title: Rotavirus antigenemia in patients with acute gastroenteritis.
abstract: 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.
authors.affiliation: 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
authors.forename: Thea K
authors.initials: TK
authors.lastname: Fischer
authors.forename: Deanna
authors.initials: D
authors.lastname: Ashley
authors.forename: Tara
authors.initials: T
authors.lastname: Kerin
authors.forename: Erica
authors.initials: E
authors.lastname: Reynolds-Hedmann
authors.forename: Jon
authors.initials: J
authors.lastname: Gentsch
authors.forename: Marc-Alain
authors.initials: MA
authors.lastname: Widdowson
authors.forename: Larry
authors.initials: L
authors.lastname: Westerman
authors.forename: Nancy
authors.initials: N
authors.lastname: Puhr
authors.forename: Reina M
authors.initials: RM
authors.lastname: Turcios
authors.forename: Roger I
authors.initials: RI
authors.lastname: Glass
mesh_terms: 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
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral; D007074:Immunoglobulin G; D012367:RNA, Viral