Clinical and molecular trends of rotavirus and norovirus infection in children and neonates

Abstract

Viral gastroenteritis is one of the major causes of life threating diarrhoea in children less than 5 years of age Rotavirus and norovirus are the most common cause of acute gastroenteritis in children less than 5 years of age Rotavirus infection in neonates is usually mild or asymptomatic The circulating rotavirus strains in neonates differ from those circulating strains in older infants There is also very limited data on norovirus infection in neonates This study was undertaken to determine the rate of detection of rotavirus and norovirus causing diarrhoea among children less than 5 years and neonates and to genetically characterize the strains circulating from 2016 to 2019 in our tertiary care centre Institutional ethics committee approval was obtained prior to the initiation of the study A total of 1070 participants were enrolled for this study Of which 547 participants were from children less than 5 years of age and 523 participants were from neonates. Rotavirus antigen was screened using ELISA The sample which tested positive for rotavirus was further characterised by using Semi nested Reverse transcriptase PCR dideoxynucleotide chain termination sequencing open bracket Sanger method close bracket and next generation sequencing Norovirus was screened by real time Multiplex PCR GI and GII Positive samples were genotyped by Sanger sequencing Capsid and Polymerase to determine the norovirus genotypes The clinical severity of gastroenteritis was assessed by Modified Vesikari Scale Among the 547 children, the median age was 15 months IQR 10 to 27 Among children less than 5 years 316 were male and 231 were female Rotavirus antigen was detected in 22percentage of children less than 5 years by antigen detection ELISA The most frequent rotavirus genotypes among children less than 5 years detected were G3P8 G1P8 followed by G2P4 In 2016 39percentage of G1P8 was the predominant genotype During 2017 to 2019 G3P8 replaced G1P8 to become the predominant genotype Sanger sequencing was performed for G3P8 targeting the VP7