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. 2014 Jul;109(4):428-35.
doi: 10.1590/0074-0276140066.

Acute gastroenteritis and enteric viruses in hospitalised children in southern Brazil: aetiology, seasonality and clinical outcomes

Sonia Maria Raboni  1 , Guilherme Augusto Costa Damasio  2 , Carla E O Ferreira  2 , Luciane A Pereira  1 , Meri B Nogueira  1 , Luine R Vidal  1 , Cristina R Cruz  2 , Sergio M Almeida  1
Affiliations

Acute gastroenteritis and enteric viruses in hospitalised children in southern Brazil: aetiology, seasonality and clinical outcomes

Sonia Maria Raboni et al. Mem Inst Oswaldo Cruz. 2014 Jul.

Abstract

Viral acute gastroenteritis (AG) is a significant cause of hospitalisation in children younger than five years. Group A rotavirus (RVA) is responsible for 30% of these cases. Following the introduction of RVA immunisation in Brazil in 2006, a decreased circulation of this virus has been observed. However, AG remains an important cause of hospitalisation of paediatric patients and only limited data are available regarding the role of other enteric viruses in these cases. We conducted a prospective study of paediatric patients hospitalised for AG. Stool samples were collected to investigate human adenovirus (HAdV), RVA, norovirus (NoV) and astrovirus (AstV). NoV typing was performed by nucleotide sequencing and phylogenetic analysis. From the 225 samples tested, 60 (26%) were positive for at least one viral agent. HAdV, NoV, RVA and AstV were detected in 16%, 8%, 6% and 0% of the samples, respectively. Mixed infections were found in nine patients: HAdV/RVA (5), HAdV/NoV (3) and HAdV/NoV/RVA (1). The frequency of fever and lymphocytosis was significantly higher in virus-infected patients. Phylogenetic analysis of NoV indicated that all of these viruses belonged to genotype GII.4. The significant frequency of these pathogens in patients with AG highlights the need to routinely implement laboratory investigations.

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Figures

Fig. 1
Fig. 1. : distribution of positive samples for human adenovirus, norovirus, group A rotavirus and the correlation between rainfall and mean temperature from September 2010-September 2011. Source: Meteorological System of Paraná.
Fig. 2
Fig. 2. : neighbour-joining tree based on a 208 nucleotides sequence of the region of VP1, depicting phylogenetic relationships among norovirus from the state of Paraná, southern Brazil, and a reference panel of sequences obtained from GenBank. Sequences used as references in the analysis were as follows: JN797508.1, JQ320072.1, JN565063.1, JQ613565.1, HM596573.1, GU445325.2, JN183165.1, GU134965.1, HQ688986.1, JN899242.1, JN899245.1, JQ911594.1, FJ384783.1, FJ515294.1, JN603244.1, GQ413970.1, JQ388274.1, JN899243.1, GU299761.1 and JQ613567.1. GenBank accessions: PR_BRA_1382_2001, KF556654, PR_BRA_1008_2011, KF556655, PR_BRA_3074_2011, KF556656, PR_BRA_2082_2011, KF556657, PR_BRA_3172_2011, KF556658, PR_BRA_3228_2011, KF556659, PR_BRA_3270_2011, KF556660, PR_BRA_3329_2011, KF556661, PR_BRA_3353_2011, KF556662, PR_BRA_3484_2011, KF556663, PR_BRA_2901_2011, KF556664, PR_BRA_3157_2011, KF556665, PR_BRA_762_2011, KF556666, PR_BRA_4287_2010, KF556667. AUS: Australia; BEL: Belgium; BRA: Brazil; Hu: human; PR: Paraná; RUS: Russia; SWE: Sweden; USA: United States of America; VNM: Vietnam.
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