Persistence of G10P[11] neonatal rotavirus infections in southern India

Abstract

Neonatal rotavirus infections are predominantly caused by distinct genotypes restricted to this age-group and are mostly asymptomatic. Stool samples from neonates admitted for >48 hours in neonatal intensive care units (NICUs) in Vellore (2014-2015) and Chennai (2015-2016) in southern India, and from neonates born at hospitals in Vellore but not admitted to NICUs (2015-2016) were tested for rotavirus by ELISA and genotyped by hemi-nested RT-PCR. Of the 791 neonates, 150 and 336 were recruited from Vellore and Chennai NICUs, and 305 were born in five hospitals in Vellore. The positivity rates in the three settings were 49.3% (74/150), 29.5% (99/336) and 54% (164/305), respectively. G10P[11] was the commonly identified genotype in 87.8% (65/74), 94.9% (94/99) and 98.2% (161/164) of the neonates in Vellore and Chennai NICUs, and those born at Vellore hospitals, respectively. Neonates delivered by lower segment caesarean section (LSCS) at Vellore hospitals, not admitted to NICUs, had a significantly higher odds of acquiring rotavirus infection compared to those delivered vaginally [p=0.002, OR=2.4 (1.4-4.3)]. This report demonstrates the persistence of G10P[11] strain in Vellore and Chennai, indicating widespread neonatal G10P[11] strain in southern India and their persistence over two decades, leading to interesting questions about strain stability.

The Current Epidemiology of Rotavirus Infection in Children Less than 5 Years of Age after Introduction of RV Vaccine in India

“…The circulating strains identified in our study, as compared to other studies, highlights the changing pattern of strains resulting in broad genomic diversity of rotavirus distribution in different geographical areas across the country. Babji et al 31 highlighted that G10P [11] was the most common and widespread strain in Vellore and Chennai, and owing to its high transmissibility, this specific neonatal strain continue to persist circulate over a decade. Few recent studies have quite different and diverse genotypic rotavirus strains distribution, which may vary due to sample size, study period, and geographical variation in different settings.…”

“…Few recent studies have quite different and diverse genotypic rotavirus strains distribution, which may vary due to sample size, study period, and geographical variation in different settings. 8,10,28,31 However, the increasing trends and emergence of G9P [4] strains was observed throughout the study; it is therefore imperative to conduct regular surveillance to continuously monitor the trends of circulating RV strains to assess the impact of rotavirus vaccination on strain distribution and diversity. 26…”