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Virus infections among young children--the first year of the INDIS study
Marja-Leena Simonen-Tikka1, Päivi Klemola, Sointu Suomenrinne
1Virology Unit, National Institute for Health and Welfare (THL), Helsinki, Finland.
Insights
Most children under 24 months with genetic type 1 diabetes risk experienced viral infections. Human rhinovirus and enterovirus were most common, with mixed infections frequent in this high-hygiene population.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Epidemiology
Background:
- Early childhood infections are common and may influence immune system development.
- Children with genetic predisposition to type 1 diabetes may have altered responses to infections.
- Understanding viral prevalence in young children is crucial for public health and disease prevention strategies.
Purpose of the Study:
- To determine the frequency and types of viral infections in healthy Finnish children at high genetic risk for type 1 diabetes.
- To identify the most prevalent viral agents, including enteric and respiratory viruses, in young children.
- To investigate the occurrence of single versus multiple viral infections in the study cohort.
Main Methods:
- Prospective follow-up study (INDIS) in Turku, Finland, involving 45 children aged 24 months or younger.
- Collection of parallel stool and nasal swab specimens during infectious episodes (2009-2010).
- Analysis of enteric and respiratory viruses using validated virus-specific real-time PCR methods.
Main Results:
- A high prevalence of viral infections was observed, with 96% of children experiencing at least one infection.
- Viral agents were detected in 76% of all collected specimen sets.
- The most common viruses identified were human rhinovirus (57.5%), enterovirus (28.8%), parechovirus (19.4%), and norovirus GII (6.9%).
- Multiple infections (two or more agents) were detected in 36.3% of specimens.
- Human enterovirus was found more frequently in nasal swabs than in stool specimens, contrary to expectations.
Conclusions:
- Healthy young children, even those with genetic risk for type 1 diabetes, frequently experience multiple viral infections.
- Human rhinovirus and enterovirus are significant contributors to the viral infectious disease burden in early childhood.
- The higher detection rate of enterovirus in nasal swabs warrants further investigation in high-hygiene settings.
Abstract:
The frequencies of early childhood infections were studied in healthy children with increased genetic risk for type 1 diabetes participating in the ongoing prospective high intensive infection follow-up Study, INDIS, started in 2009 in Turku, Finland. Here the results obtained from 160 stool to 160 nasal swab specimens collected in parallel at times of infectious symptoms in 2009-2010 from 45 children at the age of 24 months or younger are reported. The specimens were analyzed for enteric (human enterovirus, norovirus, rotavirus, sapovirus, astrovirus) and respiratory RNA viruses (human enterovirus and rhinovirus) common in early childhood, respectively, using highly validated virus-specific real-time PCR methods. According to the results 96% of the children had at least one virus infection during the study period and one or several viral agents were detected in 76% of sample sets. The most prevalent viral agents were human rhinovirus, enterovirus, parechovirus, and norovirus (genotype GII) with positive specimens 57.5%, 28.8%, 19.4%, and 6.9%, respectively. Other intestinal viruses were found in less than 2% of stool specimens. Single infections covered 40.0% of the specimens while multiple infections with two or more infectious agents were detected in 36.3% of specimens and altogether 11 combinations of viruses were included in the mixed infections. Although human enterovirus is known to be a frequent finding in stool specimens, especially during early childhood, it was found in this study more frequently in nasal swab specimens. Whether this is true, more general, in countries with the high hygiene level remains to be shown.
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