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
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 (45.6%) and G1P (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. "
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 acute gastroenteritis is one of the most common infectious diseases worldwide; every child in the world is infected with gastro-enteritis viruses during their first years of life. In the developed world, the result is substantial morbidity and expense while in developing countries hundreds of thousands of children die. The spectrum of disease can range from asymptomatic infections to severe disease with dehydration. Acute gastroenteritis is a common, generally self-limiting disease characterized by rapid onset of watery diarrhea and associated symptoms such as nausea, vomiting, fever, and/or abdominal pain. It is estimated that this illness occurs at an overall rate of 1.2 to 1.5 episodes per person per year and at higher rates among children under the age of 3 years (1.3 to 2.3 episodes per child per year). Intensive investigation of enteric infections has made it increasingly clear that viruses cause a significant proportion of enteric illnesses worldwide. In contrast to bacterial pathogens, enteric viruses cannot multiply outside their host; hence, the original inoculum into the common source determines infectivity. Rotaviruses are the leading cause of severe diarrhea in childhood; noroviruses are a diverse group of viruses responsible for a large proportion of outbreaks of nonbacterial gastroenteritis and listed as the second etiologic agents. Sapoviruses, astroviruses, and enteric adenoviruses are other viral agents of gastroenteritis. Before the early 1970s, no virus had been confirmed as a cause of acute gastroenteritis. The etiologic evaluation of patients with gastroenteritis was limited to investigations for a few bacterial and parasitic agents (e.g., Salmonella, Shigella, Amoeba); consequently, the causes of illness remained unidentified in a majority of cases. The importance of viral agents as causes of diarrheal disease has been increasingly appreciated, beginning with the discovery of rotavirus and caliciviruses in the 1970s. In 1972, Norwalk virus became the first viral agent identified to cause gastroenteritis. Using immune electron micro-scopy, Kapikian et al. identified the 27-nm Norwalk virus particle in stool filtrates of a volunteer challenged with fecal specimens from patients of an outbreak of gastroenteritis. In the next few years, electron microscopy played a key role in the identification or confirmation of many other viruses causing gastroenteritis, such as rotaviruses, astroviruses, and enteric adenoviruses. These viruses are usually transmitted directly from person to person via the fecal-oral route. Viral gastroenteritis (mainly after rotavirus infection) causes death through dehydration. Thus, treatment and prevention of dehydration is the first goal in caring for infants with gastroenteritis. The optimal solution to the disease burden of viral gastroenteritis would be prevention via effective vaccines but that option remains several years away. While there are already very good cost-effective strategies for correcting the sequel of viral gastroenteritis, there is little yet available to effectively treat the acute symptoms of vomiting and diarrhea. Several potential modes of symptomatic therapy for viral gastroenteritis are discovered including oral rehydration therapy, probiotics, anti-viral, passive immunotherapy, and anti-diarrheal.
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