Acute Infantile Gastroenteritis Associated with Human Enteric Viruses in Tunisia

Abstract

, investigated the incidence and the clinical role of various enteric viruses responsible for infantile gastroenteritis in 632 Tunisian children presenting in dispensaries (380 children) or hospitalized (252 children) for acute diarrhea. At least one enteric virus was found in each of 276 samples (43.7%). A single pathogen was observed in 234 samples, and mixed infections were found in 42 samples. In terms of frequency, rotavirus and norovirus were detected in 22.5 and 17.4% of the samples, respectively, followed by astrovirus (4.1%), Aichi virus (3.5%), adenovirus types 40 and 41 (2.7%), and sapovirus (1.0%). The seasonal distribution of viral gastroenteritis showed a winter peak but also an unusual peak from May to September. The severity of the diarrhea was evaluated for hospitalized infants. No significant differences were observed between rotavirus and norovirus infections with regard to the incidence and the clinical severity of the disease, especially in dehydration.Diarrhea is one of the major causes of morbidity and mortality among infants throughout the world, especially in developing countries, where malnutrition and poor local health service are factors responsible for the increased severity of the diarrhea. In infants, group A rotavirus (RV) is the major etiologic agent of viral gastroenteritis and is responsible for 29 to 45% of hospitalizations, depending on the income level of the country (32, 33). Other enteric viruses such as human norovirus (NoV), sapovirus, astrovirus (HAstV), adenovirus (HAdV) types 40 and 41, and Aichi virus are also associated with acute gastroenteritis, and their relative importance in high-income countries has been reported previously (2, 4).Human NoVs, which are members of the Caliciviridae family, are found in all age groups (7, 10) and are a major cause of food-and water-related outbreaks (11,22). Recent work has showed that NoVs are the second most frequent etiologic agents of viral gastroenteritis (16). Sapovirus, another genus of the family Caliciviridae, HAstV (41), and enteric type 40 and 41 HAdVs have also been associated with diarrhea. Aichi virus (42) has recently been classified into the Kobuvirus genus in the Picornaviridae family and has been associated with oyster consumption.Although the role of these viruses in outbreaks of gastroenteritis in industrialized countries has been established (7, 29), little is known about their contribution to outbreaks in developing countries and few data are currently available (25). In Tunisia, a middle-income Mediterranean country, earlier studies showed the contribution of RVs (8, 38) and more recently that of HAstVs and HAdVs (12) in cases of childhood diarrhea. However, the nature of the contribution of NoVs and Aichi viruses to outbreaks of gastroenteritis in Tunisia remains unknown.The aim of this study was to determine the incidence of these enteric viruses and their contribution to diarrheal diseases in Tunisian children. We conducted a prospective 2-year study of children who were hospitalized in or presented to ...

Genotypes of rotavirus associated with acute gastroenteritis in Seoul, Korea

“…Genotype G1 was observed to be broadly circulating in Korea, with overall incidences of 54.3%. This result is in agreement with the earlier findings that G1 was the most prevalent strain (45-81%) regardless of geographical area or season in Korea (16). Human G9 RoVs have recently been highlighted as the fifth most common strain in circulation.…”

“…RoVs have shown a seasonal pattern of infection in developed countries, epidemic peaks occurring in the cooler c 2011 The Societies and Blackwell Publishing Asia Pty Ltd months of each year (16). In this study, RoVs were identified throughout the 12 month study period in Seoul, Korea.…”

Increase in the detection rate of viral and parasitic enteric pathogens among Egyptian children with acute diarrhea

“…We found that NoV, RV, AsV and AdV were present in 26.5%, 19%, 11.7% and 4.7% respectively of cases as a single or co-pathogen with seasonal distribution from May to October. A similar finding was reported by SidiriLoulizi et al [22] from Tunisia, where RV was slightly more dominant than NoV (22.5 v 17.4%), followed by AsV (4.7%) and AdV (2.7%) in children hospitalized because of acute diarrhea. Distribution of viral gastroenteritis showed both a winter peak and a summer/autumn peak (May to October) in Tunis.…”

“…Enzyme immunosorbent assays have been used to study diarrheal infection for years and commercial kits with high sensitivity and specificity are readily available [20,21]. Despite this, only a few studies report the burden of enteric viruses in North Africa [13,22]. This report, the first comprehensive surveillance describing etiologies of enteric viruses and parasites from children with diarrhea seeking medical care, demonstrated that inclusion of additional laboratory tests significantly The previous publication by our colleagues [7] characterized the frequency of bacterial etiologies of diarrhea in the same region, but in our study, additional analyses illustrated the significance of enteric viral infection in the first year of life in Egyptian children, both as a sole pathogen and as part of what may be a true polymicrobial infection.…”

Epidemiology and clinical features of gastroenteritis in hospitalised children: prospective survey during a 2-year period in a Parisian hospital, France

“…A number of previous studies found lower levels of disease severity in norovirus than in rotavirus gastroenteritis, and most of these were carried out in developed countries [7,[43][44][45][46][47]. In contrast, other studies found no significant differences between the severity of rotavirus and norovirus infections [48][49][50][51]. One such study was conducted by us in Tunisia, and we attributed the severity of the norovirus infection to a lack of medical care at home and the delay to hospitalization for children infected with norovirus.…”