Article

Norovirus gastroenteritis in young children receiving human rotavirus vaccine.

Vaccine Research Centre, University of Tampere Medical School, Tampere, Finland.
Scandinavian Journal of Infectious Diseases (impact factor: 1.72). 07/2010; 42(6-7):540-4. DOI:10.3109/00365541003652556 pp.540-4
Source: PubMed

ABSTRACT We explored whether human rotavirus vaccine had any efficacy against norovirus (NV)-associated gastroenteritis in young children. In an efficacy trial of rotavirus vaccine, 405 infants were immunized with a human rotavirus vaccine or placebo at a ratio of 2:1, and prospectively followed for acute gastroenteritis (AGE) from approximately 2 months to 2 y of age. Multiplex real-time reverse transcription polymerase chain reaction (Mrt RT-PCR) assays were used for detection and quantitation of NVs of genogroup I (GI) and genogroup II (GII) in stool specimens. NVs were detected in 155 (32%) of 485 episodes of AGE. Of these, NV was the only gastroenteritis virus detected in the stools in 142 (29%) episodes. GI and GII NVs were found in 12% and 88% of the cases, respectively. NV as the only gastroenteritis virus was detected in 36% of the infants in the rotavirus vaccine group and 27% in the placebo group. The clinical severity of NV-associated AGE in the vaccine and placebo recipients was not different. NVs were the most common etiologic agents of AGE in children under 2 y of age. Human rotavirus vaccine did not protect against NV gastroenteritis.

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    Article: Norovirus infections in children under 5 years of age hospitalized due to the acute viral gastroenteritis in northeastern Poland.
    E Oldak, A Sulik, D Rozkiewicz, N Liwoch-Nienartowicz
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    ABSTRACT: The primary aim of this study was to evaluate the frequency and seasonality of norovirus infection in hospitalized Polish children under 5 years of age, and a secondary aim was to compare the clinical severity of norovirus and rotavirus disease. The prospective surveillance study was carried out from July 2009 through June 2010. Stool samples from 242 children hospitalized due to acute viral gastroenteritis were tested for rotavirus group A and adenovirus with commercial immunochromatographic test and for norovirus with EIA assay. Single norovirus infection was found in 35/242 (14.5%) patients and in a further 5 (2.1%) children as co-infection with rotavirus. Overall, norovirus was detected in 16.5% of stool specimens. Norovirus infections tended to peak from October to November and again from February to March. In autumn months and in February, the proportion of norovirus gastroenteritis cases was equal or even surpassed those of rotavirus origin. Both norovirus and rotavirus infections most commonly affected children between 12 and 23 months of age. The low-grade or no fever was significantly more common in children infected with norovirus (94.3%) compared to rotavirus cases (52.9%). Overall, norovirus gastroenteritis was less severe than rotavirus disease with regard to 20-point severity scale (p < 0.05). Noroviruses have emerged as a relevant cause of acute gastroenteritis in Polish children. There is a great need for introducing routine norovirus testing of hospitalized children with gastroenteritis.
    European Journal of Clinical Microbiology 07/2011; 31(4):417-22. · 2.86 Impact Factor
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Keywords

acute gastroenteritis
 
clinical severity
 
common etiologic agents
 
efficacy trial
 
gastroenteritis virus
 
genogroup II
 
GII NVs
 
human rotavirus vaccine
 
Mrt RT-PCR
 
norovirus
 
NV gastroenteritis
 
NV)-associated gastroenteritis
 
NV-associated AGE
 
NVs
 
placebo group
 
placebo recipients
 
rotavirus vaccine
 
rotavirus vaccine group
 
stool specimens
 
young children