Longitudinal study of rotavirus infections among children from Belém, Brazil

Abstract

From December 1982 to March 1986 a group of 80 children between 0 and 3 years old who lived in the peripheral area of Belém, Brazil, were followed up for episodes of diarrhoea. A total of 441 diarrhoeal episodes were recorded and 36 (8.2%) were associated with rotavirus. This agent was the only pathogen in 50% of rotavirus-related episodes of acute diarrhoea, and strains were characterized by analysis of RNA in polyacrylamide gels. Forty-one belonged to subgroup II (long pattern) and five to subgroup I. Reinfections by rotavirus were noted in 12 children involving either the same or different subgroups. Ten distinct electrophoretypes were detected in the study period and the predominant one had the '1N2L' profile. The cumulative age-specific attack rate for diarrhoea reached 2.8 by the end of the first year of life; a frequency of 2.3 episodes of diarrhoea per child per year was observed throughout the complete investigation. In comparing the age-specific attack rates for diarrhoea between breast-fed and bottle-fed children, a peak at 6 months of age was noted in the former, and at 1 month in the latter. A comparison by Fischer's exact test (P = 0.21) provided no evidence for protection against clinical rotavirus disease by maternal milk. By the same test, however (P = 0.021), we found significant evidence that early rotavirus infections were more likely to be asymptomatic and that infections after 4 months were more likely to be symptomatic. The clinical picture in children with rotavirus-related diarrhoea was more severe than in those suffering from acute diarrhoea due to another agent.

Epidemiologia das infecções por rotavírus no Brasil e os desafios para o seu controle

“…A mais extensa investigação nesse particular se desenvolveu no norte do país, abrangendo 237 crianças admitidas em um hospital público de 1992 a 1994 (Gusmão et al, 1995;Gusmão et al, 1999). Concluiu-se que aproximadamente 1/3 das gastroenterites agudas desenvolvidas no curso da internação se re- No curso de investigação prospectiva mais recente (1990 a 1992), conduzida na mesma área , registrou-se taxa anual de 0,2 caso de gastroenterite relacionada a rotavírus por indivíduo, similar à estabelecida antes, 0,25 (Linhares et al, 1989a). Estudos longitudinais desenvolvidos no nordeste revelaram índice pelo menos quatro vezes mais elevado, 1,33, a considerar-se o grupo etário de 6 a 11 meses (Guerrant et al, 1983).…”

“…As primeiras informações pertinentes à multiplicidade antigênica dos rotavírus detectados em casos de gastroenterite infantil resultaram de estudo longitudinal na comunidade, conduzido no norte do país de 1983de (Linhares et al, 1988bLinhares et al, 1989a). Os tipos G1 e G2 prevaleceram, concorrendo com 50% e 30% das amostras, respectivamente.…”

“…Instala-se com freqüência a desidratação do tipo isotônica, não raro daí decorrendo o óbito (Kapikian & Chanock, 1996). No Brasil, as investigações clínico-epidemiológicas conduzidas até então sustentam, invariavelmente, a maior gravidade de que se reveste a gastroenterite causada pelos rotavírus (Coiro et al, 1985;Linhares et al, 1989a;Linhares, 1997;Gusmão et al, 1999;Oliveira & Linhares, 1999).…”

“…À luz dessa comparação, e a tí-tulo de exemplo, registrem-se os achados de Linhares et al (1989a), indicando a maior freqüência de (a) evacuações líquidas, (b) vômi-tos, (c) náuseas, (d) cólicas abdominais e (e) febre entre crianças infectadas pelos citados ví-rus no seio comunitário. Nos hospitais, por outro lado, os parâmetros clínicos (a) febre, (b) vômitos e (c) desidratação prevaleceram amplamente nas diarréias associadas aos rotaví-rus, com base em recente análise procedida por Gusmão et al (1999) em Belém, Pará.…”

Serological survey of anti-group A rotavirus IgM in UK adults

“…Although there have been many studies investigating the epidemiology of disease and repeat infection (symptomatic and asymptomatic) in children [2,3,[9][10][11][12][13] less attention has focused on infection and disease in other age groups. Studies which have investigated rotaviral infection in older age groups have long suggested that infection rates could be high, especially in case contacts [14,15].…”