Sapovirus: an emerging cause of childhood diarrhea

Abstract

Purpose of review: Sapovirus, a genus in the Caliciviridae family alongside norovirus, is increasingly recognized as an important cause of childhood diarrhea. Some challenges exist in our ability to better understand sapovirus infections, including the inability to grow sapovirus in cell culture, which has hindered diagnosis and studies of immunity. Another challenge is that individuals with sapovirus infection are commonly co-infected with other enteric pathogens, complicating our ability to attribute the diarrhea episode to a single pathogen.Recent findings: Development of molecular methods for sapovirus detection has increased our ability to measure disease prevalence. The prevalence of sapovirus varies between 1 to 17% of diarrhea episodes worldwide, with the highest burden in young children and older adults. Further, epidemiological studies have used novel approaches to account for the presence of co-infections with other enteric pathogens; one multi-site cohort study of children under two years of age found that sapovirus had the second highest attributable incidence among all diarrheal pathogens studied. Summary:Especially in settings where rotavirus vaccines have been introduced, efforts to reduce the overall burden of childhood diarrhea should focus on the reduction of sapovirus transmission and disease burden.

Epidemiological and Genetic Characterization of Sapovirus in Patients with Acute Gastroenteritis in Valencia (Spain)

“…Many other studies have reported mixed infections of sapovirus with other enteric pathogens [ 27 , 39 , 40 ]. Interestingly, the detection of sapovirus in healthy controls has also been reported [ 1 , 41 ]. However, the multinational Malnutrition and Enteric Disease (MAL-ED) cohort study estimated that sapovirus has the third highest attributable incidence for diarrhea among children under 1 year of age and the second-highest attributable incidence between 1 and 2 years of age, just behind Shigella sp.…”

“…In the present study it was found that noroviruses and sapoviruses were the most prevalent enteric viruses in the study population, with positive rates of 12.22% and 8.09%, respectively, followed by rotaviruses (7.11%), human astroviruses (4.91%) and enteric adenoviruses (2.9%). The detection frequency of sapovirus has been reported to range from 1 to 17% of diarrhea cases [ 1 ], although it varies across age groups and geographical locations. Similar results have been obtained in other studies performed in the post-rotavirus vaccine era, in which norovirus, sapovirus, and rotavirus infection were identified in this order of frequency [ 20 , 36 , 37 , 38 ].…”

“…GI.1 and GII.2 were the two most common, followed by GII.1, the same predominant genotypes found in 2010–2011 in Galicia (Spain) by Varela et al [ 27 ]. It has been reported that these three dominant genotypes are more frequent not only in the first year of life but also in adults [ 1 , 27 ]. Other genotypes detected in our study were also found previously circulating in Galicia (GII.4, GII.5, GV.1); however, we have not found GI.3, GII.2 and GIV.1 genotypes, and they did not detect GII.3 strains.…”

“…Sapoviruses cause acute gastroenteritis in patients of all ages, with the highest prevalence in children under 5 years old. The burden of sapovirus disease has often been neglected due to the lack of commercial diagnostic tests [ 1 ]. The implementation of diagnostic molecular assays in clinical laboratories has contributed to an increased detection of sapovirus infections in recent years [ 2 , 3 ].…”

“…The implementation of diagnostic molecular assays in clinical laboratories has contributed to an increased detection of sapovirus infections in recent years [ 2 , 3 ]. Sapoviruses have been reported worldwide to cause outbreaks of acute gastroenteritis mainly in daycare centers and healthcare facilities throughout the year, and are associated with 1–17% of diarrhea sporadic cases, usually in the cold season and in younger children [ 1 , 4 ]. They can be transmitted from person-to-person and by contaminated water or foods [ 5 ].…”