Enteric viruses in pediatric diarrhea in Saudi Arabia

Abstract

Between September 1st, 2002 and August 31st, 2003, a panel of 1,000 stool samples was collected from patients presenting with diarrhea in the three major urban centers of Saudi Arabia; Riyadh, Mecca, and Jeddah. Each sample was tested for rotavirus, and astrovirus by ELISA, G and P type was determined for all rotaviruses. Adenoviruses were sought by hexon-specific PCR and identified by RFLP. A subset of 253 samples was also tested for norovirus by ELISA. Data were analyzed for seasonality of infection, patient nationality and likelihood of hospitalization. Although the overall incidence of rotavirus identification in acute diarrheal stool continued to decline, this was still the virus identified most commonly (6%). Norovirus accounted for 3.5%, astrovirus, 1.9% and adenovirus, 1.4%. Type G9 rotavirus was found to be present (and already common) in 2003, predating its first reported identification in the country in 2004. Most of the virus infections (and most of the G9 detections) occurred in April, the month following the occurrence of the Hajj in the study year. Although most viruses were spread equally in the population, rotaviruses were significantly more common in non-Saudis than in Saudi citizens. Overall the data are consistent with an increase in all virus infections following al Hajj and the potential introduction of novel strains (such as the G9 rotaviruses) by pilgrims. Hospitalization was significantly associated only with norovirus infections.

Enteric Pathogens Associated with Childhood Diarrhea in Tripoli-Libya

“…Predominance of norovirus and rotavirus infections in children with diarrhea has also been reported from Egypt and Saudi Arabia. 16,17 Norovirus, adenovirus, and astrovirus have never previously been reported from Libya.…”

“…Predominance of norovirus and rotavirus infections in children with diarrhea has also been reported from Egypt and Saudi Arabia. 16,17 Norovirus, adenovirus, and astrovirus have never previously been reported from Libya.Kamel and others, 16 in Egypt, reported that all cases of severe dehydration in pediatric populations were associated with either rotavirus or norovirus monoinfections or mixed infections. A study from Tunisia reported that norovirus is equal to rotavirus infection in terms of necessity of hospitalization and severity of the clinical symptoms.…”

High Variety of Known and New RNA and DNA Viruses of Diverse Origins in Untreated Sewage

“…The positive singlestranded RNA (ssRNA) family Astroviridae consists of two genera, Avastrovirus and Mamastrovirus, known to infect avian and mammalian hosts, respectively. Human astroviruses are transmitted through the fecal-oral route and have been associated with gastroenteritis (13,26,29,32,39,91). Several new human astroviruses have recently been described (24,25,44).…”

Multiple novel astrovirus species in human stool

“…Astroviruses, transmitted through the fecal-oral route can cause gastroenteritis in mammalian and avian species including humans, calves, piglets, sheep, minks, dogs, cats, mice, chickens, and turkeys (Jonassen et al , 2001; Jonassen et al , 2003). All 8 known human astroviruses serotypes belonging to the first identified human astrovirus species (HAstV) have been associated with gastroenteritis (Clark & McKendrick, 2004; Fodha et al , 2006; Gabbay et al , 2007; Jin et al , 2009; Tayeb et al , 2008). Clinical symptoms of human HAstV infection usually last 2–4 days and consist of watery diarrhea and, less commonly, vomiting, headache, fever, abdominal pains, and anorexia (Mendez & Arias, 2007; Monroe et al , 2005).…”