Epidemiology of major entero-pathogenic viruses and genetic characterization of Group A rotaviruses among children (≤5 years) with acute gastroenteritis in eastern India, 2018–2020

Abstract

Aims: This study was carried out from January 2018 to March 2020 in Kolkata, eastern India to determine the prevalence rates and epidemiological patterns associated with the major viral agents of gastroenteritis among children ≤5 years of age.Molecular characterization of GARV, the predominant agent of viral gastroenteritis, was done to understand their genotype diversity.Methods and Results: 1284 of 3157 stool samples (~40%) from children (≤5 years) with acute gastroenteritis tested positive for one or more enteric viruses with positivity rates 25.11%, 8.74%, 6.62% and 6.11% for GARV, HAdV-F, AstV and NoV respectively. Co-infection was observed in 5.31% of cases. Associated clinical/meteorological variables like age, sex, symptoms, temperature and precipitation were assessed to find any correlation between these and enteric virus infection rates. >70% of viral gastroenteritis cases were observed in 6-24 months' age group. GARV and AstV infection occurred mostly during cooler months while HAdV-F infection mostly occurred during warmer periods. No definite seasonality was observed for NoV infections. Clinical severity associated with GARV infection was higher compared to other enteric viruses. Genotyping of rotavirus positive samples revealed G3P[8] was the predominantly circulating GARV genotype throughout the study period.Conclusions: GARV remained the predominant viral agent of acute gastroenteritis among children though its prevalence rates in this region declined significantly compared to the previous years (2010)(2011)(2012)(2013)(2014)(2015)(2016). The prevalence of other enteric viruses was below 10%. Significance and Impact of study:This study provides valuable insights regarding the current burden of viral gastroenteritis in Eastern India. The 2-year study in children will provide the baseline data for future surveillance studies in evaluating the impact of the introduced GARV vaccine on the overall prevalence of viral gastroenteritis.

Emergence of equine‐like G3 and porcine‐like G9 rotavirus strains in Sarawak, Malaysia: 2019−2021

“…This postulates that reassortment of VP4 (from P[8] to P[4]) of G9 strains might have initially occurred even before 2010 and spread to the US, Benin, India, Czech, and Malaysia as these G9P[4] strains were placed in the same clade as shown in Figure 3. Sarawak G9P[4] strain in 2019 is highly likely to have been introduced from India since the strain clustered with the strains that had been associated with multiple outbreaks in India from 2010 to 2020, 28–30 a scenario similar to the observation that the G9P[4] strain was introduced in Argentina from another country 31 . The high evolutionary rate of G9 (1.87 × 10 −3 substitutions/site/year) 17 is the key factor in the phylodynamic and high variation in the VP7 epitope structure (Figure 6).…”

Virus entéricos distintos de rotavirus y norovirus en menores de 5 años con gastroenteritis en Argentina, 2010-2021. Estudio descriptivo

“…Una fracción de las muestras presentó infecciones mixtas (2,4 %), en línea con estudios anteriores en India y en Europa. 26,27 Asimismo, sería de esperar una proporción aún mayor considerando la posibilidad de detectar alguno de estos tres agentes en muestras positivas para rotavirus y norovirus, o con algún patógeno bacteriano o parasitario. Este tipo de hallazgos aún representa un desafío debido a que no se conoce con claridad si la detección de más de un agente se asocia con mayor gravedad clínica o si alguno pudiese actuar como copatógeno, favoreciendo la infección de otro microorganismo.…”

Enteric viruses other than rotavirus and norovirus in children under 5 years of age with gastroenteritis in Argentina, 2010–2021. A descriptive study

“…A fraction of the samples showed mixed infections (2.4%), which is in line with previous studies carried out in India and Europe. 26,27 Likewise, an even higher proportion would be expected considering the possibility of detecting any of these 3 viruses in samples positive for rotavirus and norovirus, or with any bacterial or parasitic pathogen. This type of finding is still challenging because it is not clear whether the detection of more than 1 agent is associated with greater clinical severity or whether any of them could act as a co-pathogen, favoring the infection by another microorganism.…”