Rotavirus in adults, Brazil, 2004-2011: G2P[4] dominance and potential impact on vaccination

Abstract

Objectives: The aim of this study was to monitor rotavirus (RV) infections in adults >18 years with acute gastroenteritis during 2004-2011 national Brazilian RV surveillance. In addition, to characterize the RV group A (RVA) strains in order to gain insight into the supposed vaccine selective pressure imposed to Brazilian children population.

Methods: A total of 2102 convenient fecal specimens were investigated by ELISA, PAGE, and RT-PCR.

Results: RV was detected in 203 (9.6%) of 2102 specimens, and showed a marked peak of detection in September. RVA infection was detected in 9.4% (197/2102) and RV group C (RVC) in 0.3% (6/2102). The most frequent genotypes detected in 2004 and 2005 were G9P[8] (38.5%; 5/13) and G1P[8] (54.5%; 6/11), respectively. The dominant genotype identified from 2006 to 2011 was G2P[4] (64.4%; 116/180). Detection rate varied during the 8-year period of the study from 0.7% to 12.9%.

Conclusion: The high detection rate of G2P[4] in adults provides further evidence that its dominance reflects the seasonality of RVA strains instead of the supposed selective advantage created by vaccination program. It also can be suggested that adult infections may serve as a reservoir to maintain RVA strains in childhood gastroenteritis. Considering the detection rate, the evident reduction of RVA frequency observed in children after vaccine introduction was not present in adults.

Keywords: Adults; Brazil; Rotavirus group A; Rotavirus group C; Vaccination.

Fig. 1

The states highlighted in black collected stool samples from patients with acute gastroenteritis, screened for rotavirus group A infection and sent to the Enteric Diseases Laboratory of the Adolfo Lutz Institute. Adolfo Lutz Institute is Regional Reference Center for rotavirus surveillance and a member of Acute Diarrhea Disease Monitoring Program with national scope.

Fig. 2

Temporal distribution of RV positive samples from adults ≥18 years old with acute gastroenteritis, Brazil, 2004–2011 (A), 2004–2007 (B), and 2008–2011 (C).