title: Resurgence of Rotavirus Genotype G12 in St. Louis During the 2014-2015 Rotavirus Season.
abstract: BACKGROUND
  Rotaviruses are a leading cause of gastroenteritis. Rotavirus vaccination has dramatically reduced rotavirus occurrence; however, we have noticed mild to moderate recurrences in the St. Louis area in alternate years. In 2013, we found rotavirus genotype G12 to be the dominant strain in the St. Louis region. In this study, we again determined the distribution of genotypes and ascertained vaccine history in patients infected with rotavirus G12 during the 2014-15 season.
  
  
  METHODS
  Samples submitted to the St. Louis Children's Hospital Microbiology Laboratory were tested for rotavirus using an antigen assay. We determined the VP7 genotype using amplicon sequence analysis. We determined genome sequences using high-throughput sequencing. We evaluated rotavirus immunization records when available.
  
  
  RESULTS
  Of 30 typed viruses from 2014-15, 29 were G12 (97%). Whole-genome sequencing revealed few changes from G12 viruses analyzed in 2012-13. VP4 and VP7 sequences were >99% identical to previously sequenced G12 strains from St. Louis, and immune epitopes were conserved. Vaccination histories were available from 17 patients. Of these, 4 had been vaccinated, 3 had received incomplete vaccination or had a vaccine history that could not be confirmed, and 10 had not been vaccinated.
  
  
  CONCLUSIONS
  G12 re-emerged as the predominant rotavirus genotype in 2014-15, comprising a higher percentage of cases than in 2012-13. The majority of patients with G12 and available vaccination histories were unvaccinated. There was no genomic evidence to indicate that the G12 strains in St. Louis had evolved to escape vaccine protection. Our work emphasizes the need for continued surveillance.
authors.affiliation: Department of Pediatrics.|The McDonnell Genome Institute, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Kristine M
authors.initials: KM
authors.lastname: Wylie
authors.affiliation: Department of Pediatrics.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Stanley
authors.affiliation: Departments of Pathology and Pediatrics, University of Texas Southwestern, Dallas, Texas.
authors.forename: Erin McElvania
authors.initials: EM
authors.lastname: TeKippe
authors.affiliation: Department of Pediatrics.
authors.forename: Kusal
authors.initials: K
authors.lastname: Mihindukulasuriya
authors.affiliation: Department of Pediatrics.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Storch
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005759:Gastroenteritis / Q000453:epidemiology / Q000821:virology; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D012401:Rotavirus / Q000235:genetics*; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000821:virology; D012621:Seasons; D017422:Sequence Analysis, DNA; D055815:Young Adult
keywords: G12; capture; rotavirus; sequencing; surveillance