[Molecular methods for the diagnosis of acute viral gastroenteritis]

Acute gastroenteritis (AGE) is a major cause of morbidity and mortality worldwide. In Europe, viruses are responsible for most episodes of gastroenteritis, and among these, rotaviruses are associated with most AGE in children under the age of 2 years, and noroviruses in older ages. Classical methods for laboratory diagnosis leave between 60 and 70% of cases undiagnosed. Most cases in which the etiology is unknown are probably caused by viruses. Through the use of molecular methods (nucleic acid amplification) with greatly improved sensitivity and specificity, this diagnostic gap in AGE can be greatly reduced. Molecular methods are particularly advantageous in the detection of viruses, and in particular, in that of noroviruses and rotaviruses. The high incidence and transmissibility of noroviruses has a major impact on public health, and noroviruses are the major cause of outbreaks of AGE worldwide. Rotaviruses are the major cause of severe acute infantile AGE throughout the world. As well as serving as tools for diagnosis, molecular methods are essential for the genetic characterization of co-circulating strains. Through the use of molecular methods, the true incidence of viral AGE can be more accurately established, and the role of novel viruses in this highly common syndrome can be assessed.