Title
Multiple norovirus infections in a birth cohort in a peruvian periurban community
Date Issued
15 February 2014
Access level
open access
Resource Type
journal article
Publisher(s)
Oxford University Press
Abstract
Background. Human noroviruses are among the most common enteropathogens globally, and are a leading cause of infant diarrhea in developing countries. However, data measuring the impact of norovirus at the community level are sparse.Methods. We followed a birth cohort of children to estimate norovirus infection and diarrhea incidence in a Peruvian community. Stool samples from diarrheal episodes and randomly selected nondiarrheal samples were tested by polymerase chain reaction for norovirus genogroup and genotype. Excretion duration and rotavirus coinfection were evaluated in a subset of episodes.Results. Two hundred twenty and 189 children were followed to 1 and 2 years of age, respectively. By 1 year, 80% (95% confidence interval [CI], 75%-85%) experienced at least 1 norovirus infection and by 2 years, 71% (95% CI, 65%-77%) had at least 1 episode of norovirus-associated diarrhea. Genogroup II (GII) infections were 3 times more frequent than genogroup 1 (GI) infections. Eighteen genotypes were found; GII genotype 4 accounted for 41%. Median excretion duration was 34.5 days for GII vs 8.5 days for GI infection (P =. 0006). Repeat infections by the same genogroup were common, but repeat infections by the same genotype were rare. Mean length-for-age z score at 12 months was lower among children with prior norovirus infection compared to uninfected children (coefficient: -0.33 [95% CI, -.65 to -.01]; P =. 04); the effect persisted at 24 months.Conclusions. Norovirus infection occurs early in life and children experience serial infections with multiple genotypes, suggesting genotype-specific immunity. An effective vaccine would have a substantial impact on morbidity, but may need to target multiple genotypes. © 2013 The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.
Start page
483
End page
491
Volume
58
Issue
4
Language
English
OCDE Knowledge area
Enfermedades infecciosas Gastroenterología, Hepatología
Scopus EID
2-s2.0-84893263000
PubMed ID
Source
Clinical Infectious Diseases
ISSN of the container
15376591
Sponsor(s)
Financial support. This work was supported by the Sixth Framework Programme of the European Union, Project CONTENT INCO-CT-2006-032136, Population Health Metrics Research Consortium Project, and the CDC. Potential conflicts of interest. All authors: No reported conflicts.
Sources of information: Directorio de Producción Científica Scopus