Dual infection due to simian G3—human reassortant and human G9 strains of rotavirus in a child and subsequent spread of serotype G9, leading to diarrhea among grandparents

Abstract

Cultivation of rotavirus from day 1 and 3 fecal specimens of a child yielded simian SA11-human reassortant, G3P [8] and AU32 like G9P [8] rotavirus strains, respectively. Diarrhea developed in the grandfather by sheer hospital visits, and in the grandmother, after wiping the vomit of the grandfather. AU32 like G9 strains were isolated from the grandparents also. Rotavirus specific IgM developed in all the three patients. A fourfold rise in G9 neutralizing antibodies was observed in the child and grandmother. The child's mother had asymptomatic rotavirus infection. The study highlights the potential of G9 serotype to spread from children to adults. J. Med. Virol. 78:134-138, 2006. ß 2005 KEY WORDS: rotavirus; adult diarrhea; simian G3 SA11-human reassortant; G9 serotype; dual infection Group A rotavirus is known as the major cause of severe dehydrating diarrhea in infants. More than 90% of children get rotavirus infection by 3 years of age. Generally, group A rotavirus is a common cause of pediatric diarrhea but less common among adults, who appear to undergo rotavirus infections mostly with minimal or no clinical manifestations [Kapikian et al., 2001]. On the contrary, group B rotavirus was involved in epidemics of severe gastroenteritis in China, which led to large outbreaks mainly among adults although children were also affected.Studies in the late 1970s and 1980s showed the presence of symptomatic rotavirus infections in adults, particularly in the elderly [Wenman et al., 1979;Cubitt and Holzel, 1980;Marrie et al., 1982;Hrdy, 1987]. Group A rotavirus has also been documented as the cause of adult diarrhea outbreaks in hospitals, nursing homes, travelers, geriatric wards, isolated communities, and families including children and adults participating in playgroup [Bishop, 1994;Kapikian et al., 2001]. In a 4 year study between 1996 and 1999 carried out both on hospitalized and out patients in Japan, group A rotavirus was detected in 97(14%) of 683 adult patients with diarrhea suggesting the importance of this disease in adults may be highly underestimated [Nakajima et al., 2001]. It has been reported that, as children can be infected by rotavirus through older siblings or adults in contact, at times parents may also be infected from children undergoing rotavirus diarrhea due to group A rotavirus [Kapikian et al., 2001].Rotavirus serotypes involved in few outbreaks have been identified in the recent studies. G1 serotype was the etiological agent in an outbreak which lasted for 3 weeks that occurred in a psychiatric nursing home for adults in Hungary [Banyai et al., 2002]. Between November 1998 and December 2000, three/263 gastroenteritis outbreaks among adults in United States were associated with rotavirus serotype G2 [Griffin et al., 2002]. Similarly, the etiological agent responsible for two gastroenteritis outbreaks among children and adults in Japan was serotype G2 [National Institute of Infectious Diseases, 2000a,b]. Rotaviruses were detected in seven gastroenteritis outbreaks, in aged care facilities i...

Vaccine preventable viral diseases and risks associated with waterborne transmission

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Mutated G4P[8] Rotavirus Associated with a Nationwide Outbreak of Gastroenteritis in Nicaragua in 2005

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Evidence of intrafamilial transmission of rotavirus in a birth cohort in South India

“…No study has, so far, utilized newer molecular methods to prove that the strains were identical. A recent study documented that a similar genotype infected grandparents of a child with rotavirus diarrhea suggesting transmission of the infection [Awachat and Kelkar, 2006]. We have carefully monitored a group of children as part of a birth cohort and it is important to note that spread from these children were noted whilst they had either symptomatic or asymptomatic rotavirus infection.…”