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Updated: Jul 5, 2025
Swab Sampling Method for the Detection of Human Norovirus on Surfaces
Published on: February 6, 2017
Hospital-based norovirus surveillance in children <5 years of age from 2017 to 2019 in India
Sidhartha Giri1, Preeti Chhabra2, Ruta Kulkarni3
1Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
Insights
Norovirus is a significant cause of acute gastroenteritis in hospitalized Indian children, even after rotavirus vaccine introduction. This study tracked norovirus prevalence and types from 2017-2019.
Area of Science:
- Virology
- Epidemiology
- Public Health
Background:
- The rotavirus vaccine was introduced in India in 2016.
- Few studies have assessed acute gastroenteritis (AGE) in hospitalized children post-vaccine introduction.
Purpose of the Study:
- To determine the prevalence and epidemiological patterns of norovirus in hospitalized children (≤5 years) with AGE in India.
- To identify common norovirus genotypes circulating in this population.
Main Methods:
- Stool specimens were collected from children with AGE admitted to six hospitals in three Indian cities (Jan 2017–Dec 2019).
- Norovirus was detected using real-time reverse transcription-polymerase chain reaction (RT-qPCR).
- Positive specimens were typed using conventional RT-PCR and Sanger sequencing.
Main Results:
- Norovirus was detected in 14.8% (322/2182) of specimens, with higher rates in 2018 (17.6%) and 2019 (14.4%).
- Norovirus positivity was 16.3% in rotavirus-vaccinated children and 12% in unvaccinated children.
- GII.4 Sydney strains (GII.4 Sydney[P16] and GII.4 Sydney[P31]) were the most prevalent, accounting for over 58% of typed strains.
Conclusions:
- Norovirus is a crucial pathogen contributing to AGE in hospitalized Indian children.
- Continued surveillance of norovirus is important for public health strategies, especially following vaccine program introductions.
Abstract:
After the introduction of the rotavirus vaccine into the Universal Immunization Program in India in 2016, relatively few studies have assessed the prevalence and epidemiological patterns of acute gastroenteritis (AGE) among hospitalized children ≤5 years of age. We used a uniform protocol to recruit children with AGE as well as standardized testing and typing protocols. Stool specimens from children with AGE younger than 5 years of age admitted to six hospitals in three cities in India were collected from January 2017 through December 2019. Norovirus was detected by real-time reverse transcription-polymerase chain reaction (RT-qPCR) followed by typing positive specimens by conventional RT-PCR and Sanger sequencing. Norovirus was detected in 322 (14.8%) of 2182 specimens with the highest rate in 2018 (17.6%, 146/829), followed by 2019 (14.4%, 122/849) and 2017 (10.7%, 54/504). Rotavirus vaccine status was known for 91.6% of the children of which 70.4% were vaccinated and 29.6% not. Norovirus positivity in rotavirus-vaccinated children was 16.3% and 12% in unvaccinated children. GII.4 Sydney[P16] (39.3%), GII.4 Sydney[P31] (18.7%), GII.2[P16] (10%), GI.3[P13] (6.8%), GII.3[P16] (5.9%), and GII.13[P16] (5%) accounted for 85.8% (188/219) of the typed strains. Our data highlight the importance of norovirus in Indian children hospitalized with AGE.
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