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Low endemicity and low pathogenicity of rotaviruses among rural children in Costa Rica
Insights
This study found rotavirus infections were uncommon and rarely caused diarrhea in rural Costa Rican children. Factors like breastfeeding and hygiene likely contributed to the low incidence and pathogenicity of rotavirus.
Area of Science:
- Virology
- Pediatrics
- Public Health
Background:
- Rotaviruses are a leading cause of severe diarrheal disease in infants and young children globally.
- Understanding rotavirus epidemiology in diverse settings is crucial for developing effective prevention strategies.
Purpose of the Study:
- To prospectively investigate the incidence and pathogenicity of rotavirus infections in rural Costa Rican children.
- To assess the role of host immunity, including secretory and serum antibodies, in rotavirus infection.
Main Methods:
- Weekly fecal sample collection from 51 children over 33 months.
- Detection of rotavirus using molecular methods.
- Serological testing for rotavirus-specific antibodies (secretory and serum).
Main Results:
- Rotavirus was detected in 1.04% of fecal specimens, with a documented infection incidence of 0.5 per child-year.
- Only 12.8% of infections were associated with diarrhea, indicating low pathogenicity.
- Short-lived secretory antibodies offered limited protection; serum antibodies were present in a majority of children but did not fully correlate with infection status.
Conclusions:
- Rural Costa Rican children exhibited low incidence and pathogenicity of rotavirus infections.
- Prolonged breastfeeding, lower infectious dose exposure, and higher hygiene standards may contribute to these findings.
- Further research is needed to fully elucidate the interplay of environmental and host factors in rotavirus epidemiology.
Abstract:
Rotaviruses were prospectively studied in 51 rural Costa Rican children from birth to two years. Samples of feces were collected weekly over a 33-month period. Rotavirus was detected in 45 (1.04%) of 4,317 fecal specimens; 39 infections were documented (an incidence of 0.5 infection per child-year), only five of which were associated with diarrhea (a pathogenicity of 12.8%). Secretory antibody in fecal extracts, detected in six of 39 infections, was short lived and did not protect against reinfection. Serum antibody was present in 69.6% of two-year-old children, but was not detected in 18.8% with documented infections. On the other hand, serum antibody was present in six of 14 children in whom rotavirus was not detected, thus increasing the overall incidence to 0.6 infection per child-year. The combination of prolonged breast-feeding, exposure to a lower infecting dose (compared with urban children), and a higher standard of hygiene than expected may explain the low incidence and low pathogenicity of rotavirus among these rural children.