High prevalence of enteric viruses associated with acute gastroenteritis in pediatric patients in a low‐income area in Vitória, Southeastern Brazil

Abstract

Acute gastroenteritis (AGE) is a significant cause of child mortality worldwide. In Brazil, despite the reduction in infant mortality achieved in recent years, many children still die because of undiagnosed AGE. The prevalence, viral load, and circulating genotypes of rotavirus A (RVA), human adenovirus (HAdV), and norovirus GII (NoV GII) were investigated in children with AGE during 12 months in Vitoria, Espírito Santo, Southeastern Brazil. Enteric viruses were detected in stool samples, quantified by quantitative polymerase chain reaction, sequenced, and compared phylogenetically. The overall prevalence was 93.3% (125/134). Cases of single infection (41.8%) and mixed infection (51.5%) were observed; in 21.6% of cases, all the three viruses were detected. RVA had the highest number of copies in all infections. Phylogenetic analysis revealed predominantly the presence of RVA genotype G3, followed by G2 and G9. HAdV clustered within subgroup C, but some samples harbored subgroups A, D, or F. All sequenced NoV‐positive samples clustered within the prevalent genotype GII.4. The high prevalence of RVA, HAdV, and NoV in diarrheal feces clarifies the etiology of AGE in this population, and the presence of RVA in vaccinated children reinforces the importance of monitoring programs to identify the causes of gastroenteritis and contribute to the reliability of diagnosis.

Human enteric adenovirus F40/41 as a major cause of acute gastroenteritis in children in Brazil, 2018 to 2020

“…In Brazil, some studies performed pre- and post-rotavirus vaccine introduction reported HAdV detection rates ranging from 3.9 to 6.8%, indicating a minor impact of HAdV as an etiologic agent of AGE in Brazil 29 – 31 . In contrast, but similar to our findings, data from two recent studies conducted in Northern and Southeastern Brazil reported HAdV detection rates of 28.6% and 18.5%, respectively, among children with AGE symptoms 32 , 33 . Another study in Northern Brazil has detected HAdV in 50% of stool samples from hospitalized children with AGE 34 .…”

“…Among the non-enteric HAdV, our study found HAdV species C and B with the second and third highest prevalence, respectively. Previous studies performed in Brazil and other developing countries have reported similar results for non-enteric HAdV, with specie C being the most prevalent and specie A, B and D alternating as the second most prevalent 22 , 23 , 29 , 32 , 38 . Moreover, despite an increasing number of studies attributing the detection of non-enteric HAdV types in AGE stool samples as a possible gastroenteritis causative agent 13 , 22 , 23 , 40 , the significance of their detection remains unclear.…”

Detection and identification of enteroviruses circulating in children with acute gastroenteritis in Pará State, Northern Brazil (2010–2011)

“…Children under 5 years old are the most affected with highest incidence and leading cause of million deaths annually worldwide, occurring mainly in low as well as in middle-income countries [ 2 ]. In Brazil, AGE also presents higher morbidity rates representing a significant cause of death in the first year of life [ 3 – 5 ]. AGE can be caused by a variety of infectious agents (viral, bacterial, protozoan) as well as non-infectious agents [ 4 ].…”

Investigation of Bufavirus and Parvovirus 4 in Patients with Gastro-Enteritis from the South-East of France

“…Previous studies showed other viruses causing gastroenteritis displayed similar viral loads. For instance, a report on children with gastroenteritis found that the adenovirus median viral load was 4.56 × 10 3 genome copies per gram of stools (range 2.14 × 10 2 –1.32 × 10 5 ) [ 22 ]. Another study on patients with gastroenteritis showed that norovirus G1 median viral load was 8.4 × 10 5 genome copies per gram of stools (range: 2.2 × 10 4 –2.9 × 10 10 ) [ 23 ].…”