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Swab Sampling Method for the Detection of Human Norovirus on Surfaces
Published on: February 6, 2017
Hospital-based Surveillance for Pediatric Norovirus Gastroenteritis in Bangladesh, 2012-2016
Syed M Satter1,2, Zarin Abdullah1,2, Cristina V Cardemil3
1icddr,b, Mohakhali, Dhaka, Bangladesh.
Insights
Norovirus is a significant cause of acute gastroenteritis (AGE) hospitalizations in young Bangladeshi children, primarily driven by Genogroup II (GII) strains. This study highlights the need for better understanding and control of norovirus in low-income settings.
Area of Science:
- Virology
- Public Health
- Pediatrics
Background:
- Noroviruses are a leading global cause of acute gastroenteritis (AGE).
- Limited epidemiological data exists for norovirus in low and middle-income countries.
- Understanding norovirus burden in children is crucial for public health interventions.
Purpose of the Study:
- To investigate the epidemiology and genetic diversity of norovirus infections.
- To determine the prevalence and common genotypes of norovirus causing AGE hospitalizations in Bangladeshi children.
- To assess the severity of norovirus-associated AGE compared to rotavirus.
Main Methods:
- Active surveillance of children under 5 hospitalized with AGE in Bangladesh (2012-2016).
- Real-time RT-PCR testing for norovirus on 1008 stool samples.
- Genotyping of norovirus-positive specimens and assessment of rotavirus coinfection.
Main Results:
- 137 (14%) of tested children were positive for norovirus, predominantly those under 2 years old.
- Genogroup II (GII) noroviruses were most common (96%), with GII.4 Sydney [P4 New Orleans] being the most frequent genotype.
- Norovirus and rotavirus infections showed similar severity scores, but norovirus was more prevalent in rotavirus-negative cases.
Conclusions:
- Norovirus is a significant pathogen contributing to AGE hospitalizations among children in Bangladesh.
- Genogroup II viruses, particularly GII.4 Sydney, are the predominant strains causing illness.
- Findings underscore the importance of norovirus surveillance and control strategies in resource-limited settings.
Background:
Globally, noroviruses are recognized as an important cause of acute gastroenteritis (AGE), but data from low and middle-income countries are limited.
Aims:
To examine the epidemiology and strain diversity of norovirus infections among children hospitalized for AGE in Bangladesh.
Methods:
We implemented active surveillance of children <5 years of age hospitalized with AGE at 8 geographically dispersed tertiary care hospitals in Bangladesh from July 2012 to June 2016. We tested random samples of AGE cases stratified by site and age group for norovirus by real-time RT-PCR. Noro-positive specimens were genotyped. Coinfection with rotavirus was assessed based on prior EIA testing.
Results:
We enrolled 5622 total AGE cases, of which 1008 were tested for norovirus. Total of 137 (14%) AGE cases tested positive for norovirus (range, 11%-17% by site). Most (94%) norovirus-associated hospitalizations were among children less than 2 years of age. Norovirus was detected year-round, with higher detection from March to June (20%-38%) and November to January (9%-18%). Genogroup II (GII) noroviruses were detected in 96% of cases, and the most frequent genotypes were GII.4 Sydney [P4 New Orleans] (33%), GII.3 [P16] (20%), and GII.4 Sydney [P16] (11%). The proportion of norovirus-positive specimens was significantly greater among rotavirus-negative AGE patients compared with rotavirus-positive AGE patients (27% vs. 5%, P < 0.001). As measured by the Vesikari severity score, a similar proportion of norovirus and rotavirus positive AGE patients were considered severe (68% vs. 70%, P = 0.86).
Conclusions:
Norovirus is an important cause of AGE hospitalization in Bangladeshi children with most infections caused by GII viruses.
