Comparison of viral load and duration of virus shedding in symptomatic and asymptomatic neonatal rotavirus infections.
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.
Ramani
Sasirekha
S
Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
Sankaran
Premi
P
Arumugam
Rajesh
R
Sarkar
Rajiv
R
Banerjee
Indrani
I
Mohanty
Ipsita
I
Jana
Atanu Kumar
AK
Kuruvilla
Kurien Anil
KA
Kang
Gagandeep
G
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
D012367:RNA, Viral