title: Rotavirus genotypes associated with acute diarrhea in Egyptian infants.
abstract: BACKGROUND
  Before the introduction of rotavirus vaccine in Egypt, information on the burden of disease and the circulating rotavirus genotypes is critical to monitor vaccine effectiveness.
  
  
  METHODS
  A cohort of 348 Egyptian children was followed from birth to 2 years of age with twice-weekly home visits to detect diarrheal illness. VP7 and VP4 genes were genotyped by reverse-transcription polymerase chain reaction and DNA sequencing.
  
  
  RESULTS
  Forty percentage of children had rotavirus-associated diarrhea at least once by their second birthday. One hundred and twelve children experienced a single rotavirus diarrheal episodes (RDE) at a median age of 9 months; while 27 infants had their second RDE at a median age of 15 months and 1 infant had 3 RDE at the age of 2, 16 and 22 months. Of the 169 RDE, 82% could be assigned a G-type, while 58% had been identified a P-type. The most prevalent genotype was G2 (32%), followed by G1 (24%) and G9 (19%). G2P[4] rotavirus episodes were significantly associated with fever (P = 0.03) and vomiting (P = 0.06) when compared with other genotypes. G2 strains were the predominant genotype causing 50% of the second RDE while G9 represented 25% of the second RDE.
  
  
  CONCLUSIONS
  Genotypes identified are similar to those detected globally except for absence of G4. Our finding that 75% of the second RDE were due to G2 and G9 indicates a possible reduction in natural protection afforded by these types compared with G1, where 90% of G1 cases did not experience a second xposure, indicating greater protection against recurrent symptomatic infection.
authors.affiliation: From the *United States Naval Medical Research Unit No.3; †Ministry of Health and Population, Cairo, Egypt; ‡Rotavirus Vaccine Program, PATH, Seattle WA; and §MRC Diarrhoeal Pathogens Research Unit, MEDUNSA Campus, University of Limpopo, Pretoria, South Africa.
authors.forename: Salwa F
authors.initials: SF
authors.lastname: Ahmed
authors.forename: Adel M
authors.initials: AM
authors.lastname: Mansour
authors.forename: John D
authors.initials: JD
authors.lastname: Klena
authors.forename: Tupur S
authors.initials: TS
authors.lastname: Husain
authors.forename: Khaled A
authors.initials: KA
authors.lastname: Hassan
authors.forename: Farag
authors.initials: F
authors.lastname: Mohamed
authors.forename: Duncan
authors.initials: D
authors.lastname: Steele
mesh_terms: D015331:Cohort Studies; D003967:Diarrhea / Q000453:epidemiology / Q000821:virology*; D004534:Egypt / Q000453:epidemiology; D005243:Feces / Q000821:virology; D006801:Humans; D007223:Infant; D012401:Rotavirus / Q000235:genetics*; D012400:Rotavirus Infections / Q000453:epidemiology / Q000821:virology*; D012621:Seasons