Types of Rotavirus Causing Acute Diarrhea among Children in Western India, their Demographic Pattern and Disease Severity.
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Date
2014-07
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Abstract
Background: Rotavirus infection is a major cause of severe acute gastroenteritis among infants and children all over the world1 with winter out-breaks of diarrhea in temperate and cooler parts almost round the year. However, this varies in different part of India.2-6 Diarrhea is a major cause of under-5 mortality, contributing to approximately over 1,50,000 infant deaths in our country per year.15,16 Different genotypes have been identified and many more are emerging by way of mutation, genetic shift and genetic drifts. Rotavirus are classified antigenically as A (Most common), B, C, D, E by ELISA and genotypically as G (1 through 12) and P (1 through 8) by Reverse Trans criptase PCR, in combinations.
Materials and methods: Stool samples of 110 infants and children from 6 to 60 months of age, with suspected viral diarrhea over one year period were studied for serotypes and genotypes; and compared for their respective disease severity.
Results: Thirty-four percent were found positive for Rotavirus-A by ELISA. Of the positive, 33.4% were found to be of G9 genotype, much higher than reported from other parts of the country. On the other hand, merely 13.6% of G1 and G4 each were detected, contrary to high prevalence elsewhere. On electro-pherotyping, the long-arm types were associated with more severe disease (64.6% showing moderate to severe dehydration) than their short-arm types (Only 16.6% showed moderate dehydration only) p < 0.009. No difference in incidence of severe dehydration between AD positive for Rotavirus (11.7%) and those found nega tive (11.8%), presumably due to other viruses, after excluding invasive diarrhea.
Conclusion: Emergence of diverse strains, i.e. more of G9 and G12 genotypes than earlier reports of G1 and G2 types indicate considerable genetic shift in the region. Such trend could have significant implication on degree of seroconversion from currently used live vaccines, using G1 or bovine reassortant G1-3 strains only, seen in recent studies from Africa and Malayi.29 Contrary to claims that Rotavirus diarrhea usually threatened severe diarrhea, no significant difference in incidence of severe diarrhea was observed between Rotavirus positive and Rotavirus negative acute diarrhea.
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Keywords
Diarrhea, Dehydration, Rotavirus, ELISA, Reverse Transcriptase PCR, RNA PAGE (Electropherotyping)
Citation
Mohanty N C, Agrawal N, Kadam N N, Shamim A, Thakur M. Types of Rotavirus Causing Acute Diarrhea among Children in Western India, their Demographic Pattern and Disease Severity. MGM Journal of Medical Sciences. 2014 July-Sept; 1(3): 105-111.