Sapovirus as a gastrointestinal pathogen in febrile pediatric patients with cancer

Abstract

Human caliciviruses are the second most common cause of viral gastroenteritis after rotavirus in children. Unlike norovirus, sapovirus infection is less well characterized and defined in the clinical setting of gastrointestinal disease, and there are no reports of sapovirus infections in pediatric oncology patients receiving chemotherapy treatment. Stool samples from all pediatric oncology patients presenting with fever and diarrhea at one pediatric oncology unit were tested prospectively for sapovirus by real-time reverse transcription-PCR sapovirus genogrouping was performed by nested PCR. Sapovirus was detected in 2 of 100 stool specimens prospectively sampled from 58 symptomatic pediatric oncology inpatients between December 2008 and September 2009. Both patients received low-dose chemotherapy for their underlying conditions at the time of infection with sapovirus. Genogrouping of the viruses showed the presence of a GI.1 strain and GII.3 strain, unlike the most common GI.2 strain responsible for outbreaks in different European countries. The contribution of sapovirus infection to the morbidity of pediatric cancer patients and its potential for nosocomial spread is discussed. Sapovirus, an often unrecognized pathogen, should be considered along with other viruses in pediatric cancer patients suffering from gastrointestinal disease.

Genetic Diversity of Sapoviruses among Inpatients in Germany, 2008−2018

“…In the past, sapovirus GI.1 [16,17,22], GI.2 (GenBank accessions AF294739 and JX993277), GII.1 [16], GII.5 [17] and GIV.1 (GenBank accession AY424804) strains were sporadically observed in isolated human stool samples from Germany. Unfortunately, those sapovirus detections typically provided exclusively short partial polymerase [16] or no sequence data at all [17]. In contrast, the present data is generated from stool samples collected during subsequent years in the same setting and area.…”

“…Sapovirus infections have been reported in stool samples from outbreaks [16] and sporadic cases [17] of gastroenteritis from Germany. Yet unlike norovirus, sapovirus is rarely assessed in diarrhea outbreaks and sporadic sapovirus infections are not notifiable at the national level.…”

Laboratory Diagnosis of Infections in Cancer Patients: Challenges and Opportunities

“…The importance of other GI viruses, including astrovirus and sapovirus, is less well established, as methods for routine recovery of these viruses were not available until recently. In a few reports from pediatric oncology patients, sapovirus was recovered infrequently, in Ͻ5% of the cases, with diarrhea resolving between 3 and 21 days (44,45). An astrovirus outbreak in a pediatric hematology and HSCT patients unit revealed that symptoms of astrovirus infections in oncology patients lasted longer and caused more severe dehydration than with sapovirus, and similar to norovirus, shedding could last for several weeks (46).…”