title: Genogroup IIb norovirus infections and association with enteric symptoms in a neonatal nursery in southern India.
abstract: Noroviruses (NoVs) are increasingly recognized as an important cause of acute gastroenteritis in children worldwide. However, there are limited data on the role of NoVs in neonatal infections and disease. The objectives of the present study were to determine the prevalence of NoVs in neonates with gastrointestinal disease using a case-control study design and to characterize the NoV strains infecting neonates. A total of 309 fecal samples from 161 neonates with gastrointestinal symptoms and 148 asymptomatic controls were screened for genogroup II (GII) NoV using reverse transcription-PCR. A subset of PCR-positive amplicons for the polymerase and capsid regions was sequenced. NoV was detected in 26.2% of samples, with the rate of detection being significantly higher among symptomatic neonates (60/161, 37.2%) than asymptomatic neonates (24/148, 14.1%) (P < 0.001). On the basis of sequencing of 29 strains, a single NoV strain, GIIb, was identified to be the predominant (27/29, 93.1%) cause of neonatal infections. Coinfection with rotavirus was seen in nearly one-third of symptomatic neonates. The study demonstrates a high prevalence of NoV infections in neonates and indicates that coinfection with rotavirus may result in significantly more gastrointestinal disease in this population.
authors.affiliation: Department of Gastrointestinal Sciences, Christian Medical College, Vellore 632004, India.
authors.forename: Vipin Kumar
authors.initials: VK
authors.lastname: Menon
authors.forename: Santosh
authors.initials: S
authors.lastname: George
authors.forename: Sasirekha
authors.initials: S
authors.lastname: Ramani
authors.forename: Jeyaram
authors.initials: J
authors.lastname: Illiayaraja
authors.forename: Rajiv
authors.initials: R
authors.lastname: Sarkar
authors.forename: Atanu Kumar
authors.initials: AK
authors.lastname: Jana
authors.forename: Kurien Anil
authors.initials: KA
authors.lastname: Kuruvilla
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Kang
mesh_terms: D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D036022:Capsid Proteins / Q000235:genetics; D016022:Case-Control Studies; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D005838:Genotype; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D008297:Male; D008969:Molecular Sequence Data; D029322:Norovirus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D009724:Nurseries, Infant; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics*; D012324:RNA-Dependent RNA Polymerase / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D014764:Viral Proteins / Q000235:genetics
chemical_list: D036022:Capsid Proteins; D012367:RNA, Viral; D014764:Viral Proteins; D012324:RNA-Dependent RNA Polymerase