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Detection of an unusual G8P[8] rotavirus in a Rotarix-vaccinated child with acute gastroenteritis using Nanopore
Jong-Hwa Kim1, Dae Yong Yi2, Inseok Lim2
1Department of Microbiology.
Insights
This study reports the first detection of a novel human-bovine recombinant rotavirus in a child with severe gastroenteritis. Nanopore sequencing identified the unusual rotavirus strain, enabling effective treatment.
Area of Science:
- Virology
- Genomics
- Pediatrics
Background:
- Routine rotavirus diagnostics have limitations in detecting all strains.
- Severe gastroenteritis can be challenging to diagnose, especially in vaccinated individuals.
Observation:
- A 27-month-old girl with severe gastroenteritis tested negative for common viral and bacterial pathogens.
- The patient had previously received the Rotarix rotavirus vaccine.
Findings:
- MinION sequencing identified a rare human-bovine recombinant rotavirus in the patient's stool sample.
- This novel rotavirus strain was not detected by standard laboratory tests.
Implications:
- Nanopore sequencing offers a powerful tool for identifying unusual or novel viral pathogens.
- Early detection of uncommon rotavirus strains is crucial for effective treatment and public health surveillance.
Rationale:
Rotavirus is routinely diagnosed by the detection of antigens or the viral genome. However, these tests have limitations, in that they do not detect all rotavirus strains.
Patient Concerns:
We present a case of a 27-month-old girl who was hospitalized for 4 days with severe gastroenteritis, including high fever, vomiting, diarrhea, mild dehydration, and periumbilical pain. Notably, the patient previously received the Rotarix vaccine.
Diagnoses:
The laboratory tests were negative for rotavirus, astrovirus, adenovirus, and norovirus as well as common diarrhea-causing bacteria. Human-bovine recombinant rotavirus was detected by MinION sequencing.
Interventions:
To investigate the cause agents from the unexplained severe gastroenteritis infant, the stool sample was prepared by random amplification for Nanopore MinION sequencing.
Outcomes:
Treatment through the administration of ORS solution and galtase powder with probiotics was successful after the diagnosis of unusual rotavirus infection.
Lessons:
This case report is the first detection of an unusual human-bovine recombinant rotavirus in an idiopathic gastroenteritis using Nanopore MinION sequencing.
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