Norovirus compared to other relevant etiologies of acute gastroenteritis among families from a semirural county in Chile

Abstract

To determine the dynamics of norovirus disease, a major cause of acute gastroenteritis (AGE), compared to other relevant etiologies, among families living in a lower middle income area. Study design: Families with three or more members and with one or more healthy children <24 months of age were followed for 1-2 years to detect any AGE. Stool samples were tested for viral and bacterial pathogens and a questionnaire was completed for those with norovirus or rotavirus AGE. Results: Between April and June 2016, 110 families were enrolled, with 103 of them completing !12 months of follow-up. A total of 159 family AGE episodes were detected, mostly affecting one individual (92%). At least one pathogen was detected in 56% (94/169) of samples, of which 75/94 (80%) were sole infections. Norovirus was most common (n = 26), followed closely by enteropathogenic Escherichia coli (EPEC) (n = 25), rotavirus (n = 24), and astrovirus (n = 23). The annual incidence of family AGE was 0.77, and 0.12 for norovirus. Most norovirus AGE occurred in children <4 years old (96%). Only 13/159 (8%) index AGE cases resulted in a secondary case, of which four were associated with norovirus. The majority of norovirus strains were GII (85%), with a mild predominance of GII.4 (9/26; 35%); most norovirus isolates (69%) were recombinants. Conclusions: The family incidence of AGE in this lower middle income community was nearly one episode per year, mostly caused by viruses, specifically norovirus closely followed by rotavirus and astrovirus. Norovirus infections primarily affected children <4 years old and secondary cases were uncommon.

Virological and Epidemiological Features of Norovirus Infections in Brazil, 2017–2018

“…Several studies performed worldwide have demonstrated the same pattern of GII genotypes predominance among the norovirus infections, with GII detection rates varying between 72.1% and 94.9% [ 38 , 39 , 40 ]. In Latin American, studies performed in Chile and Bolivia detected GII percentages of 85% and 97.8%, respectively, among patients with AGE [ 6 , 41 ]. In Sergipe state, southeastern Brazil, Santos et al [ 42 ] found similar detection rates of GI (6.4%) and GII (93.6%) among outpatient children <12 years old with AGE, and other studies performed in Brazil also reported the predominance of GII compared to GI among norovirus-positive samples [ 43 , 44 ].…”

Epidemiology, Clinical Features, and Unusual Complications of Norovirus Infection in Taiwan: What We Know after Rotavirus Vaccines

“…During the era of post-rotavirus vaccination, considerable genetic diversity among NoVs was discovered worldwide. Although the genotypes varied among studies in different areas, GII.4 was still the most common over the recent 10 years [31][32][33][34][35][36][37][38][39]. The increasing prevalence of NoV infection is also associated with the recent change in global genotype distribution such as GII.4 [11,29,31,40,41].…”

Norovirus: Facts and Reflections from Past, Present, and Future

“…Selected recent publications on the genotype distribution of human NoVs in various locations and the main variants identified, focused on both sporadic episodes and outbreaks, are detailed in Table 1. These studies differed in various aspects, such as their design (prospective, sometimes population-based, vs. retrospective analysis), age of participants, sporadic cases vs. outbreak-based studies, and/or hospitalized vs. community cases [33,34,43,[48][49][50][51][52][53][54][55][56]. Although the relative prevalence of NoV genotypes varied among studies and locations, genotype GII.4 was the most common among all studies.…”