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Rotavirus infections in young Nicaraguan children
F Espinoza1, M Paniagua, H Hallander
1Department of Microbiology, National University (UNAN) León, Nicaragua.
Insights
Rotavirus infections are common in infants, with most being asymptomatic and reinfections frequent. Breast milk, particularly IgA antibodies, offers partial protection, suggesting early infant vaccination is key for developing countries.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Rotavirus is a leading cause of severe diarrhea in young children globally.
- Understanding rotavirus reinfection, immunity, and breast milk's protective role is crucial for developing effective immunization strategies.
Purpose of the Study:
- To investigate the incidence and characteristics of rotavirus infections in infants.
- To explore the relationship between breast milk, rotavirus immunity, and infection outcomes.
Main Methods:
- A prospective cohort study followed 235 infants in León, Nicaragua, from birth to 2 years.
- Fecal and serum samples were collected, with stools obtained during diarrhea episodes.
- Rotavirus antigen detection and isotype-specific antibody enzyme-linked immunosorbent assays were performed.
Main Results:
- Over 50% of infants showed evidence of rotavirus infection by 2 months of age.
- The incidence of rotavirus infection was 0.7 per child-year, with 83% being asymptomatic.
- Higher colostral anti-rotavirus IgA correlated with delayed first infection; prolonged breastfeeding suggested a link to asymptomatic infection.
Conclusions:
- Rotavirus infections are acquired early in Nicaraguan infants, with frequent asymptomatic reinfections.
- Breast milk, likely via IgA antibodies, provides partial protection against rotavirus.
- Effective rotavirus vaccination in developing countries may require administration at a very young age.
Background:
Rotavirus is an important cause of dehydrating diarrhea in young children throughout the world. Knowledge about frequency of reinfections, development of immunity to the virus and the possible protective effect of breast milk is important, in particular in relation to possible strategies for immunization.
Methods:
A prospective study of rotavirus infections in a cohort of 235 infants followed from birth until 2 years of age was performed in León, Nicaragua. Fecal and serum specimens were collected at specified times, and stools were also obtained during episodes of diarrhea. Fecal specimens were screened by rotavirus antigen detection and serum and colostral specimens were analyzed by isotype-specific rotavirus antibody enzyme-linked immunosorbent assay.
Results:
As judged by anti-rotavirus IgA antibody seroconversion and/or demonstration of rotavirus antigen in fecal specimens, > 50% of the babies had evidence of past rotavirus infection by the age of 2 months. The total incidence of rotavirus infections, including many reinfections, was 0.7 infection/child-year, of which only 17% were associated with diarrhea. The time from birth to the first demonstration of rotavirus in stool samples correlated significantly with the concentration of anti-rotavirus IgA antibodies in colostrum. There was also a tendency toward a relationship between long duration of breast-feeding and asymptomatic infection.
Conclusions:
Rotavirus infections are acquired very early in infants in León, Nicaragua, and reinfections are common. Most infections are asymptomatic. Breast milk appears to confer partial protection against rotavirus infection, probably mediated by specific IgA antibodies. To be effective rotavirus vaccination would probably have to be given at a very early age to infants in developing countries.