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Neonatal rotavirus infection and its relation to cord blood antibodies
1Department of Paediatrics, All India Institute of Medical Sciences, New Delhi.
Insights
Neonatal rotavirus infection is common in Indian hospitals, with over 70% of infants shedding the virus within five days. Exclusive breastfeeding significantly reduces rotavirus acquisition in newborns.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Neonatal rotavirus infection is a significant concern in healthcare settings.
- Understanding transmission dynamics and risk factors is crucial for prevention.
Purpose of the Study:
- To investigate the prevalence and transmission of rotavirus in neonates in an Indian urban hospital.
- To identify risk factors associated with rotavirus acquisition and explore the role of maternal antibodies.
Main Methods:
- Enzyme-linked immunosorbent assay (ELISA) was used to detect rotavirus in fecal samples.
- Electropherotyping of viral RNA was performed to assess common sources of infection.
- Infant feeding practices and cord blood antibody levels were analyzed.
Main Results:
- A high prevalence of rotavirus shedding (36.1% by 72 hours, 70.3% by 5 days) was observed in neonates.
- Supplement-fed infants had a significantly higher rate of rotavirus acquisition (49%) compared to exclusively breastfed infants (24.7%).
- Most rotavirus-excreting infants were asymptomatic, and cord blood antibody levels did not show significant protective effects.
Conclusions:
- Neonatal rotavirus infection is widespread in this Indian hospital setting, often asymptomatic.
- Exclusive breastfeeding is a protective factor against rotavirus acquisition in neonates.
- Maternal antibodies in cord blood offer limited protection against neonatal rotavirus infection.
Abstract:
Among 274 neonates born at the maternity services of an urban hospital in India, 36.1% of the infants shed rotavirus in feces (as detected by ELISA) by 72 h of life. The excretion rate increased to 70.3% among the 120 infants who stayed for 5 days or more at the hospital. Diarrhoeal symptoms of mild and self-limited nature were observed only in 19.2% of the rotavirus excretors, the remaining being asymptomatic. Among the 98 infants who received supplement feeds, 49% acquired rotavirus infection as against 24.7% of the 150 exclusively breast fed infants (p less than 0.001). Viral RNA in the feces of all rota positive infants showed the same electropherotype, indicating infection from a common source. The mean percentage rotavirus inhibitory activity of cord sera in the infected and non-infected infants was 50.2 +/- 21.7 and 56.6 +/- 19.2 respectively (p greater than 0.05), suggesting that cord blood antibodies do not offer significant protection against neonatal rotavirus infection.