Rotavirus antigenemia in patients with acute gastroenteritis.
Although rotavirus infections are generally considered to be confined to the intestine, recent reports suggest that extraintestinal disease occurs. We studied whether rotavirus infection was associated with antigenemia during a major outbreak of gastroenteritis in the Kingston metropolitan area, during July-August 2003. Rotavirus antigen was identified in 30 of 70 acute-phase serum samples (including from 2 deceased individuals) but in only 1 of 53 control samples. Serum antigen levels were inversely associated with time since symptom onset and were directly associated with antigen levels in stool (P = .02). Serum antigen levels were significantly elevated during primary infections (acute-phase serum immunoglobulin G [IgG] titers, <25), compared with those in subsequent infections (acute-phase serum IgG titers, > or = 25) (P = .02). Antigenemia was common in this outbreak and might provide a mechanism to help explain rare but well-documented reports of findings of extraintestinal rotavirus. In situations in which stool samples are not readily available (i.e., patients with severe dehydration or those recently recovered or deceased), serum testing by enzyme immunoassay offers a new and practical diagnostic tool.
Fischer
Thea K
TK
Viral Gastroenteritis Team, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. thf7@cdc.gov or thf@ssi.dk
Ashley
Deanna
D
Kerin
Tara
T
Reynolds-Hedmann
Erica
E
Gentsch
Jon
J
Widdowson
Marc-Alain
MA
Westerman
Larry
L
Puhr
Nancy
N
Turcios
Reina M
RM
Glass
Roger I
RI
D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D012367:RNA, Viral / Q000737:chemistry / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012401:Rotavirus / Q000235:genetics / Q000254:growth & development*; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000276:immunology / Q000821:virology
D000914:Antibodies, Viral; D000956:Antigens, Viral; D007074:Immunoglobulin G; D012367:RNA, Viral