title: Comparison of viral load and duration of virus shedding in symptomatic and asymptomatic neonatal rotavirus infections.
abstract: A single rotavirus strain causing asymptomatic infections as well as severe gastrointestinal disease has been described in the neonatal nurseries of the Christian Medical College, Vellore. In this study, quantitative real-time RT-PCR was used to determine the association of viral load with the presence of gastrointestinal symptoms in neonates. Viral load was estimated in terms of the crossing point [C(t) value] at which the amplicon could be detected in the real-time PCR assay. The study was carried out on 103 neonates, including 33 asymptomatic neonates and 70 neonates with different gastrointestinal symptoms. The duration of virus shedding was also compared between five symptomatic and four asymptomatic neonates using real-time RT-PCR. There was no significant difference in viral load between symptomatic and asymptomatic neonates (P = 0.087). Among neonates with different gastrointestinal symptoms, those presenting with feed intolerance and abdominal distension had a significantly higher viral load than those with other gastrointestinal symptoms (P = 0.02). For the study on virus shedding, nine neonates were followed up for a median duration of 53 days, with a median of 31 samples tested per child. Extended shedding of low copies of rotavirus was found, with no significant differences in pattern of shedding between symptomatic and asymptomatic neonates. The lack of correlation between viral load and gastrointestinal disease demonstrates yet another difference between neonatal rotavirus infection and infection in older children where higher viral load correlates with severe disease.
authors.affiliation: Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Sasirekha
authors.initials: S
authors.lastname: Ramani
authors.forename: Premi
authors.initials: P
authors.lastname: Sankaran
authors.forename: Rajesh
authors.initials: R
authors.lastname: Arumugam
authors.forename: Rajiv
authors.initials: R
authors.lastname: Sarkar
authors.forename: Indrani
authors.initials: I
authors.lastname: Banerjee
authors.forename: Ipsita
authors.initials: I
authors.lastname: Mohanty
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: D005500:Follow-Up Studies; D005759:Gastroenteritis / Q000473:pathology* / Q000821:virology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012367:RNA, Viral / Q000235:genetics / Q000302:isolation & purification; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012401:Rotavirus / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000473:pathology* / Q000821:virology*; D013997:Time Factors; D019562:Viral Load; D017201:Virus Shedding
chemical_list: D012367:RNA, Viral