:Seasons; D014777:Virus Diseases / Q000453:epidemiology / Q000821:virology; D014780:Viruses / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification