High prevalence of rotavirus infection among neonates born at hospitals in Delhi, India

Cicirello, Helen; Das, Bimal Kumar; Gupta, Akshat; Bhan, Maharaj Kishan; Gentsch, Jon R.; Kumar, Ramesh; Glass, Roger I.

doi:10.1097/00006454-199408000-00008

Cited by 68 publications

(93 citation statements)

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“…Studies so far carried out in India have revealed that the predominant strains are G1 to G4 (1,2,4,16,18,25), except from northern and central India (5,25), where G9 has been reported as the predominant G type. Although G9 was not detected separately in this study, it appeared as part of the multiple G types.…”

Section: Discussionmentioning

confidence: 99%

Genomic Diversity of Group A Rotavirus Strains Infecting Humans in Eastern India

Das¹,

A²,

Uma³

et al. 2002

J Clin Microbiol

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(1.25%), were also detected during this study period. Twenty two percent of specimens showed mixed infections, 38 (24%) of the total samples remained untypeable for either VP7 or VP4, while only 4 (2.5%) of the samples were untypeable for both genes. Eleven specimens collected from Manipur were also genotyped and revealed a very high degree of genomic reassortment.Group A rotaviruses are the major cause of severe dehydrating gastroenteritis among human infants and young of a wide variety of mammalian and avian species (17), and it has been estimated that nearly a million deaths occur every year (9, 20), predominantly in developing countries.Fifteen G serotypes of rotaviruses (27) are recognized, depend on the molecular characterization of VP7 (glycosylated outer capsid protein). However, G1 to G4 are the most predominant genotypes in humans. Moreover, a number of unusual genotypes, G5, G8, and G9, have also been reported recently from various countries (8). Thirteen P serotypes (22) and 21 P genotypes are recognized on the basis of VP4 (protease-sensitive outer capsid protein), but the most common P serotypes infecting humans are P1A and P1B, corresponding to the P[8] and P[4] genotypes, respectively. Although the role of VP4 protein in protective immunity is not very well established, information on G and P typing is important for identifying unusual or new virus strains circulating in different populations (19).The first human rotavirus vaccine (a human-animal tetravalent vaccine) was licensed in the United States in 1998; however, the same vaccine has not been tried extensively in other countries. Due to strain diversity in different parts of the world, knowledge of molecular epidemiology and antigenic diversity of rotaviruses in circulation is imperative for the development of a suitable, efficacious vaccine to combat rotaviral diarrhea. Therefore, in this study we report the characterization of different G and P types of rotavirus strains circulating in a particular area of India.

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Section: Discussionmentioning

confidence: 99%

Genomic Diversity of Group A Rotavirus Strains Infecting Humans in Eastern India

Das¹,

A²,

Uma³

et al. 2002

J Clin Microbiol

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“…In addition, G2 rotavirus infections at CHOP occurred twice as frequently in children <6 months of age than in children 6-12 months of age. To further complicate direct comparisons of our results with prior studies indicating that infection with rotavirus in young infants requiring a healthcare intervention is not uncommon (4,37,38), some publications do not clearly distinguish nosocomial from community-acquired acquisition. The methodological limitations of our analysis should be acknowledged.…”

Section: Discussionmentioning

confidence: 65%

“…In the absence of a safe and effective vaccine (1-3), rotavirus has consistently been the leading cause of dehydrating gastroenteritis in infants and young children around the world (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Virtually all children are infected at least once within the first 5 years of life, with the peak incidence widely quoted as occurring between 6 and 24 months of age (5,7,11,13,14,16,(20)(21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

Unexpectedly high burden of rotavirus gastroenteritis in very young infants

et al. 2010

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Background: The highest incidence of rotavirus gastroenteritis has generally been reported in children 6-24 months of age. Young infants are thought to be partially protected by maternal antibodies acquired transplacentally or via breast milk. The purpose of our study was to assess the age distribution of children with confirmed community-acquired rotavirus gastroenteritis presenting to an urban referral hospital. Methods: Children presenting to The Children's Hospital of Philadelphia with acute gastroenteritis have been monitored for the presence of rotavirus antigen in the stool by ELISA (followed by genotyping if ELISA-positive) since the 1994-95 epidemic season. Results: Over the last 12 rotavirus seasons prior to the introduction of the pentavalent rotavirus vaccine in 2006, stool specimens from 1646 patients tested positive for community-acquired rotavirus infection. Gender or age was not recorded in 6 and 5 cases, respectively. Overall, 58% of the cases occurred in boys. G1 was the predominant VP7 serotype, accounting for 72% of cases. The median (IQR) age was 11 (5-21) months. A total of 790 (48%) cases occurred in children outside the commonly quoted peak age range, with 27% in infants <6 months of age and 21% in children >24 months of age. A total of 220 (13%) cases occurred during the first 3 months of life, and the highest number of episodes per month of age [97 (6%)] was observed during the second month of life. Conclusions:The incidence of community-acquired rotavirus gastroenteritis monitored over 12 seasons in the prevaccine era at a major university hospital was nearly constant for each month of age during the first year of life, revealing an unexpectedly high incidence of symptomatic rotavirus disease in infants <3 months old. A sizeable fraction of cases occurred in children too young to have been vaccinated according to current recommendations.

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“…Over the last 40 years, several RV strains have been identified that have a predisposition for replication in neonates, frequently without causing gastrointestinal (GI) disease (5)(6)(7)(8)(9)(10). In some cases, the asymptomatic phenotype may reflect the unusual genome constellations that can comprise neonatal virus strains (11)(12)(13)(14).…”

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confidence: 99%

Absence of Genetic Differences among G10P[11] Rotaviruses Associated with Asymptomatic and Symptomatic Neonatal Infections in Vellore, India

Libonati

Dennis

Ramani

et al. 2014

J Virol

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Rotaviruses (RVs) are leading causes of severe diarrhea and vomiting in infants and young children. RVs with G10P[11] genotype specificity have been associated with symptomatic and asymptomatic neonatal infections in Vellore, India. To identify possible viral genetic determinants responsible for differences in symptomology, the genome sequences of G10P[11] RVs in stool samples of 19 neonates with symptomatic infections and 20 neonates with asymptomatic infections were determined by Sanger and next-generation sequencing. The data showed that all 39 viruses had identical genotype constellations (G10-P[11]-I2-R2-C2-M2-A1-N1-T1-E2-H3), the same as those of the previously characterized symptomatic N155 Vellore isolate. The data also showed that the RNA and deduced protein sequences of all the Vellore G10P[11] viruses were nearly identical; no nucleotide or amino acid differences were found that correlated with symptomatic versus asymptomatic infection. Next-generation sequencing data revealed that some stool samples, both from neonates with symptomatic infections and from neonates with asymptomatic infections, also contained one or more positive-strand RNA viruses (Aichi virus, astrovirus, or salivirus/klassevirus) suspected of being potential causes of pediatric gastroenteritis. However, none of the positive-strand RNA viruses could be causally associated with the development of symptoms. These results indicate that the diversity of clinical symptoms in Vellore neonates does not result from genetic differences among G10P[11] RVs; instead, other undefined factors appear to influence whether neonates develop gastrointestinal disease symptoms. IMPORTANCERotavirus (RV) strains have been identified that preferentially replicate in neonates, in some cases, without causing gastrointestinal disease. Surveillance studies have established that G10P[11] RVs are a major cause of neonatal infection in Vellore, India, with half of infected neonates exhibiting symptoms. We used Sanger and next-generation sequencing technologies to contrast G10P[11] RVs recovered from symptomatic and asymptomatic neonates. Remarkably, the data showed that the RNA genomes of the viruses were virtually indistinguishable and lacked any differences that could explain the diversity of clinical outcomes among infected Vellore neonates. The sequencing results also indicated that some symptomatic and some asymptomatic Vellore neonates were infected with other enteric viruses (Aichi virus, astrovirus, salvirus/klassevirus); however, none could be correlated with the presence of symptoms in neonates. Together, our findings suggest that other poorly defined factors, not connected to the genetic makeup of the Vellore G10P[11] viruses, influence whether neonates develop gastrointestinal disease symptoms.

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High prevalence of rotavirus infection among neonates born at hospitals in Delhi, India

Cited by 68 publications

References 0 publications

Genomic Diversity of Group A Rotavirus Strains Infecting Humans in Eastern India

Genomic Diversity of Group A Rotavirus Strains Infecting Humans in Eastern India

Unexpectedly high burden of rotavirus gastroenteritis in very young infants

Absence of Genetic Differences among G10P[11] Rotaviruses Associated with Asymptomatic and Symptomatic Neonatal Infections in Vellore, India

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