Epidemiology and Clinical Characteristics of Rotavirus and Norovirus Infections in Hospitalized Children Less Than 5 Yaers of Age With Acute Gastroenteritis in Tehran, Iran
Epidemiology of rotavirus and norovirus
Acute gastroenteritis is one of the most important causes of death in children in developing countries which cause by different enteropathogens, including bacteria, viruses, and parasites. Among these, most of the acute gastroenteritis in children are caused by viral infections mainly by rotavirus and norovirus. This study aimed to study the epidemiological and clinical status of acute gastroenteritis resulting from rotavirus and norovirus in children between June 2015 and June 2016 in Iran. A total of 211 stool specimens were collected from Ali Asghar Children's Hospital and Bahrami Children's Hospital in Tehran, from June 2015 to June 2016. The samples were screened by commercial enzyme immunoassay (EIA) Ridascreen kit and real time RT-PCR to detect rotavirus and norovirus genogroups I and II, respectively. The information on demographic and clinical manifestations was collected, and data analyzed using IBM SPSS statistics version 22. Overall, the detection rate of rotavirus was 25.6 %, and for norovirus infection, it was 17.5%. All norovirus positive specimens belonged to genogroup II. Higher rates of rotavirus infections were observed in children from 7 to 24 months, and higher rates of norovirus infections were detected in children from 1 to 12 months. Clinical symptoms were not different between rotavirus and norovirus case-patients. The present study not only highlights the importance of rotavirus and norovirus infections in Iran but also verifies the relevance of norovirus as the cause of severe gastroenteritis in children.
2. Webb A, Starr M. Acute gastroenteritis in children. Aust Fam Physician 2005;34(4):227-31.
3. Ramani S, Kang G. Viruses causing childhood diarrhoea in the developing world. Curr Opin Infect Dis 2009;22(5):477-82.
4. Parashar UD, Burton A, Lanata C, Boschi-Pinto C, Shibuya K, Steele D, et al. Global mortality associated with rotavirus disease among children in 2004. J Infect Dis 2009;200 Suppl 1:S9-S15.
5. Tate JE, Burton AH, Boschi-Pinto C, Parashar UD, World Health Organization-Coordinated Global Rotavirus Surveillance N. Global, Regional, and National Estimates of Rotavirus Mortality in Children <5 Years of Age, 2000-2013. Clin Infect Dis 2016;62 Suppl 2:S96-S105.
6. Patel MM, Widdowson M-A, Glass RI, Akazawa K, Vinjé J, Parashar UD. Systematic literature review of role of noroviruses in sporadic gastroenteritis. Emerg Infect Dis 2008;14(8):1224-31.
7. Kapikian AZ, Wyatt RG, Dolin R, Thornhill TS, Kalica AR, Chanock RM. Visualization by immune electron microscopy of a 27-nm particle associated with acute infectious nonbacterial gastroenteritis. J Virol 1972;10(5):1075-81.
8. Green KY. Caliciviridae: the noroviruses. In: Howley DMKaP, editor. Fields Virology: Lippincott Williams &Wilkins, Philadelphia, Pa, USA,; 2013. p. 582-608.
9. Rolfe K, Parmar S, Mururi D, Wreghitt T, Jalal H, Zhang H, et al. An internally controlled, one-step, real-time RT-PCR assay for norovirus detection and genogrouping. Journal of Clinical Virology 2007;39(4):318-21.
10. Kageyama T, Kojima S, Shinohara M, Uchida K, Fukushi S, Hoshino FB, et al. Broadly reactive and highly sensitive assay for Norwalk-like viruses based on real-time quantitative reverse transcription-PCR. Journal of clinical microbiology 2003;41(4):1548-57.
11. Shoja Z, Jalilvand S, Mokhtari-Azad T, Nategh R. Epidemiology of cocirculating human rotaviruses in Iran. Pediatr Infect Dis J 2013;32(4):e178-81.
12. John BM, Devgan A, Mitra B. Prevalence of rotavirus infection in children below two years presenting with diarrhea. Med J Armed Forces India 2014;70(2):116-9.
13. Yang SY, Hwang KP, Wu FT, Wu HS, Hsiung CA, Chang WC, et al. Epidemiology and clinical peculiarities of norovirus and rotavirus infection in hospitalized young children with acute diarrhea in Taiwan, 2009. J Microbiol Immunol Infect 2010;43(6):506-14.
14. Chen CJ, Wu FT, Huang YC, Chang WC, Wu HS, Wu CY, et al. Clinical and Epidemiologic Features of Severe Viral Gastroenteritis in Children: A 3-Year Surveillance, Multicentered Study in Taiwan With Partial Rotavirus Immunization. Medicine (Baltimore) 2015;94(33):e1372.
15. Koopmans M. Progress in understanding norovirus epidemiology. Curr Opin Infect Dis 2008;21(5):544-52.
16. Ahmed SM, Hall AJ, Robinson AE, Verhoef L, Premkumar P, Parashar UD, et al. Global prevalence of norovirus in cases of gastroenteritis: a systematic review and meta-analysis. Lancet Infect Dis 2014;14(8):725-30.
17. Boga JA, Melon S, Nicieza I, De Diego I, Villar M, Parra F, et al. Etiology of sporadic cases of pediatric acute gastroenteritis in asturias, Spain, and genotyping and characterization of norovirus strains involved. J Clin Microbiol 2004;42(6):2668-74.
18. Shoja Z, Jalilvand S, Mollaei-Kandelous Y, Validi M. Epidemiology of viral gastroenteritis in Iran. The Pediatric infectious disease journal 2014;33(2):218-20.
19. Romani S, Mohebbi SR, Hosseini SM, Azimzadeh P, Vahedi M, Derakhshan F, et al. Prevalence of norovirus infection in children and adults with acute gastroenteritis, Tehran, Iran, 2008-2009. Food Environ Virol 2012;4(1):1-5.
20. Roodsari SR, Bitajian F, Gachkar L, Jadali F, Adabian S, Nia RSS, et al. Detection of Noroviruses Isolated From Children With Acute Gastroenteritis by Rt-PCR in Iran. Archives of Pediatric Infectious Diseases 2013;1(2):57-60.
21. Fazeli Z, Baghaie N, Khavarinejad RA, Khoramdel M, Sigaroodi A, Nadji SA. Hospital based study of prevalence and genotyping of Noroviruses and Sapoviruses isolated from children with acute gastroenteritis referred to Masih Daneshvari hospital. Gastroenterology and Hepatology from bed to bench 2010;3(2).
22. Fretz R, Herrmann L, Christen A, Svoboda P, Dubuis O, Viollier E, et al. Frequency of Norovirus in stool samples from patients with gastrointestinal symptoms in Switzerland. European Journal of Clinical Microbiology and Infectious Diseases 2005;24(3):214-6.
23. Tran TH, Trainor E, Nakagomi T, Cunliffe NA, Nakagomi O. Molecular epidemiology of noroviruses associated with acute sporadic gastroenteritis in children: global distribution of genogroups, genotypes and GII. 4 variants. Journal of Clinical Virology 2013;56(3):269-77.
24. Wollants E, De Coster S, Van Ranst M, Maes P. A decade of norovirus genetic diversity in Belgium. Infection, Genetics and Evolution 2015;30:37-44.
25. Shioda K, Kambhampati A, Hall AJ, Lopman BA. Global age distribution of pediatric norovirus cases. Vaccine 2015;33(33):4065-8.
26. Steele AD, Madhi SA, Cunliffe NA, Vesikari T, Phua KB, Lim FS, et al. Incidence of rotavirus gastroenteritis by age in African, Asian and European children: Relevance for timing of rotavirus vaccination. Hum Vaccin Immunother 2016;12(9):2406-12.
27. Subekti D, Lesmana M, Tjaniadi P, Safari N, Frazier E, Simanjuntak C, et al. Incidence of Norwalk-like viruses, rotavirus and adenovirus infection in patients with acute gastroenteritis in Jakarta, Indonesia. FEMS Immunol Med Microbiol 2002;33(1):27-33.
28. Narkeviciute I, Tamusauskaite I. Peculiarities of norovirus and rotavirus infections in hospitalised young children. J Pediatr Gastroenterol Nutr 2008;46(3):289-92.
29. Cheng AC, McDonald JR, Thielman NM. Infectious diarrhea in developed and developing countries. J Clin Gastroenterol 2005;39(9):757-73.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.