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Viral shedding in gastroenteritis in children caused by variants and novel recombinant norovirus infections
- Source :
- Medicine. 100(12)
- Publication Year :
- 2020
-
Abstract
- Human norovirus (NoV) is the leading cause of acute gastroenteritis and the rapid transmission of NoV renders infection control problematic. Our study aimed to investigate viral shedding in gastroenteritis in children caused by variants of emerging norovirus strains infections.We used RNA-dependent RNA polymerase (RdRp) sequencing to measure NoV genome copies in stool to understand the relationship between the clinical manifestations and viral shedding in hospitalized patients. The near full-length NoV genome sequence was amplified via reverse transcription-polymerase chain reaction (RT-PCR) and NoV recombination was analyzed using the Recombination Analysis Tool (RAT).From January 2015 to March 2018, 77 fecal specimens were collected from hospitalized pediatric patients with confirmed NoV gastroenteritis. The NoV genotypes were GII.4 (n = 22), non-GII.4 (n = 14), GII.4 Sydney (n = 21), and GII.P16-GII.2 (n = 20). Viral load increased from days 2 to 9 from the illness onset, resulting in an irregular plateau without peaks. After day 9, the viral load declined gradually and most viral shedding in feces ceased by day 15. The average viral load was highest in GII.4 Sydney followed by GII.P16-GII.2 infections and lowest in non-GII.4 infections. GII.4 unclassified infections showed the longest viral shedding time, followed by GII.4 Sydney infections, GII.P16-GII.2 recombinant infection resulted in the shortest duration. NoVs evolved to form a group of GII.P16-GII.2 variants during the 2017 to 2018 period.The viral load and shedding period and was different in variants of NoV infections in children. High mutation rate of emerging and re-emerging variants was observed to an enhanced epidemic risk rendering continuous surveillance.
- Subjects :
- Male
Genotype
viruses
Taiwan
medicine.disease_cause
Real-Time Polymerase Chain Reaction
03 medical and health sciences
Feces
fluids and secretions
0302 clinical medicine
medicine
Infection control
Humans
030212 general & internal medicine
Viral shedding
Phylogeny
Caliciviridae Infections
Recombination, Genetic
Inpatients
Transmission (medicine)
business.industry
Norovirus
virus diseases
Genetic Variation
Infant
General Medicine
Viral Load
Virology
Gastroenteritis
Virus Shedding
Real-time polymerase chain reaction
030220 oncology & carcinogenesis
Child, Preschool
Female
business
Viral load
Subjects
Details
- ISSN :
- 15365964
- Volume :
- 100
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Medicine
- Accession number :
- edsair.doi.dedup.....5fde7e8825074ad39f30eb274d7737c9