Norovirus compared to other relevant etiologies of acute gastroenteritis among families from a semirural county in Chile. (December 2020)

• Record Type: Journal Article
• Authors: Lucero, Yalda; Lagomarcino, Anne J.; Espinoza, Mónica; Kawakami, Nanami; Mamani, Nora; Huerta, Nicole; Del Canto, Felipe; Farfán, Mauricio; Sawaguchi, Yoshihiro; George, Sergio; O'Ryan, Miguel
• Is Part Of: International journal of infectious diseases. Volume 101(2020)
• Page Start: 353
• Page End: 360
• Publication Date: 2020-12
• Subjects: Norovirus -- Rotavirus -- Acute gastroenteritis -- Genotypes; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2020.10.013
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Norovirus is one of the leading causes of acute gastroenteritis (AGE) in clinical settings and outbreaks, but household-based studies are scarce. In this lower middle income community, annual family AGE incidence was 0.77. Norovirus was the most common agent of AGE, followed closely by EPEC, rotavirus, and astrovirus. Most cases of norovirus AGE occurred in children and secondary cases were uncommon. Abstract: Objective: To determine the dynamics of norovirus disease, a major cause of acute gastroenteritis (AGE), compared to other relevant etiologies, among families living in a lower middle income area. Study design: Families with three or more members and with one or more healthy children <24 months of age were followed for 1–2 years to detect any AGE. Stool samples were tested for viral and bacterial pathogens and a questionnaire was completed for those with norovirus or rotavirus AGE. Results: Between April and June 2016, 110 families were enrolled, with 103 of them completing ≥12 months of follow-up. A total of 159 family AGE episodes were detected, mostly affecting one individual (92%). At least one pathogen was detected in 56% (94/169) of samples, of which 75/94 (80%) were sole infections. Norovirus was most common ( n = 26), followed closely by enteropathogenic Escherichia coli (EPEC) ( n = 25), rotavirus ( n = 24), and astrovirus ( n = 23). The annual incidence of family AGE was 0.77, and 0.12 for norovirus. Most norovirus AGE occurred in children <4 years old (96%). Only 13/159 (8%) index AGE cases resulted in a secondary case, of which four were associated with norovirus. The majority of norovirus strains were GII (85%), with a mild predominance of GII.4 (9/26; 35%); most norovirus isolates (69%) were recombinants. Conclusions: The family incidence of AGE in this lower middle income community was nearly one episode per year, mostly caused by viruses, specifically norovirus closely followed by rotavirus and astrovirus. Norovirus infections primarily affected children <4 years old and secondary cases were uncommon.