Molecular epidemiology and clinical characterization of group A rotavirus infections in Tunisian children with acute gastroenteritis

Laboratory of Infectious Diseases and Biological Agents, Faculty of Pharmacy, Monastir, Tunisia.
Canadian Journal of Microbiology (Impact Factor: 1.22). 09/2011; 57(10):810-9. DOI: 10.1139/w11-074
Source: PubMed


Rotaviruses are the most common cause of severe viral gastroenteritis in early childhood worldwide. Thus, the objectives of our study were to determine the molecular epidemiology and the clinical features of rotavirus gastroenteritis in Tunisia. Between January 2003 and April 2007, a prospective study was conducted on 788 stool samples collected from children under 12 years of age who were suffering from acute gastroenteritis. Rotavirus was detected by multiplex RT-PCR in 27% (n = 213) of samples, among them 79.3% (n = 169) cases were monoinfections. The frequency of rotavirus infections was significantly higher among inpatients (29%) than among outpatients (13%) (P < 0.001). The seasonal distribution of rotavirus diarrhea showed a winter peak, with an unusual peak from June to September. The mean duration of hospitalization was 6.5 ± 8.1 days and the mean age was 15.8 ± 22.8 months for rotavirus monoinfections. Fever, vomiting, abdominal pain, and dehydration were observed in 88, 98, 13, and 80 cases, respectively, in children with rotavirus monoinfections. G3P[8] (45.6%) and G1P[8] (23.9%) were the most common genotypes found in our study. The determination of rotavirus infection prevalence and the characterization of the rotavirus strains circulating will help us to better understand the molecular biology and epidemiology of the disease in our country.

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    • "The detection and genotyping of human and animal RV-A in sewage were used to seek a relationship between environmental strains and those found in the same area during the same period in children and cattle suffering from gastroenteritis as described in our previous reports (Sdiri-Loulizi et al. 2010; Sdiri-Loulizi et al. 2011; Hassine-Zaafrane et al. 2011; Hassine-Zaafrane et al. 2014a). Furthermore the influence of the treatment using activated sludge on viral load was estimated by quantification of the RV-A genome before and after treatment. "
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    ABSTRACT: To ascertain the viral load, the distribution of G and P types of group A rotaviruses (RV-A) in sewage samples and to compare strains in clinical, animal and environmental samples. During our study from April 2007 to April 2010, 518 samples of raw and treated sewage were collected from two biological sewage treatment plants (STPs) located in the Monastir region, Tunisia. RV-A was detected by real-time RT-PCR in 375 (72.4%) sewage samples. According to the quantification results of RV-A, it appears that the viral load in raw and treated sewage of the two STPs was quite similar (P = 0.735). The genotyping of RV-A strains detected in sewage samples showed a great diversity with 10 G types and 8 P types. Most of them were described as common in humans, but we also detected genotypes commonly found in animals. All the genotypes detected in two previous studies performed in our laboratory on clinical and bovine samples were also found in environmental samples. However, some genotypes commonly found in animal were only found in sewage samples. The comparison of environmental, clinical and animal data suggests that STPs may convey not only human sewage but also animal wastes, both of them contaminated with numerous RV-A strains which are not efficiently eliminated by the sewage treatment process and may spread to surface waters. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
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    ABSTRACT: Different types of viruses are the leading cause of acute diarrhea among infants and young children worldwide. Epidemiological surveillance of viral agents is critical for the develop.ment of effective preventive measures, including vaccines. This study aimed to determine the prevalence of the four major enteropathogenic viruses-rotavirus, norovirus, adenovirus and astrovirus-in children over 7 years of age. A cross-sectional descriptive study conducted on stool specimens of children with acute gastroenteritis admitted to the Pediatrics Unit of 17 Shahrivar Hospital in Borazjan, Iran from October 2008 to September 2010. Acute gastroenteritis was defined as >=3 loose watery stools per 24 hours. A total of 375 stool samples were collected from hospitalized children aged < 7 years old with acute gastroenteritis. All samples were investigated by using enzyme-linked immunosorbent assay for the presence of viral antigens. Rotavirus was detected in 91 (24.3%) of the patients whereas the prevalence of norovirus, adenovirus and astrovirus was 12.5%, 5.1% and 2.4%, respectively. On average, 75.9% of children with viral diarrhea were younger than 2 years old (P=.023). All the strains of viral gastroenteritis studied peaked in the autumn, except for adenovirus which peaked in spring (P=.015). The most common clinical symptoms included diarrhea (92.2%), vomiting (68.7%), abdominal cramp (60.8%) and moderate dehydration (57.2%). Since nearly half of gastroenteritis cases (44.3%) were due to viral agents, testing for the viral antigens may guide the clinical approach to those patients with acute diarrhea particularly in the case of children less than 2 years old, and during cold seasons.
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    ABSTRACT: Viral gastroenteritis can be a life-threatening disease in infants and young children, especially in developing countries. The aim of this study was to continue the epidemiological surveillance of norovirus (NoV) infections in Tunisian children suffering from acute gastroenteritis. Surveillance was initiated in January 2003, to monitor potential variations in strains over time, in terms of frequency and diversity of NoV genotypes, and more particularly the potential emergence of new GII.4 variants following the 2004 Hunter variant. From April 2007 to April 2010, a total of 407 stool specimens were collected from sporadic cases (238 inpatients and 169 outpatients). Furthermore, 28 stool samples were collected from children involved in 3 gastroenteritis outbreaks. Stool specimens were screened for NoV genogroup I (GI) and II (GII) by RT-PCR. NoV strains were genotyped, and variants identified, based on sequence and phylogenetic analyses of the polymerase and capsid genes. NoVs were detected in 38 sporadic cases (9.3%) and 21 epidemic cases (75%). Great diversity was observed throughout the period, with seven distinct NoV genotypes characterized in sporadic cases, and three in outbreaks. GIIb/II.3 and GII.4 were predominant globally, with fluctuations of their prevalence over time. Interestingly, the Hunter variant, which was the unique GII.4 variant observed from 2003 to April 2007 in the region of Monastir, was replaced by the 2006b variant. NoV is an important enteropathogen responsible for viral gastroenteritis among infants and children in Tunisia, and the infecting strains between 2007 and 2010 were different from those in previous years. J. Med. Virol. © 2013 Wiley Periodicals, Inc.
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