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Adapting Gastrointestinal Organoids for Pathogen Infection and Single Cell Sequencing under Biosafety Level 3 (BSL-3) Conditions
Published on: September 10, 2021
Viruses that multiply in the gut and cause endemic and epidemic gastroenteritis
1Provincial Laboratory, B.C. Centre for Disease Control, 828 West 10th Avenue, Vancouver, B.C., Canada V5Z 1L8.
Insights
Viral enteritis is a common cause of childhood diarrhea, often more frequent than bacterial infections in developed nations. Early diagnosis and management, including rehydration therapy, are crucial for young patients.
Area of Science:
- Pediatric infectious diseases
- Gastroenterology
- Virology
Background:
- Acute infectious diarrhea is a major cause of illness and death in young children globally.
- In developed countries, infectious enteritis is a significant childhood morbidity cause, second only to respiratory infections.
Purpose of the Study:
- To identify viral agents responsible for enteritis in children.
- To elucidate the pathogenesis, clinical presentation, epidemiology, and diagnostic methods for viral enteritis.
Main Methods:
- Literature review of pertinent studies on viral enteritis.
- Recall of findings from investigations by colleagues in the field.
Main Results:
- Identified viruses include Rotaviruses, Adenoviruses, Caliciviridae (e.g., Norwalk virus), Astrovirus, Coronavirus, Torovirus, Cytomegalovirus (CMV), and Picobirnavirus.
- Viral replication occurs in small intestinal villi, leading to watery diarrhea and sometimes vomiting and fever. Diagnostic tools include electron microscopy (EM), ELISA, and PCR.
- Viral shedding in stool typically lasts 3-7 days.
Conclusions:
- Viral enteritis in young children can be up to three times more prevalent than bacterial gut disease in developed countries.
- Non-bloody stools and absence of white blood cells are characteristic, except in cases of CMV involvement.
- Management focuses on rehydration therapy, either intravenous for severe dehydration or oral for milder cases.
Background:
Acute infectious diarrhea in young children is a leading cause of morbidity and mortality in developing countries. Even in developed countries, infectious enteritis is second only to respiratory infections as a cause of morbidity in early childhood.
Objective:
To nominate the various viral agents that cause enteritis, discuss the pathogenesis, clinical features, epidemiology and diagnostic procedures employed.
Study Design:
Pertinent literature was reviewed and the findings of investigations carried out on viral enteritis by various colleagues recalled.
Results:
The viruses causing gastroenteritis include: Rotaviruses; Adenoviruses-especially Ad 31, Ad 40 and Ad 41; members of the Caliciviridae, e.g. Norwalk virus, Hawaii virus, Snow Mountain virus, Taunton virus, Southampton virus, Toronto virus (formerly mini-reovirus) and others; Astrovirus; Coronavirus; Torovirus; Cytomegalovirus (CMV) and possibly Picobirnavirus. Enteritis-producing viruses replicate in columar epithelial cells in the distal parts of villi of the small intestine. Two mechanisms are addressed to explain why diarrhea occurs. Clinically, the main expression of illness is a watery diarrhea that lasts 24 h to about 7 days. Vomiting is of shorter duration and may not always accompany the diarrhea. Fever is generally 38.5 degrees C. Virus is shed in the stool for about 3-7 days. Diagnostic procedures employ electron microscopy (EM), immune electron microscopy (IEM), enzyme-linked immunosorbent assay (ELISA), time-resolved fluoroimmunoassay (TR-FIA), latex agglutination, polyacrylamide gel electrophoresis (PAGE) and the polymerase chain reaction (PCR).
Conclusion:
In developed countries viral enteritis among young children may be up to three times more common than bacterial gut disease. With the exception of CMV enteric involvement, the stool is characteristically not bloody and white blood cells are not found. Patient management may involve the employment of IV replacement therapy to counter dehydration and electrolyte imbalance. Milder cases may be managed with oral rehydration.
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