Epidemiological study of group C rotavirus

By electron microscopy survey of acute gastroenteritis of children in Matsuyama, rotaviruses were detected in 561 of 2479 fecal samples obtained between October, 1984 and September, 1988, in which 60 atypical and 259 typical rotaviruses, so far tested, were detected by polyacrylamide gel electrophoresis (PAGE) of viral RNA. Out of 60 atypical rotaviruses, 5 were observed in 1985, 7 in 1986, none in 1987 and 48 in 1988. These atypical rotaviruses were morphologically indistinguishable from typical ones and showed very similar RNA migration patterns of PAGE to those of group C rotavirus. Furthermore, one atypical virus (86-542) reacted with antiserum against a porcine group C rotavirus in immune electron microscopy, while it did not react with anti-group A rotavirus serum. On the other hand, hyperimmune guinea pig antiserum against 86-542 reacted with a couple of atypical rotavirus including viruses isolated in 1988, so far tested, but did not react with any of the typical viruses. These findings showed that atypical rotaviruses which were endemic in Matsuyama city in 1988 were defined as group C rotavirus. Moreover, these group C rotaviruses showed two kind of RNA migration patterns in PAGE, which clearly discriminated the virus were isolated before and after 1987. Epidemiological features of group C rotavirus were as follows. Children from whom group C rotavirus was isolated were older than those from of whom group A rotavirus was isolated. The epidemic season was in February through April, compared to December through March in group A virus. Retrospective seroepidemiological study by immune adherence hemagglutination test (IAHA) using the purified 86-542 virus as antigen indicated that 15 of 78 sera of children obtained in 1971 already possessed IAHA antibody against group C rotavirus.     

一起由星状病毒1型引起的新生儿腹泻暴发的病原确证

目的 对一起新生儿急性胃肠炎暴发事件进行病原确证.方法 2008年12月至2009年2月,内蒙古自治区某妇幼医院新生儿室发生腹泻流行,高峰期采集38例患儿的45份粪标本,ELISA法检测轮状病毒、腺病毒和星状病毒病原,RT-PCR法检测星状病毒核酸,其中13份星状病毒核酸阳性标本进行测序分析和进化树分析,4份星状病毒及病毒核酸均阳性的标本进行免疫电子显微镜观察.结果 45份粪标本中,轮状病毒、腺病毒病原检测均阴性.30份标本ELISA检测星状病毒病原阳性,阳性率为66.7%;31份标本星状病毒核酸阳性,阳性率为68.9%.采用星状病毒分型引物进行分型,均为星状病毒1型.选择13株与GenBank中星状病毒1型参考株进行比较,其核苷酸序列同源性为90.9%～96.3%.13株星状病毒1型株彼此间核苷酸序列同源性为94.7%～100.0%.随机选择的4份阳性标本,免疫电子显微镜下2份有大量星状病毒颗粒.结论 此起新生儿腹泻暴发由星状病毒1型引起.     

Two sequential outbreaks of rotavirus gastroenteritis: evidence for symptomatic and asymptomatic reinfections

In two sequential outbreaks of rotavirus gastroenteritis that occurred in a kibbutz in southern Israel (the Negev), 32 persons (9% of the population) were ill in the first and 45 (13% of the population) in the second. Excretion of virus, changes in titers of rotavirus-specific serum IgG, or both implicated rotavirus in 72% of the illnesses in outbreak 1 and in 56% of the illnesses in outbreak 2. In both outbreaks the age-specific morbidity rate decreased with increasing age. Half (six of 12) of the children six to 27 months of age who were ill with rotavirus in outbreak 1 were ill with rotavirus again in outbreak 2, whereas two were asymptomatically infected; older children who were ill in outbreak 1 were not ill in outbreak 2. Serotype determination by enzyme-linked immunosorbent assay using monoclonal antibodies to VP7 implicated a serotype 3 virus in outbreak 1 and a serotype 1 virus in outbreak 2.     

Atypical rotavirus isolated from acute infectious nonbacterial gastroenteritis in Fukuoka

An outbreak of epidemic diarrhea (nonbacterial acute gastroenteritis) in Fukuoka was studied electron microscopically and electrophoretically. From the result of electron microscopy, rotavirus particles about 70 nm in diameter were observed in fecal samples. However, the serological study did not reveal any antigenic relatedness to the ordinary rotaviruses by RPHA. The outbreak appeared to be caused by group C rotaviruses, based on the pattern of the RNA genome segments in polyacrylamide gels.     

Incidence and genetic diversity of group C rotavirus among adults

Fecal samples from a 1-year prospective study were investigated to establish the role of group C rotavirus infections in acute diarrhea in Swedish adults (>15 years old). Rotaviruses were found in samples from 3% of the patients, and, in 35% of these, group C rotavirus was detected. Clinical symptoms of group C rotavirus infection were generally milder than those of group A rotavirus infection. Gene 8 (vp7) from 12 group C isolates, including strains from the prospective study, a military outbreak, and a sporadic case, was sequenced. The gene was found to be extremely conserved, with identities of 99.1%-100% at the amino acid level. This study has systematically investigated the prevalence and genetic diversity of group C rotavirus in adults. The data confirm the extreme sequence conservation within human group C rotavirus strains and suggest that symptomatic group C rotavirus infections occur more frequently in adults than has been previously recognized.     

Detection of rotaviruses by nucleic acid hybridization with cloned DNA of simian rotavirus SA11 genes

We developed a dot-blot hybridization assay to detect rotaviral RNA sequences in tissue culture or in clinical samples. 32P-labeled cloned cDNA probes of the simian rotavirus SA11 specifically detected rotaviral RNA sequences and were more sensitive for detecting SA11 than was the commercial enzyme-linked immunosorbent assay Rotazyme test. A full-length probe of SA11 gene 6 detected 2.5 X 10(5) SA11 particles or approximately 0.27 ng of purified SA11 dsRNA. Combined probes from genes 6 and 9 detected 0.135 ng of purified SA11 dsRNA. The assay detected group A rotaviruses from different subgroups and serotypes, but the sensitivity of RNA detection varied from 0.5 to 31 ng when RNA from heterologous strains of virus was analyzed. An analysis of coded stool samples correctly identified 31 (91%) of 34 samples positive for rotavirus by electron microscopy and 100% of 26 samples negative for rotavirus by electron microscopy. Preliminary experiments also showed the assay has potential to directly characterize (subgroup and serotype) rotaviral isolates.     

Simplified radioimmunoassay for detection of human rotavirus in stools.

A simplified radioimmunoassay (RIA) technique was developed to facilitate the diagnosis of human rotavirus in stools of infants with diarrhea. This microtiter solid-phase RIA utilizes as a critical reagent hyperimmune serum against a tissue culture-grown simian rotavirus that is immunologically closely related to the human agent. One hundred thirteen pediatric stool samples were tested. Thiry-five specimens known to be positive for rotavirus by electron microscopy were also positive by RIA. All RIA-positive reactions (36) were shown to be specific for rotavirus by means of an antibody-blocking test. Nonspecific RIA-positive reactions were not encountered. This accurate, sensitive RIA technique is practical for use in diagnostic laboratories because critical serum reagents are prepared against culture-grown virus and not against rotavirus derived from carefully selected stools of humans or experimentally infected gnotobiotic animals.     

Rotavirus infections in newborns: an epidemiological and clinical study

An outbreak of rotavirus infections among newborns at Karolinska Hospital, Stockholm, which has been going on for greater than 2 years has been followed with clinical and epidemiological investigations. About one third of the babies born in the hospital were infected at the age of 3 days. The clinical symptoms were mild, 8.8% of the rotavirus positive babies had loose stools compared to 1.9% of those who did not excrete the virus. An epidemiological survey in the neonatal intensive care unit suggested that rotavirus was introduced into the unit by babies admitted from the obstetric wards. The main reservoir of rotavirus was the babies and rotavirus was not found among staff or mothers. In the beginning hygienic measures seemed to be effective but after some weeks the colonization rate again increased. Electropherotyping of samples collected during different periods showed that one single rotavirus electropherotype belonging to the subgroup 1 of human rotavirus was found throughout the outbreak.     

Human serogroup C rotavirus in Finland

Among 600 rotavirus specimens collected in Finland during 1985-1987, 6 isolates were found to be related to serogroup C rotavirus by RNA profile analysis and solid phase immune electron microscopy (SPIEM). The group C isolates originated from 4 children (4.5, 4.5, 6.5 and 7 years old) with diarrhoea.     

An epidemic of rotavirus-associated gastroenteritis in a nursing home for the elderly

92 cases of acute gastroenteritis were registered among 256 individuals during an outbreak in a nursing home for the elderly, the majority of patients being between 70 and 90 years of age. Most cases appeared in 4 of the 8 wards; 66% of the inmates of these wards became ill. Characteristic symptoms were initial nausea and vomiting followed by diarrhoea and low fever. A number of patients were severely ill. One patient died. Rotavirus infection was diagnosed by virus detection and/or antibody titre rise during the acute phase of the illness in 13 of 16 patients examined. At the end of the outbreak, high titres of complement-fixing antibodies against rotavirus (greater than or equal to 64) were detected in serum from 21/22 patients convalescing from the disease, as compared to only 5/45 individuals with no signs of disease. It is tentatively suggested that the outbreak became extensive and rather severe because of lowered immunity against rotavirus infection among the elderly.     

Norwalk virus in Norway: an outbreak of gastroenteritis studied by electron microscopy and radioimmunoassay

An outbreak of acute gastroenteritis affected approximately half of 40 children staying at a holiday centre in Southern Norway. By direct electron microscopy Norwalk-like viruses were demonstrated in 4/8 available stool specimens. No other pathogens were detected. Antibody against these viruses was demonstrated by immune electron microscopy in all of 7 convalescent phase sera but in none of 11 acute phase sera collected. Radioimmunoassay examination showed a rise in titre of Norwalk virus antibody in 6 available paired sera. This outbreak of Norwalk virus gastroenteritis in Norway was thus documented by a combined use of direct and immune electron microscopy and radioimmunoassay.     

Group C rotavirus infections in patients with diarrhea in Thailand, Nepal, and England

Atypical rotavirus obtained from fecal specimens of six patients with diarrhea from Thailand, Nepal, and England were characterized by using polyacrylamide gel electrophoresis and immune electron microscopy. The electropherotypes were characteristic of the porcine reference group C rotavirus strain but demonstrated considerable strain-to-strain variation. Human convalescent group C sera had a high titer (1:320) when tested against the human isolates and a low titer (1:40) when tested against a porcine reference strain (Cowden). When porcine antiserum (Cowden) was tested against the human isolates, the titers ranged from 1:40 to 1:320, indicating significant antigenic diversity between strains. Group C rotavirus appears to have a worldwide distribution as an agent associated with diarrhea in children and adults.     

A reovirus-like agent (rotavirus) in gastroenteritis of children. Virus detection and serological studies.

A reovirus-like agent (rotavirus) was detected in 26 children (44%) when fecal specimens from 59 children with acute gastroenteritis were examined by electron microscopy. No rotavirus was detected in the feces of 49 children with other diseases. Sera from the acute and the convalescent phase from 40 children with acute gastroenteritis and from 18 other patients were examined for antibodies against a bovine rotavirus by an indirect fluorescent antibody test. 26 of the patients with gastroenteritis (65%) developed antibodies during their disease, whereas none of the other patients showed a rise in antibody titre. The specimens were submitted to the laboratory from hospitalized children during the period January 1973 through March 1975. Most of the cases of rotavirus gastroenteritis occurred during late autumn and early winter among children between 0.5 and 3 years of age. It is concluded that electron microscopy is a sensitive diagnostic technique during the acute phase of the disease, and that the serological test with bovine rotavirus antigen served as a useful diagnostic tool.     

Rotavirus infection in a geriatric population

An outbreak of gastroenteritis affected 19 of 34 geriatric patients and four of 23 staff assigned to the ward in a period of 3 1/2 weeks in January 1980. Fourteen of the 19 patients with gastroenteritis (17 were tested properly) and four of the ten asymptomatic patients (five asymptomatic patients were not tested) showed evidence of rotavirus infection by virus positivity and/or a significant antibody response to rotavirus. One of the four staff members with gastroenteritis showed serologic evidence (three were tested) of rotavirus infection. Nine of the 18 asymptomatic staff members (two remaining staff members were not tested) showed a fourfold rise in antibody to rotavirus but four had antibody titers of 1:32 or more. The patients had diarrhea for a mean of 2.6 days. Most of them had five or fewer diarrheal stools in one day. Six patients had a severe illness and two died. Thirteen of 15 symptomatic patients who had serum samples, collected during the acute and convalescent phases, tested manifested high titers (greater than or equal to 1:32) of complement-fixing antibody to rotavirus antigen.     

A prospective study of rotavirus infection in infants and young children

Diarrhea in neonates, followed as a cohort, and their families was studied prospectively. The families were followed for an average of 16.3 months. Stool and serum specimens were obtained at least every three months. Stool specimens were examined for viruses by electron microscopy and cultured for enteropathogens, and serum specimens were tested for antibodies to rotavirus and Norwalk virus. During the study, 237 episodes of gastroenteritis were observed in 104 infants and their 62 siblings. Rotavirus, detected 82 times in 72 children, was by far the most common enteropathogen. It was associated with gastrointestinal symptoms in 72% (with diarrhea in 65%). Rotavirus diarrhea occurred mostly in winter months and was significantly more frequently associated with respiratory symptoms than were diarrheas with other etiologies. Rotavirus infection was uncommon in the first six months of life, but by two years of age, 62% of the infants had had at least one infection. Neither breast feeding nor the presence of antibody to rotavirus in cord blood appeared to be protective.     

An epidemic of rotavirus infection in a nursing home for the elderly in Japan

An outbreak of diarrheal disease in a Japanese home for aged is reported. Out of 202 residents, 47 cases complained of diarrhea (23.3%) during a month. Clinical symptom were diarrhea (100%) vomiting (40.4%) and fever (31.9%). Fecal examination of 9 cases revealed positive A-group rotavirus antigen. Bacterial and small round shaped virus infection was excluded. Examination of rotavirus antibody, CF titer was positive in about 50% in each age group but the titer decreased year by year. In Japan, rotavirus infection has been epidemic only in nursing home for baby and titer of antigen has been believed to be sustain by repeated provocation. However, Japanese situation is changing to be west Europe and north America.     

Common exposure outbreak of gastroenteritis due to type 2 rotavirus with high secondary attack rate within families.

A sharp outbreak of gastroenteritis associated with human rotavirus type 2 involved not only all of nine infants and young children in a playgroup but also seven of 10 parents and grandparents studied. The source of the outbreak appeared to be two non-playgroup siblings. Six of 11 individuals studied shed human rotavirus type 2, and each of seven from whom paired sera were obtained developed a type 2 sero-response. Overall, evidence of infection with rotavirus type 2 was demonstrated in 10 of 11 individuals by detection of virus in stools and/or a serologic response in an enzyme-linked immunosorbent assay.     

Presence of two distinct types of rotavirus in infants and young children hospitalized with acute gastroenteritis in Mexico City, 1977.

Between December 1976 and January 1978, infection with rotavirus was detected by electron microscopy in 61 (25%) of 242 infants and young children hospitalized with acute gastroenteritis at two hospitals in Mexico City. This type of infection was more frequent in autumn than in winter. The presence of virus could also be detected by the electrophoretic pattern of its segmented, double-standed ribonucleic acid (RNA) in the stool samples taken from 52 (85%) of the 61 patients who were shown by electron microscopic examination to excrete rotavirus. Two distinct patterns, previously called 2s and 21, were observed, which were distinguishable by the relative migration of the second, 10th, and 11th viral RNA segments in gel electrophoresis; the 21 pattern was observed much more frequently than with the 2s pattern.