An Outbreak of Diarrhea in a Neonatal Medium Care Unit Caused by a Novel Strain of Rotavirus: Investigation Using Both Epidemiologic and Microbiological Methods

Widdowson, Marc‐Alain; Doornum, G. J. J. Van; Poel, Wim van der; Boer, Annette S. de; Heide, Reina van de; Mahdi, Ulrike; Haanen, Paul; Kool, Jolanda; Koopmans, Marion

doi:10.1086/501991

Cited by 49 publications

(37 citation statements)

References 25 publications

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“…Also, it can be speculated that GARVs may circulate in an asymptomatic fashion in nonsusceptible animals (39,43,45), due to an age-related mechanism of disease restriction (8) or to active immunization after previous infection or vaccination (53). Accurate measures of cleaning and disinfection are required in equine facilities, although meticulous environmental disinfection procedures do not appear to remove completely rotavirus environmental contamination (56).…”

Section: Discussionmentioning

confidence: 99%

Molecular Characterization of Equine Rotavirus in Ireland

et al. 2008

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Group A rotaviruses are important causative agents of severe, acute dehydrating diarrhea in foals. A total of 86 rotavirus-positive fecal samples, collected from diarrheic foals from 11 counties in three of the four provinces of Ireland, were obtained from the Irish Equine Centre in Kildare during a 7-year (1999 to 2005) passive surveillance study and were characterized molecularly to establish the VP7 (G type) and VP4 (P type) antigenic specificities. Fifty-eight samples (67.5%) were found to contain G3 viruses, while in 26 samples (30.2%) the rotaviruses were typed as G14 and in 2 samples (2.3%) there was a mixed infection, G3 plus G14. All samples except for two, which were untypeable, were characterized as P

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Section: Discussionmentioning

confidence: 99%

Molecular Characterization of Equine Rotavirus in Ireland

et al. 2008

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“…Studies have been conducted using swabs to test for environmental contamination: with noroviruses by using a nested RT-PCR (3, 13) in hotels and hospitals and with rotaviruses by using an RT-PCR (33,35) in hospital pediatric and neonatal units.…”

Section: An Outbreak Of Astrovirus Gastroenteritis Occurred In the Prmentioning

confidence: 99%

Use of a Heminested Reverse Transcriptase PCR Assay for Detection of Astrovirus in Environmental Swabs from an Outbreak of Gastroenteritis in a Pediatric Primary Immunodeficiency Unit

Gallimore¹,

Taylor²,

Gennery

et al. 2005

J Clin Microbiol

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An outbreak of astrovirus gastroenteritis occurred in the Primary Immunodeficiency Unit at Newcastle General Hospital in March 2004. Environmental swabbing of the unit was undertaken after the outbreak, with multiple sites swabbed pre- and postcleaning. Astroviruses were detected in four environmental swabs and from two patient fecal samples using heminested reverse transcriptase PCR. An astrovirus genotype 3 strain was identified in both environmental swabs and fecal specimens and was the strain identified as being responsible for the outbreak. Environmental transmission of the virus was thought to have occurred by contamination of a syringe pump outside the laminar-flow curtain of a patient who was admitted with astrovirus gastroenteritis. This was subsequently transmitted to a cubicle next door and to a television/games console in a parents' room in the ward. Environmental monitoring of surfaces/equipment, using PCR assays for gastroenteric viruses in hospital situations where infection can give rise to serious clinical complications, may have a role in controlling and monitoring cleaning and the subsequent prevention of nosocomial transmission of gastroenteritis.

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“…These new rotavirus genotypes can also cause serious outbreaks of diarrhea in humans and may have a high attack rate, like the [P6]G9 strain in The Netherlands (41). Understanding rotavirus diversity is important, and G1-to G4-based vaccines will not confer optimal protection against the new strains, such as G9 (33).…”

mentioning

confidence: 99%

Molecular Characterizations of Human and Animal Group A Rotaviruses in The Netherlands

Heide¹,

Koopmans²,

Shekary³

et al. 2005

J Clin Microbiol

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To gain more insight into interspecies transmission of rotavirus group A, human and animal fecal samples were collected between 1997 and 2001 in The Netherlands. A total of 110 human stool samples were successfully P and G genotyped by reverse transcriptase PCR. All strains belonged to the main human rotavirus genotypes G1 to G4, G9, [P4], [P6], [P8], and [P9].[P8]G1 was predominant, and 5.5% belonged to the G9 genotype. Eleven percent of all P[8] genotypes could be genotyped only by a recently published modified primer. Rotavirus-positive fecal samples from 28 calf herds were genotyped by DNA sequencing. Genotypes G6 and G10 predominated; G6 and G10 were detected in 22 (78.6%) and 16 (57.1%) of the rotavirus-positive calf herds, respectively. In 12 (42.9%) calf herds, we found mixed infections. Genotype G8 was not found. Genotype G6 bovine rotaviruses were divided into three clusters: UK-like, VMRI-29-like, and Hun4-like. DNA sequencing of a part of the VP7 gene was shown to be useful as a quick determination of uncommon or novel strains of which the genotyping cannot be done by genotyping PCR. Of equine strains, both VP4 and VP7 genes could be used for genotyping: two [P12]G3 and four [P12]G14 equine rotaviruses were determined. We did not find indications for rotavirus interspecies transmissions, although the recently published human G6-Hun4 is genetically related to our G6 bovine isolates. All bovine, porcine, and equine rotaviruses were within genotypes previously reported for these animal species.Group A rotaviruses (family Reoviridae) are the most common cause of gastroenteritis in young children and young animals (27). Rotavirus particles consist of three layers: the central core (enclosing 11 segments of double-stranded genomic RNA), the inner capsid, and the outer capsid (13). The outer capsid is studded with VP7 and VP4 proteins, which elicit neutralizing antibody responses and form the basis of the present dual classification system of G (VP7) and P (VP4) types (27). The VP7 protein expresses the major neutralization antigen and is distinguishable by means of both serological and genomic techniques in 14 G types, with good correlation between the serological and genomic classifications (21, 27). VP4 expresses a minor neutralization antigen, and the serological classification of the P types is much more difficult than genomic classification. To date, 13 P serotypes, including subtypes, and 20 P genotypes have been defined, but a precise correlation between the serological and genomic classifications has not been made (27 G3, and [P8]G4 are the most common G and P types (9, 29). However, rotavirus strains with other G and P types have increasingly been reported in different parts of the world, like the predominance of [P6]G9 strains in India (34), [P6]G8 strains in Malawi (6), and [P8]G5 strains in Brazil (2). Some strains, like G9 rotaviruses, have been found commonly across the world (9).These new rotavirus genotypes can also cause serious outbreaks of diarrhea in humans and may have a high attack r...

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An Outbreak of Diarrhea in a Neonatal Medium Care Unit Caused by a Novel Strain of Rotavirus: Investigation Using Both Epidemiologic and Microbiological Methods

Abstract: Case-control studies can be successful in identiffying risk factors for nosocomial outbreaks of diarrhea. High levels of rotavirus antibodies in mothers may not protect infants. The environment may be the most important reservoir of rotavirus during outbreaks.

Cited by 49 publications

References 25 publications

Molecular Characterization of Equine Rotavirus in Ireland

Molecular Characterization of Equine Rotavirus in Ireland

Use of a Heminested Reverse Transcriptase PCR Assay for Detection of Astrovirus in Environmental Swabs from an Outbreak of Gastroenteritis in a Pediatric Primary Immunodeficiency Unit

Molecular Characterizations of Human and Animal Group A Rotaviruses in The Netherlands

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