Prevalence and characterization of rotaviruses in children hospitalized for diarrheal disease in a tertiary care hospital, Pune

Background: Diarrhoea remains the second most common cause of death among children below 5 years globally. Among various enteric pathogens, rotavirus appears to be the most important aetiological agent of acute gastroenteritis in infants and young children. Increased understanding of epidemiology of rotavirus infections is needed to improve the vaccine efficacy. Aim: This study aims to determine prevalence rotavirus infection and prevalent circulating strains of rotavirus in and around Pune. Setting and Design: Prospective hospital-based study. The study was approved by Institutional Ethical Committee. Materials and Methods: Stool samples (n = 100) were collected from children aged <5 years, hospitalised for acute diarrhoea in paediatric ward at a tertiary care hospital. Samples were subjected for rotavirus antigen capture ELISA. The viral RNA was subjected to multiplex reverse transcription polymerase chain reaction to amplify VP7 genotypes G1–G4, G8–G10 and G12 and VP4 genotypes P[4], P[6], P[8], P[9], P[10] and P[11]. Nontypable rotavirus strains were sequenced. Results: About 35% stool samples were positive for rotavirus antigen by ELISA. G9P[4] (28.6%) was found to be the most prevalent rotavirus strain. The detection of emerging strain G12P[6] (14.3%) and rare reassortant strain G9P[4] was the significant finding. Conclusion: Genotypes found in circulation are not present in the currently used vaccine. Thus, an emergence of newer genotypes over a period calls for the continued surveillance and genomic characterisation of rotaviruses to improve the vaccine efficacy.

[1]  S. Madhi,et al.  Effect of human rotavirus vaccine on severe diarrhea in African infants. , 2010, The New England journal of medicine.

[2]  A. Bavdekar,et al.  Changing trends in circulating rotavirus strains in Pune, western India in 2009-2012: emergence of a rare G9P[4] rotavirus strain. , 2014, Vaccine.

[3]  G. Kang,et al.  Diversity of circulating rotavirus strains in children hospitalized with diarrhea in India, 2005-2009. , 2013, Vaccine.

[4]  S. Bhave,et al.  Immunogenicity and safety of the pentavalent human-bovine (WC3) reassortant rotavirus vaccine (PRV) in Indian infants , 2013, Human vaccines & immunotherapeutics.

[5]  G. Kang,et al.  Prevalence of Rotavirus Diarrhea among Hospitalized Children Less than 5 Years in Kerala, South India , 2013 .

[6]  S. Ramani,et al.  Detection and characterisation of rotaviruses from children less than 5 years hospitalised with acute gastroenteritis in Nagercoil. , 2013, Indian journal of medical microbiology.

[7]  John W. Glasser,et al.  Understanding Reduced Rotavirus Vaccine Efficacy in Low Socio-Economic Settings , 2012, PloS one.

[8]  G. Kang,et al.  A systematic review of rotavirus strain diversity in India, Bangladesh, and Pakistan. , 2012, Vaccine.

[9]  G. Kang,et al.  Protective effect of natural rotavirus infection in an Indian birth cohort. , 2011, The New England journal of medicine.

[10]  M. Levine,et al.  Efficacy of pentavalent rotavirus vaccine against severe rotavirus gastroenteritis in infants in developing countries in sub-Saharan Africa: a randomised, double-blind, placebo-controlled trial , 2010, The Lancet.

[11]  M. Levine,et al.  Efficacy of pentavalent rotavirus vaccine against severe rotavirus gastroenteritis in infants in developing countries in Asia: a randomised, double-blind, placebo-controlled trial , 2010, The Lancet.

[12]  J. Matthijnssens,et al.  Rotavirus disease and vaccination: impact on genotype diversity. , 2009, Future microbiology.

[13]  G. Kang,et al.  Disease and economic burden of rotavirus diarrhoea in India. , 2009, Vaccine.

[14]  G. Kang,et al.  Multicenter, hospital-based surveillance of rotavirus disease and strains among indian children aged <5 years. , 2009, The Journal of infectious diseases.

[15]  G. Kang,et al.  Immunogenicity, reactogenicity and safety of human rotavirus vaccine (RIX4414) in Indian infants , 2009, Human vaccines.

[16]  R. Glass,et al.  First Detection of G12 Rotaviruses in Newborns with Neonatal Rotavirus Infection at All India Institute of Medical Sciences, New Delhi, India , 2007, Journal of Clinical Microbiology.

[17]  G. Kang,et al.  Burden of disease & molecular epidemiology of group A rotavirus infections in India. , 2007, The Indian journal of medical research.

[18]  R. Glass,et al.  Rotavirus and Severe Childhood Diarrhea , 2006, Emerging infectious diseases.

[19]  D. Bernstein,et al.  A rotavirus vaccine for infants: the Asian experience. , 2006, Annals of the Academy of Medicine, Singapore.

[20]  N. Kobayashi,et al.  Emergence of Novel Human Group A Rotavirus G12 Strains in India , 2003, Journal of Clinical Microbiology.

[21]  A. Kapikian,et al.  Rotavirus vaccines: an overview , 1996, Clinical microbiology reviews.

[22]  N. Kobayashi,et al.  Nucleotide sequence of VP4 and VP7 genes of human rotaviruses with subgroup I specificity and long RNA pattern: implication for new G serotype specificity , 1990, Journal of virology.