title: Diversity of circulating rotavirus strains in children hospitalized with diarrhea in India, 2005-2009.
abstract: BACKGROUND
  India accounts for 22% of the 453,000 global rotavirus deaths among children <5 years annually. The Indian Rotavirus Strain Surveillance Network provides clinicians and public health partners with valuable rotavirus disease surveillance data. Our analysis offers policy-makers an update on rotavirus disease burden with emphasis on regional shifts in rotavirus strain epidemiology in India.
  
  
  METHODS
  Children <5 years requiring hospitalization for acute gastroenteritis were selected from 10 representative hospitals in 7 cities throughout India between November 2005 through June 2009. We used a modified World Health Organization protocol for rotavirus surveillance; stool specimens were collected and tested for rotavirus using enzyme immunoassay and reverse-transcription polymerase chain reaction.
  
  
  RESULTS
  A total of 7285 stool specimens collected were tested for rotavirus, among which 2899 (40%) were positive for rotavirus. Among the 2899 rotavirus detections, a G-type could not be determined for 662 (23%) and more than one G type was detected in 240 (8%). Of 1997 (69%) patients with only one G-type, the common types were G1 (25%), G2 (21%), G9 (13%), and G12 (10%). The proportion of rotavirus infections attributed to G12 infections rose from 8% to 39% in the Northern region and from 8% to 24% in the Western region.
  
  
  CONCLUSIONS
  This study highlights the large, ongoing burden of rotavirus disease in India, as well as interesting regional shifts in rotavirus strain epidemiology, including an increasing detection of G12 rotavirus strains in some regions. While broad heterotypic protection from rotavirus vaccination is expected based on pre- and post-licensure data from other settings, effectiveness assessments and rotavirus strain monitoring after vaccine introduction will be important.
authors.affiliation: Christian Medical College, Vellore 632002, India.
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Kang
authors.forename: Rishi
authors.initials: R
authors.lastname: Desai
authors.forename: Rashmi
authors.initials: R
authors.lastname: Arora
authors.forename: Shobha
authors.initials: S
authors.lastname: Chitamabar
authors.forename: Trilok Nath
authors.initials: TN
authors.lastname: Naik
authors.forename: Triveni
authors.initials: T
authors.lastname: Krishnan
authors.forename: Jagdish
authors.initials: J
authors.lastname: Deshpande
authors.forename: Mohan D
authors.initials: MD
authors.lastname: Gupte
authors.forename: S
authors.initials: S
authors.lastname: Venkatasubramaniam
authors.forename: Jon R
authors.initials: JR
authors.lastname: Gentsch
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
authors.forename: Ann
authors.initials: A
authors.lastname: Mathew
authors.lastname: Anita
authors.forename: Sasirekha
authors.initials: S
authors.lastname: Ramani
authors.forename: Thuppal V
authors.initials: TV
authors.lastname: Sowmynarayanan
authors.forename: Prabhakar D
authors.initials: PD
authors.lastname: Moses
authors.forename: Indira
authors.initials: I
authors.lastname: Agarwal
authors.forename: Anna
authors.initials: A
authors.lastname: Simon
authors.forename: Anuradha
authors.initials: A
authors.lastname: Bose
authors.forename: Ritu
authors.initials: R
authors.lastname: Arora
authors.forename: Preeti
authors.initials: P
authors.lastname: Chhabra
authors.forename: Prachi
authors.initials: P
authors.lastname: Fadnis
authors.forename: Jyoti
authors.initials: J
authors.lastname: Bhatt
authors.forename: Sushmita J
authors.initials: SJ
authors.lastname: Shetty
authors.forename: Vinay Kumar
authors.initials: VK
authors.lastname: Saxena
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Mathur
authors.forename: Alka
authors.initials: A
authors.lastname: Jadhav
authors.forename: Soumyabrata
authors.initials: S
authors.lastname: Roy
authors.forename: Anupam
authors.initials: A
authors.lastname: Mukherjee
authors.forename: Ng Brajachand
authors.initials: NB
authors.lastname: Singh
mesh_terms: D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000821:virology; D005759:Gastroenteritis / Q000453:epidemiology / Q000821:virology; D005838:Genotype; D006760:Hospitalization; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D016133:Polymerase Chain Reaction; D012401:Rotavirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000453:epidemiology / Q000821:virology; D014611:Vaccination