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Natural history of human rotavirus infection
1Department of Gastroenterology, Royal Children's Hospital, Parkville, Victoria, Australia.
Insights
Rotavirus infections cause severe diarrhea, especially in young children globally, with high mortality in developing nations. Group A rotaviruses, particularly serotype G1, are the main cause of human illness and disease spread.
Area of Science:
- Virology
- Epidemiology
- Public Health
Background:
- Rotavirus infections are a common cause of gastroenteritis in humans of all ages, with severe illness predominantly affecting young children.
- While mortality is low in developed countries, rotavirus causes nearly a million deaths annually in young children in developing nations.
- Rotaviruses are classified into groups (A-E) and types (G and P) based on capsid proteins, with Group A viruses and serotypes G1-4 responsible for most human disease.
Purpose of the Study:
- To review the epidemiology and clinical significance of rotavirus infections worldwide.
- To discuss the classification and typing of rotaviruses, focusing on strains causing severe disease in children.
- To highlight the public health impact, transmission dynamics, and potential for reassortant strains.
Main Methods:
- Literature review of rotavirus epidemiology, clinical manifestations, and classification.
- Analysis of global morbidity and mortality data for rotavirus gastroenteritis.
- Discussion of viral characteristics, including infectivity, shedding, and strain diversity.
Main Results:
- Rotavirus infections are ubiquitous, with severe diarrhea posing a significant mortality risk in developing countries.
- Group A rotaviruses, particularly G1 serotype, are the predominant cause of severe childhood rotavirus gastroenteritis globally.
- High viral shedding, prolonged infectivity, seasonal transmission patterns, and nosocomial spread are characteristic of rotavirus.
Conclusions:
- Rotavirus remains a major global health challenge, necessitating continued surveillance and control strategies, especially in resource-limited settings.
- Understanding rotavirus strain diversity and transmission is crucial for developing effective vaccines and interventions.
- The potential role of reassortant strains in future epidemics warrants further investigation.
Abstract:
Rotavirus infections occur repeatedly in humans from birth to old age. Most are asymptomatic or are associated with mild enteric symptoms. Infection in young children can be accompanied by severe life-threatening diarrhea, most commonly after primary infection. Annual childhood morbidity rates for severe diarrhea are similar worldwide. Mortality rates are low in developed countries but approach 1,000,000 annually in young children in developing countries. Rotaviruses can be classified into Groups A-E according to antigenic groups on VP6, the major capsid antigen. Only Group A,B and C rotaviruses have been shown to infect humans, and most human rotavirus disease is caused by Group A viruses. These are further classified into G and P types based on identification of antigens on the outer capsid proteins VP7 and VP4 respectively. Most severe infections in young children are caused by serotypes G1-4, and during the last two decades, G1 infections appear to have predominated worldwide. In general the more densely populated countries show the most complex patterns of occurrence of serotypes. Clinical rotavirus disease can be accompanied by shedding of > 10(12) rotavirus particles/gm feces. The virus is highly infectious and appears to retain infectivity over many months. In temperate climates, disease is most common during the colder months, when it is likely that rapid spread within families and communities occurs. Nosocomial infections are frequent, and rotaviruses can become endemic within obstetric hospital nurseries for the newborn. Few (if any) human rotavirus infections appear to be zoonoses, even though Group A rotaviruses are widespread in the young of all mammalian species. However infection of humans with reassortant rotavirus strains derived from human-animal sources can occur. The extent to which this contributes to new epidemic strains within particular countries (or worldwide) remains to be determined.