Clinical, epidemiological, and molecular aspects of picornaviruses (entero, parecho) in acute gastroenteritis: A study from Pune (Maharashtra), Western India

Abstract

Among enteric viruses, rotavirus A (RVA), norovirus (NoV), adenovirus, and astrovirus (AstV) are the major etiological agents associated in acute gastroenteritis. The present study highlights, clinical, epidemiological, and molecular aspects with respect to RVA, NoV, enterovirus (EV), and human parechovirus (HPeVs) in sporadic cases (n = 305) of acute gastroenteritis, Pune (Maharashtra), Western India. Detection of RVA was carried out by enzyme‐linked immunosorbent assay, NoV, EV, and HPeVs by reverse transcription PCR. Prevalence of 36.06%, 20.32%, 14.09%, 3.93%, respectively was observed for RVA, EV, HPeVs, and NoV along with coinfections. Infections occurred in children less than 2 years old, with peak infections within 12 months age. The disease severity in RV infections was found high (70.90%) with severe disease, followed by EV (62.9%), NoV (58.33%), and HPeV (44.58%). Predominant strains of RV G1P[8], G2P[4] types with unusual G9P[4], NoV Genogroup II of genotype 4 strains and multiple EV types with EV‐B species, E14 and E17 and two novel EV‐75, EV‐107 types were detected. Circulation of heterogeneous HPeV genotypes (HPeV1–5, 7, 8, 13, 14, 16) with predominance of HPeV‐1 was noticed. Changing trends in circulation of a rare HPeV‐2 genotype, with emerging and reemerging strains was noted. The study highlights association of RVA, NoV, EV, and HPeV and their mono‐infections, genotype distribution, and changing trends in acute gastroenteritis, and added more knowledge on rota and nonrota enteric viruses in acute gastroenteritis. More such studies in rota vaccinated era are required across the country, as Indian rotavirus vaccine has been implemented under the National Immunization program.

Hospital‐based norovirus surveillance in children <5 years of age from 2017 to 2019 in India

“…In a recent study on global genotype trends among children with norovirus gastroenteritis, GII.4 Sydney[P16] and GII.4 Sydney[P31] viruses comprised more than 50% of the strains 30 . In our study, GI viruses were detected in 10.2% of the norovirus positive cases, which is higher than reported in other studies from India 8–12,19 …”

“…Globally, GII.4 noroviruses are the most frequently detected genotype 4 . There are few reports on the disease burden of noroviruses among children less than 5 years of age in India; these range from 1.2% to 15.1%, depending on the setting which includes hospital‐based, community‐based, or in a birth cohort setting 8–13 . There are no studies describing norovirus disease burden in rotavirus vaccinated children after the introduction of rotavirus vaccine into the Universal Immunization Program (UIP) in India in 2016 14 …”

“…4 There are few reports on the disease burden of noroviruses among children less than 5 years of age in India; these range from 1.2% to 15.1%, depending on the setting which includes hospital-based, community-based, or in a birth cohort setting. [8][9][10][11][12][13] There are no studies describing norovirus disease burden in rotavirus vaccinated children after the introduction of rotavirus vaccine into the Universal Immunization Program (UIP) in India in 2016. 14 In this study, we determined the prevalence and genetic diversity of norovirus among children ≤5 years of age hospitalized with AGE in six hospitals in Southern and Western India after introduction of rotavirus vaccine.…”

Parechovirus A infection and risk of gastroenteritis in children: A systematic review and meta‐analysis

“…The final dataset included data on young people aged less than 18 years from 18 countries (Thailand, Spain, Korea, Japan, China, Iran, Pakistan, Turkey, Bulgaria, Italy, India, Germany, Ethiopia, Nigeria, Bangladesh, United States, Ghana, and Russia). Amidst the included studies, 33 were cross‐sectional in study design, of which 31 were case‐only 17–20,24,41–66 and 2 presented data for healthy individuals 25,67 . Thirty‐three cross‐sectional studies comprised 17,226 paediatric patients with gastroenteritis and 277 children without gastroenteritis.…”

Detection of parechovirus‐A in hospitalized children with acute lower respiratory infection in Myanmar, 2017–2018

“…The epidemiology of PeV‐A14 is poorly understood, but it has been reported in stool samples from healthy children and patients with acute gastroenteritis in China, 6 Thailand, 14 Malawi, 18 and India, 19 among other countries. A study of stool samples from children with acute gastroenteritis in Thailand reported that PeV‐A14 was the third‐most‐prevalent PeV‐A genotype 14 .…”