The role of the sapovirus infection increased in gastroenteritis after national immunisation was introduced

Abstract

Aim This study examined the prevalence and clinical significance of the sapovirus infection in children with acute gastroenteritis before and after the introduction of the rotavirus vaccination in Finland in 2009. Methods We collected 1437 stool samples from children under 16 years during three prospective hospital‐based surveillance studies of acute gastroenteritis at Tampere University Hospital, Finland. The children were seen in the emergency department (47%) or admitted to the ward (53%). Sapovirus findings from 2006 to 2008 (n = 759), before national immunisation, were compared to 2009–2011 (n = 330) and 2012–2014 (n = 348), after the national programme was launched. Results The overall incidence of the sapovirus was 3.3%. It was present in 1.4% of acute gastroenteritis cases in 2006–2008 and 5.5% in the post‐vaccination years, but the absolute number did not increase. Sapoviruses mainly occurred in the winter and spring, but did not follow the prevalence of the norovirus or rotavirus. Sapovirus GI.1 and GII.1 were the most common genotypes, but the predominant strain was different each season. Many sapovirus lineages appeared during multiple seasons and reappeared later. Conclusion The sapovirus was uncommonly and sporadically detected in children seen in the hospital for acute gastroenteritis, and its relative role increased after national immunisation was introduced.

Genetic Diversity of Sapoviruses among Inpatients in Germany, 2008−2018

“…Consistent with previous studies [3,11,13,14,15,25], sapovirus genotype distribution fluctuated between sampling years. In the whole, GI.1, GII.1 and GI.2 predominated, which have commonly been among the major genotypes in other European countries [3,23,24,25,26,28,29] and beyond [11,14,30,31]. Notably, occasional nosocomial sapovirus infections by various sapoviruses but no major outbreaks were identified in the present patients.…”

“…The final phylogenetic analysis was based on sequencing data spanning more than one third of the VP1 gene, which exceeds the coverage of common sapovirus genotyping approaches [3,11,13,14,15,23,24,25,26]. The more comprehensive sequencing data obtained thus allowed marking out intragenotypic lineages and clusters in phylogenetic trees comprising present strains and reference sequence data from GenBank.…”

“…Among patients with sporadic gastroenteritis, sapoviruses were shown to rank second to fourth as the major viral pathogens [2]. In the post-rotavirus vaccine era, their role further increased [3]. Though tending to be somewhat milder, the clinical symptoms of sapovirus gastroenteritis are indistinguishable from those caused by noroviruses [4].…”

“…Comprehensive data is available from Japan [11,12]. Recently, studies from Finland [3], South Africa [13], Peru [14] and India [15] substantially increased our knowledge on the global sapovirus genotype distribution.…”

Molecular detection and characterisation of sapoviruses and noroviruses in outpatient children with diarrhoea in Northwest Ethiopia

“…This value is similar to the lately assessed positivity rate of wildtype rotaviruses in the same sample set [14]. Due to the recent introduction of anti-rotavirus vaccines in Ethiopia, the relative role of norovirus and sapovirus-related diarrhoea cases is likely to increase in the future [21, 22]. The high number of calicivirus and rotavirus co-infections indicates frequent exposure to viral enteric pathogens, which may be shed for weeks after acute infection [23–25].…”