title: Salivirus type 1 and type 2 in patients with acute gastroenteritis, Germany.
abstract: BACKGROUND
  Salivirus (SaV-A) is a novel member of the family Picornaviridae and has been associated with acute gastroenteritis. Recently, a second type of SaV-A, SaV-A2, was identified in a sewage sample from Bangkok, Thailand. No information is available on the prevalence of SaV-A in Western Europe.
  
  
  OBJECTIVE
  Stool samples from patients with symptoms of acute viral gastroenteritis were analyzed for SaV-A and the clinical course of SaV-A-positive individuals was evaluated.
  
  
  METHODS
  A total of 3019 fecal samples collected during 2012-2013 from 1941 hospitalized patients with acute gastroenteritis were screened for SaV-A by a newly designed real-time reverse transcription polymerase chain reaction targeting a conserved sequence in the 5'-untranslated region. Positive results were verified by sequencing the viral capsid protein 1 gene also allowing typing of the virus. Medical records of SaV-A-infected patients were reviewed for clinical features and laboratory data.
  
  
  RESULTS
  SaV-A was detected in five patients. Viral RNA concentrations ranged from 7.1×10(6) to 7.2×10(8)copies/g feces. The viruses from four patients were classified as SaV-A1 while SaV-A2 was present in one patient. After reviewing the medical records, SaV-A could not be considered as the sole possible cause of gastroenteritis symptoms given the presence of other plausible causes in all five patients.
  
  
  CONCLUSIONS
  SaV-A infection can be detected in Germany, Western Europe, albeit at low levels. The detection of SaV-A2 in Europe suggests wider spread of SaV-A2. Presence of SaV-A, even at high concentrations, in a stool sample provides no conclusive evidence that SaV is the major cause of the patient's gastroenteritis symptoms.
authors.affiliation: Institute of Virology, University of Bonn Medical Centre, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany.
authors.forename: Souhaib
authors.initials: S
authors.lastname: Aldabbagh
authors.affiliation: Institute of Virology, University of Bonn Medical Centre, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany.
authors.forename: Isabella
authors.initials: I
authors.lastname: Eckerle
authors.affiliation: Dept. of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn Medical Centre, Adenauerallee 119, D-53113 Bonn, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Müller
authors.affiliation: Blood Systems Research Institute, Department of Laboratory Medicine, University of California, 270 Masonic Ave., San Francisco, CA 94118, USA.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Delwart
authors.affiliation: Institute of Virology, University of Bonn Medical Centre, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany. Electronic address: anna-maria.eis-huebinger@ukb.uni-bonn.de.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Eis-Hübinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010849:Picornaviridae / Q000145:classification* / Q000302:isolation & purification*; D010850:Picornaviridae Infections / Q000453:epidemiology* / Q000821:virology*; D015995:Prevalence; D060888:Real-Time Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D055815:Young Adult
keywords: Acute gastroenteritis; Prevalence; Reverse transcription polymerase chain reaction; SaV-A1; SaV-A2; Salivirus