Norovirus infection in children admitted to hospital for acute gastroenteritis in Belém, Pará, Northern Brazil.
Noroviruses are the leading cause of epidemic, non-bacterial outbreaks of acute gastroenteritis, and are also a major cause of sporadic acute gastroenteritis in infants. The aim of the present study was to identify norovirus infections in children not infected by rotavirus admitted to hospital for acute gastroenteritis in Belém. A total of 348 fecal specimens were obtained from children with diarrhea aged less than 5 years, all of whom had tested negative for rotavirus, between May 2008 and April 2010. Fecal samples were screened for norovirus antigen using enzyme-immunoassay (EIA). Specimens were subjected to reverse-transcription polymerase chain reaction (RT-PCR) using the primers Mon432/434-Mon431/433 for detection of the GI and GII norovirus strains, respectively. Based on both methods, the overall norovirus positivity rate was 36.5% (127/348). Of the 169 samples collected in the first year, 44.4% (n = 75) tested positive for norovirus using both methods, 35.5% (n = 60) by EIA and 40.8% (n = 69) by RT-PCR. Using RT-PCR as a reference standard, a sensitivity of 78.3%, specificity of 94%, and agreement of 87.6% were recorded. Genome sequencing was obtained for 22 (31.9%) of the 69 positive samples, of which 90.9% (20/22) were genotype GII.4d and 9.1% (2/22) were genotype GII.b. Norovirus infection was most frequent in children under 2 years of age (41.5%-115/277). The peak incidence (62.1%) of norovirus-related acute gastroenteritis in these patients (not infected by rotavirus) was observed in February 2010. These findings emphasize the importance of norovirus as a cause of severe acute gastroenteritis among children in Belém, Pará, Northern Brazil.
Postgraduate Program in Tropical Diseases, Tropical Medicine Center, Federal University of Pará State. Belém, Pará, Brazil.
Jones Anderson Monteiro
JA
Siqueira
Alexandre da Costa
Ada C
Linhares
Thaís Cristina Nascimento
TC
de Carvalho
Glicélia Cruz
GC
Aragão
Darleise de Souza
Dde S
Oliveira
Mirleide Cordeiro
MC
Dos Santos
Maisa Silva
MS
de Sousa
Maria Cleonice Aguiar
MC
Justino
Joana D'Arc Pereira
JD
Mascarenhas
Yvone Benchimol
YB
Gabbay
D001938:Brazil / Q000453:epidemiology; D017250:Caliciviridae Infections / Q000453:epidemiology / Q000821:virology*; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000821:virology*; D005838:Genotype; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D029322:Norovirus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D015995:Prevalence; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D012680:Sensitivity and Specificity