No abstract

iHuman sapovirus has been shown to be one of the most important etiologies in pediatric patients with acute diarrhea. However, very limited data are available about the causative roles and epidemiology of sapovirus in community settings. A nested matched case-control study within a birth cohort study of acute diarrhea in a peri-urban community in Peru from 2007 to 2010 was conducted to investigate the attributable fraction (AF) and genetic diversity of sapovirus. By quantitative reverse transcription-realtime PCR (qPCR) sapovirus was detected in 12.4% (37/299) of diarrheal and 5.7% (17/300) of nondiarrheal stools (P ‫؍‬ 0.004). The sapovirus AF (7.1%) was higher in the second year (13.2%) than in the first year (1.4%) of life of children. Ten known genotypes and one novel cluster (n ‫؍‬ 5) within four genogroups (GI, GII, GIV, and GV) were identified by phylogenetic analysis of a partial VP1 gene. Further sequence analysis of the full VP1 gene revealed a possible novel genotype, tentatively named GII.8. Notably, symptomatic reinfections with different genotypes within the same (n ‫؍‬ 3) or different (n ‫؍‬ 5) genogroups were observed in eight children. Sapovirus exhibited a high attributable burden for acute gastroenteritis, especially in the second year of life, of children in a Peruvian community. Further large-scale studies are needed to understand better the global burden, genetic diversity, and repeated infections of sapovirus. Acute diarrhea is one of the most important causes of morbidity and mortality in pediatric populations, especially in developing countries. Rotavirus, norovirus, and other viruses are common causative etiological agents, and rotavirus accounts for about 440,000 child deaths annually (1), while norovirus is a leading cause of epidemic and sporadic acute diarrhea (2). Currently a rotavirus vaccination program has been implemented in 80 countries as a part of national immunization programs (http://sites.path.org /rotavirusvaccine/rotavirus-vaccines/#global-intro). It successfully reduced the number of hospitalizations and deaths due to acute gastroenteritis (3, 4) and is cost-effective (5). Norovirus has now replaced rotavirus as the leading cause of medically attended acute diarrhea in pediatric populations (6, 7), and sapovirus, belonging to a separate genus of the Caliciviridae family, has been reported as the second most commonly detected virus after norovirus in children with acute diarrhea where rotavirus vaccination was implemented (8, 9). In addition, reports on sapovirus outbreaks across all age groups have increased in South Asia, Europe, and North America recently (10)(11)(12)(13)(14).The genome of sapovirus consists of a positive-sense, singlestranded RNA with two open reading frames (ORFs) (12). ORF1 encodes the nonstructural proteins and a major capsid protein, VP1, and ORF2 encodes a protein whose function is still unknown (12). Like for norovirus, multiple genetic clusters of human sapovirus have been reported, including four genogroups (GI, GII, GIV, and GV) with 17 gen...

Summary: Congenital Trypanosoma cruzi transmission is now estimated to account for 22% of new infections. Though the proportion of T. cruzi infected infants with clinical signs has fallen from the 1990s, but symptomatic congenital Chagas disease still represents a significant, albeit increasingly challenging to detect, public health problem. 3 AbstractBackground: Congenital Trypanosoma cruzi transmission is now estimated to account for 22%

This was the first birth cohort study with active surveillance of sapovirus infection in a developing country. High incidences of sapovirus infection and associated diarrhea during the first 2 years of life were reported. Sapovirus reinfection is common but rare with the same genotype.

h Trypanosoma cruzi causes Chagas disease, which affects an estimated 7 million to 8 million people. Chagas disease is endemic throughout Latin America, with the highest prevalence in Bolivia. Conventional diagnosis requires a well-equipped laboratory with experienced personnel. We evaluated the Chagas Detect Plus (CDP) (InBios, Seattle, WA), a rapid immunochromatographic assay for IgG antibodies to T. cruzi. CDP performance was compared to infection status based on results obtained by indirect hemagglutination assay, immunofluorescent-antibody test, and enzyme-linked immunosorbent assay. Confirmed infection required positive results by at least 2 conventional assays. We used specimens from adults of both sexes in a general hospital in the city of Santa Cruz and from pregnant women in a hospital and children in villages in the Bolivian Chaco, an area of hyperendemicity. CDP was performed in paired whole-blood and serum specimens from 385 individuals in the two hospital studies and in 200 serum specimens from the community study. CDP showed sensitivities/specificities of 96.2% (95% confidence interval, 92.7 to 98.4)/98.8% (95.9 to 99.9) in whole blood and 99.3% (97.5 to 99.9)/96.9% (94.2 to 98.6) in serum, with no differences by sex, age group, or study site. CDP showed excellent sensitivity and specificity in our study population, comparable to those of conventional serology. The test is reliable for field surveys, requires no laboratory equipment, and performed well in serum and whole blood. The CDP could also be used for accurate maternal screening to identify neonates at risk of congenital transmission. CDP performance data in diverse geographic areas are needed to strengthen the evidence base for its use.