Viral gastrointestinal infections and norovirus genotypes in a paediatric UK hospital, 2014-2015.
Diarrhoea in children is a common disease; understanding the incidence of causative viruses can aid infection control and vaccine development.



Describe the incidence and characteristics of gastroenteric viruses including norovirus genotypes in a paediatric hospital cohort.



Norovirus, adenovirus, sapovirus, astrovirus, rotavirus qPCR and norovirus genotyping results for all stool specimens (n=4786; 1393 patients) at a UK paediatric tertiary referral hospital June 2014-July 2015.



24% (329/1393) of patients were positive for a GI virus; the majority were positive for norovirus (44%, 144/329) or adenovirus (44%, 146/329). The overall incidence of rotavirus (2%) is reduced compared to pre-vaccination studies; however the incidence of other GI viruses has not increased. Norovirus infections had a significantly higher virus burden compared to other GI viruses (P ≤0.03); sapovirus infections had the lowest viral burden. The number of norovirus cases per month did not follow the typical winter seasonal trend of nationally reported outbreaks. The number of cases per month correlates with the number of hospital admissions (R=0.703, P=0.011); the number of admissions accounts for 50% of the variability in number of cases per month. The breadth of genotypes seen (48% non-GII.4), suggests a community source for many norovirus infections and has implications for vaccine development. All GI viruses caused chronic infections, with the majority (50-100%) in immunocompromised patients. Incidence or duration of infection in chronic norovirus infections did not differ between genotypes, suggesting host-mediated susceptibility.
Microbioloby, Virology and Infection Control, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; NIHR Biomedical Research Centre at Great Ormond Street Hospital for Children NHS Foundation Trust and University College London, UK. Electronic address: julianne.brown@nhs.net.
Julianne R
JR
Brown
Microbioloby, Virology and Infection Control, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; NIHR Biomedical Research Centre at Great Ormond Street Hospital for Children NHS Foundation Trust and University College London, UK.
Divya
D
Shah
Microbioloby, Virology and Infection Control, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Infection and Immunity, University College London, UK.
Judy
J
Breuer
D000257:Adenoviridae Infections / Q000453:epidemiology / Q000821:virology; D000260:Adenoviruses, Human / Q000235:genetics; D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000821:virology; D002675:Child, Preschool; D002908:Chronic Disease / Q000453:epidemiology; D003967:Diarrhea / Q000453:epidemiology / Q000821:virology; D004196:Disease Outbreaks; D005243:Feces / Q000821:virology*; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D005838:Genotype; D006776:Hospitals, Pediatric; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D029322:Norovirus / Q000235:genetics* / Q000302:isolation & purification; D010802:Phylogeny; D012401:Rotavirus / Q000235:genetics / Q000302:isolation & purification; D029341:Sapovirus / Q000235:genetics / Q000302:isolation & purification; D006113:United Kingdom / Q000453:epidemiology; D014777:Virus Diseases / Q000821:virology; D014780:Viruses / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*
Genotypes; Norovirus; PCR; Paediatric; Polymerase chain reaction; Viral gastroenteritis