Adenovirus types 40 and 41 and rotaviruses associated with diarrhea in children from Guatemala

Abstract

From March 1987 to February 1988, fecal excretion of adenovirus types 40 and 41 and rotavirus serotypes in 194 children (age, 0 to 3 years) from a rural community of Guatemala was monitored. In total, 458 samples taken during 385 episodes of diarrhea and 191 specimens obtained during symptom-free periods were examined by enzyme-linked immunosorbent assay. Fifty-seven children hospitalized because of diarrhea were also studied. Among the rural children, 43 (22.2%) excreted adenovirus types 40 and 41 and 20 (10.3%) shed rotaviruses. Adenovirus types 40 and 41 were associated with 54 (14.0%) illnesses, and rotaviruses were associated with 18 (4.7%) illnesses. Asymptomatic infections with adenovirus types 40 and 41 were documented in nine children and with rotaviruses in two children. Fifteen typeable rotaviruses were identified as serotype 2. In the hospital population, 36 (63.2%) children had viral infections. Rotaviruses were identified in 29 (50.9%) and adenovirus types 40 and 41 were identified in 15 (31.2%) of 48 subjects tested. Dual infections by these viruses were found in eight children. Of 22 typeable strains of rotaviruses, 9 (34.6%) were serotype 1, 12 (46.1%) were serotype 2, and 1 (3.8%) was serotype 3. All the children infected with serotype 2 rotavirus were coinfected with other enteric pathogens, while only three (37.5%) of those infected with rotavirus serotype 1 excreted another pathogen. Adenovirus types 40 and 41 are an important cause of gastroenteritis in both ambulatory and hospitalized Guatemalan children. There seems to be a difference in the pathogenicity among rotavirus serotypes.

Rotavirus y adenovirus 40–41 como causantes de gastroenteritis infantil

“…En cuanto al lugar que ocupan los adenovirus 40-41 en la GEA viral infantil, algunos autores lo sitúan como la tercera causa, después del rotavirus y el calicivirus 1 . La incidencia en niños es variable y depende del grado de desarrollo del país 1 , de manera que en los países industrializados la incidencia oscila entre el 1 y el 8% 3,5,26,28 , mientras que en países en vías de desarrollo se sitúa entre el 2 y el 31% 29 . Sin embargo, este intervalo se acorta cuando adenovirus es el único agente responsable de la diarrea y no está en el contexto de una infección mixta.…”

Astroviruses, Enteric Adenoviruses, and Other Gastroenteritis Viruses

“…Enteric adenoviruses were more common than rotavirus in a rural outpatient setting in Guatemala (14% of children with diarrhea had EA detected in stool compared to 5% with rotavirus), and were associated with 31% of hospital admissions for diarrhea. 68 In two South African studies, 6.5% to 13.2% of hospital admissions for diarrhea were associated with EAs 69,70 ; in one study, 70 EAs were detected as often as rotaviruses. In the few studies that have examined the role of EAs in an adult population, they appear to be less important causes of gastroenteritis than in children.…”

“…In the few studies that have examined the role of EAs in an adult population, they appear to be less important causes of gastroenteritis than in children. No seasonality of EA infections was apparent in studies in temperate 31,[71][72][73] or tropical countries, 68,74 but few studies have reviewed multiple seasons.…”

“…71,72,[75][76][77][78][79] Children often have 6 to 10 stools per day, and the mean duration of illness is 5 to 9 days. 68,71,72,[75][76][77][78] Abdominal pain 71,76 and 2 to 3 days of low-grade fever (<38.5 o C) are also frequently present, whereas temperatures greater than or equal to 39 o C occur in less than 10% to 25% of children. 71,75 Mild isotonic dehydration may occur in 15% to 50% of children, 71,72,76 and only severe cases require hospitalization.…”

“…72,75,77 Asymptomatic infections have been documented in 8% and 17% of children in day-care center studies. 23,68,71,72 Serum electrolytes are usually normal, and a slight leukocytosis may be present in a minority of children. 71 Gastroenteritis associated with EAs has a similar presentation among patients in developed and developing countries.…”