Etiology of Viral Gastroenteritis in Children < 5 Years of Age in the United States, 2008-2009

Gastroenteritis and Respiratory Viruses Laboratory Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA.
The Journal of Infectious Diseases (Impact Factor: 6). 06/2013; 208(5). DOI: 10.1093/infdis/jit254
Source: PubMed


Although rotavirus and norovirus cause nearly 40% of severe endemic acute gastroenteritis (AGE) in children <5 years of age in the United States, there are limited data on the etiologic role of other enteric viruses in this age group.

We conducted active population-based surveillance in children presenting with AGE to hospitals, emergency departments, and primary care clinics in 3 US counties. Stool specimens from these children and from age-matched healthy controls collected between October 2008 and September 2009 were tested for enteric adenovirus, astrovirus, sapovirus, parechovirus, bocavirus, and aichivirus. Typing was performed by sequencing and phylogenetic analysis.

Adenovirus, astrovirus, sapovirus, parechovirus, bocavirus, and aichivirus were detected in the stool specimens of 11.8%, 4.9%, 5.4%, 4.8%, 1.4%, and 0.2% of patients with AGE and 1.8%, 3.0%, 4.2%, 4.4%, 2.4%, and 0% of healthy controls, respectively. Adenovirus (type 41), astrovirus (types 1, 2, 3, 4, and 8), sapovirus (genogroups I and II), parechovirus (types 1, 3, 4, and 5), and bocavirus (types 1, 2, and 3) were found cocirculating.

Adenovirus, astrovirus, and sapovirus infections were detected in 22.1% of the specimens from children <5 years of age who had medical visits for AGE and tested negative for rotavirus and norovirus. No causal role for parechovirus and bocavirus was found.


Available from: Jan Vinjé
    • "However, SaVs have also been associated with asymptomatic infections and were detected in 28.6% (16/56) of children in a day-care study in Brazil [19]. Another study in three sites in the United States detected SaVs in 5.4% (42/782) of diarrhoea cases and 4.2% (21/499) of controls [20]. Mortality associated with SaV is rare, but may occur especially among elderly patients [21]. "
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    • "The clinical data accumulated since the discovery of HBoV demonstrate that HBoV1 is an agent that causes upper and lower respiratory diseases but is also detectable in stool samples of GE patients (Alam et al., 2015; Albuquerque et al., 2007; Campos et al., 2015; Chhabra et al., 2013; Jartti et al., 2012; Kapoor et al., 2010; Khamrin et al., 2012; Levican et al., 2013; Monavari et al., 2013; Nadji et al., 2010; Proenca-Modena et al., 2013; Risku et al., 2012; Santos et al., 2010; Vicente et al., 2007; Zhang et al., 2014 ). HBoV2–HBoV4 are mainly recorded in stool samples (Alam et al., 2015; Babkin et al., 2015; Jartti et al., 2012; Kapoor et al., 2009 Kapoor et al., , 2010 Khamrin et al., 2012; Levican Risku et al., 2012) but are also detectable in nasopharyngeal aspirates (Neske et al., 2007; Vicente et al., 2007). "
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    • "However, the presence of a pathogen in a fecal sample is not necessarily associated with a gastrointestinal disease, since high detection rates have also been reported for asymptomatic individuals [1,4567. Many studies have also reported mixed infections in children with AGE or in asymptomatic cases making the interpretation of PCR results very difficult [1,4,8,9]. Indeed, it is not possible to determine which pathogen is related to the disease at the time the sample is analyzed. "
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