title: Rotavirus and norovirus infections among acute gastroenteritis children in Morocco.
abstract: BACKGROUND
  Acute gastroenteritis is a serious cause of child mortality and morbidity in resource-limited countries. A viral etiology is most common, and rotavirus and norovirus are reported to be the leading causative agents. There are still few epidemiological data on the simultaneous occurrence of these viruses in Morocco. The aim of this study was to provide useful epidemiological data on the gastroenteritis associated with rotavirus and norovirus among children aged less than 5 years.
  
  
  METHODS
  From January to December 2011, 335 samples were tested for rotavirus and norovirus using enzyme-linked immunosorbent assay, reverse-transcription-polymerase chain reaction (RT-multiplex PCR) and real-time RT-PCR. Partial sequences of the norovirus were phylogenetically analyzed to determine the genotype.
  
  
  RESULTS
  The overall rates of rotavirus and norovirus infections were 26.6% and 16.1%, respectively. Mixed viral infections were detected in 9 of 335 stool specimens (2.7%).The most common genotype combination in the rotavirus strains was G1[P8] (51.7%), followed by G2[P4] (10.1%), G2[P8] (4.5%), G9[P8] (3.4%), G4[P8] (3.4%), and G1[P6] (2.3%). Among patients positive for norovirus, 42 (77.8%) tested positive for GII and 12 (22.2%) for GI. Thirty-three (78.6%) of the norovirus GII-positive cases were successfully characterized. Genotype GII.4 was the most prevalent (n = 27; 81.8%), followed by GII.3 (n = 2; 6.1%), GII.13 (n = 2; 6.1%), GII.16 (n = 1; 3%), and GII.17 (n = 1; 3%).
  
  
  CONCLUSIONS
  This study suggests that in Morocco, norovirus is the most frequent cause of acute gastroenteritis after rotavirus, but further enteric viruses need to be integrated in the surveillance system so that a conclusion could be drawn.
authors.affiliation: Immunology-Virology Department, National Institute of Hygiene, Ministry of Health, 27 Avenue Ibn Batouta, Rabat, Morocco. elqazouimaria@yahoo.fr.
authors.forename: Maria
authors.initials: M
authors.lastname: El Qazoui
authors.forename: Hicham
authors.initials: H
authors.lastname: Oumzil
authors.forename: Larbi
authors.initials: L
authors.lastname: Baassi
authors.forename: Nezha
authors.initials: N
authors.lastname: El Omari
authors.forename: Khalid
authors.initials: K
authors.lastname: Sadki
authors.forename: Saaid
authors.initials: S
authors.lastname: Amzazi
authors.forename: Mohamed
authors.initials: M
authors.lastname: Benhafid
authors.forename: Rajae
authors.initials: R
authors.lastname: El Aouad
mesh_terms: D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009018:Morocco / Q000453:epidemiology; D029322:Norovirus / Q000235:genetics / Q000302:isolation & purification*; D010802:Phylogeny; D060888:Real-Time Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012401:Rotavirus / Q000235:genetics / Q000302:isolation & purification*