Comparative study of the epidemiology of rotavirus in children from a community-based birth cohort and a hospital in South India.
Rotavirus gastroenteritis is the major cause of severe dehydrating diarrhea in children worldwide. This study compares rotavirus diarrhea in 351 children in a community-based cohort and 343 children admitted to a hospital during the same period. Clinical information and fecal specimens were obtained during diarrheal episodes. Fecal samples were screened for VP6 antigen, and the positive samples were G and P typed by reverse transcription-PCR. Rotavirus was detected in 82/1,152 (7.1%) episodes of diarrhea in the community and 94/343 (27.4%) cases in the hospital. The median age of affected children (7.5 versus 10.5 months) and the mean severity of symptoms (Vesikari score, 7.6+/-3.4 versus 11+/-2.5) were lower in the community. A larger proportion of children in the community were breast-fed than were children admitted to the hospital (73% versus 34.8%). In the community, the genotypes identified in symptomatic patients, in order of frequency, were G1 (36.5%), G10 (17.1%), G2 (15.9%), and G9 (7.3%) and mixed infections (7.3%). The most common G-P combinations were G1P[8], G2P[4], G1P[4], and G10P[11]. The distribution of G types from hospitalized children was G1 (46.8%), G9 (19.1%), G2 (8.5%), G10 (1.1%), and 4.3% mixed infections. The most common G-P combinations were G1P[8] and G9P[8]. This study documents significant genetic heterogeneity of rotaviruses in the community and the hospital. G10P[11] strains resembling a vaccine candidate strain caused disease in the community, indicating the need for careful epidemiological studies as well as safety studies for the vaccine candidates.
Banerjee
Indrani
I
Department of Gastrointestinal Sciences, Christian Medical College, Vellore 632004, India.
Ramani
Sasirekha
S
Primrose
Beryl
B
Moses
Prabhakar
P
Iturriza-Gomara
Miren
M
Gray
James J
JJ
Jaffar
Shabbar
S
Monica
Bindhu
B
Muliyil
Jaya Prakash
JP
Brown
David W
DW
Estes
Mary K
MK
Kang
Gagandeep
G
D000367:Age Factors; D000956:Antigens, Viral / Q000032:analysis; D001942:Breast Feeding; D036022:Capsid Proteins / Q000032:analysis; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000821:virology; D003967:Diarrhea / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology*; D005243:Feces / Q000821:virology; D005260:Female; D005838:Genotype; D006760:Hospitalization; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012367:RNA, Viral / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012401:Rotavirus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology*; D014764:Viral Proteins / Q000235:genetics
D000956:Antigens, Viral; D036022:Capsid Proteins; D012367:RNA, Viral; C061332:VP6 protein, Rotavirus; D014764:Viral Proteins