Detection and molecular characterisation of noroviruses in hospitalised children in Malawi, 1997-2007.

Despite the increasing recognition of noroviruses as major pathogens associated with community-acquired diarrhoea in children, there are few studies from Africa. Long-term surveillance studies of rotavirus gastroenteritis in Malawian children have provided an opportunity to undertake a study of the importance and epidemiological features of norovirus infection in this population. Faecal specimens were collected from children <5 years of age admitted to hospital with acute diarrhoea, as well as from a comparison group of diarrhoea-free children, in Blantyre, Malawi between 1997 and 2007.

Ljungan virus is endemic in rodents in the UK.

Ljungan virus is a recently identified member of the family Picornaviridae that was isolated from bank voles in Sweden. LjV has been associated with [corrected] type 1 diabetes-like symptoms and myocarditis in bank voles (Myodes glareolus), and it has been suggested that it has zoonotic potential. Here, we show for the first time that Ljungan virus is prevalent (20-27 % positive by PCR) in four species of UK rodent (Myodes glareolus [bank vole], Apodemus sylvaticus [wood mouse], Microtus agrestis [field vole] and Mus musculus [house mouse]).

Campylobacter infection in children in Malawi is common and is frequently associated with enteric virus co-infections.

Background: Campylobacter species are the most common cause of bacterial gastroenteritis in the developed world. However, comparatively few studies have determined the epidemiological features of campylobacteriosis in resource-poor settings.

Methods: A total of 1,941 faecal specimens collected from symptomatic (diarrhoeic) children and 507 specimens from asymptomatic (non-diarrhoeic) children hospitalised in Blantyre, Malawi, between 1997 and 2007, and previously tested for the presence of rotavirus and norovirus, was analysed for C.

Surveillance of rotavirus gastro-enteritis in children in Blantyre, Malawi.

Background: Rotavirus is a leading cause of acute gastro-enteritis in infants and young children worldwide. Previous studies of rotavirus gastro-enteritis in Malawi have documented a high disease burden with an extensive diversity of circulating rotavirus strains.

Methods: In anticipation of the introduction of national rotavirus vaccination, a 2-year surveillance study was undertaken in 2008 and 2009 of children in Blantyre seeking hospital care for acute gastro-enteritis.

G8 rotaviruses with conserved genotype constellations detected in Malawi over 10 years (1997-2007) display frequent gene reassortment among strains co-circulating in humans.

Rotavirus A, the most common cause of severe diarrhoea in children worldwide, occurs in five major VP7 (G) and VP4 (P) genotype combinations, comprising G1P[8], G2P[4], G3P[8], G4P[8] and G9P[8]. However, G8, a common bovine rotavirus genotype, has been reported frequently among children in African countries. Surveillance of rotavirus gastroenteritis conducted in a sentinel hospital in Blantyre, Malawi between 1997 and 2007 provided a rare opportunity to examine the whole genotype constellation of G8 strains and their evolution over time.

PCR based bronchoscopic detection of common respiratory pathogens in chronic cough: a case control study.

Background: Viral respiratory tract infection is the most frequent cause of acute cough and is reported at onset in about one third of patients with chronic cough. Persistent infection is therefore one possible explanation for the cough reflex hypersensitivity and pulmonary inflammation reported in chronic cough patients.

Methods: Bronchoscopic endobronchial biopsies and bronchoalveolar lavage cell counts were obtained from ten healthy volunteers and twenty treatment resistant chronic cough patients (10 selected for lavage lymphocytosis).

Molecular characterization of rotavirus strains detected during a clinical trial of a human rotavirus vaccine in Blantyre, Malawi.

The human, G1P[8] rotavirus vaccine (Rotarix™) significantly reduced severe rotavirus gastroenteritis episodes in a clinical trial in South Africa and Malawi, but vaccine efficacy was lower in Malawi (49.5%) than reported in South Africa (76.9%) and elsewhere.

Unusual norovirus and rotavirus genotypes in Ethiopia.

Background: Gastro-enteritis is associated with significant mortality in low- and middle-income countries, and rotavirus and norovirus are the principal viral agents implicated.

Aims: To investigate the molecular epidemiology and burden of disease associated with rotavirus and norovirus in children attending a health centre in Ethiopia.

Methods: A cross-sectional study was conducted in children attending a health centre in Awassa, southern Ethiopia.

Clinical features and molecular epidemiology of rotavirus and norovirus infections in Libyan children.

Rotaviruses and noroviruses are leading viral causes of diarrhoea in children. A cross-sectional study was undertaken among children aged <5 years with acute gastroenteritis at Al-Jala Children's Hospital, Tripoli, Libya, from October 2007 to September 2008. Of 1,090 fecal samples collected, 260 from inpatients and 830 from outpatients, all inpatients and approximately a third of outpatients, selected systematically, were investigated for rotavirus and norovirus infection by ELISA and real-time RT-PCR, respectively.

PCR improves diagnostic yield from lung aspiration in Malawian children with radiologically confirmed pneumonia.

Background: Accurate data on childhood pneumonia aetiology are essential especially from regions where mortality is high, in order to inform case-management guidelines and the potential of prevention strategies such as bacterial conjugate vaccines. Yield from blood culture is low, but lung aspirate culture provides a higher diagnostic yield. We aimed to determine if diagnostic yield could be increased further by polymerase chain reaction (PCR) detection of bacteria (Streptococcus pneumoniae and Haemophilus influenzae b) and viruses in lung aspirate fluid.

Acute diarrhoea in a community cohort of children who received an oral rotavirus vaccine in Northeast Brazil.

Rotavirus is an important cause of childhood diarrhoea. A monovalent rotavirus vaccine (Rotarix®) was introduced into the Immunization Program of Brazil in 2006. In this study, we describe the incidence and burden of disease of rotavirus diarrhoea in two cohorts of children (vaccinated and unvaccinated).

Detection and molecular characterisation of rotavirus and norovirus infections in Jordanian children with acute gastroenteritis.

Rotavirus and norovirus are globally important causes of paediatric gastroenteritis, but no studies of viral genotypes have been reported from Jordan. We undertook a molecular epidemiological study in children hospitalised with acute gastroenteritis in Jordan between January 2006 and December 2007. Among 368 children, rotavirus and norovirus infections were detected in 49.

Rotavirus and norovirus infections in children in Sana'a, Yemen.

Objectives: To describe the epidemiology of rotavirus and norovirus infection among children with acute gastroenteritis in Sana'a, Yemen.

Methods: A cross-sectional study from November 2007 to March 2009 of children aged 1 month to 5 years attending the emergency and outpatient departments of two hospitals in Sana'a with acute gastroenteritis. Rotavirus was detected by ELISA and genotyped by RT-PCR.

Molecular phylogenetic and evolutionary analyses of Muar strain of Japanese encephalitis virus reveal it is the missing fifth genotype.

Japanese encephalitis virus (JEV) is the most important cause of epidemic encephalitis worldwide but its origin is unknown. Epidemics of encephalitis suggestive of Japanese encephalitis (JE) were described in Japan from the 1870s onwards. Four genotypes of JEV have been characterised and representatives of each genotype have been fully sequenced.

An evaluation of the RIDASCREEN and IDEIA enzyme immunoassays and the RIDAQUICK immunochromatographic test for the detection of norovirus in faecal specimens.

Background: The detection of norovirus by ELISA and immunochromatographic methods may facilitate epidemiological studies into the global disease burden associated with norovirus gastroenteritis and provide a quick method of testing for norovirus infection.

Objectives: To evaluate the new RIDASCREEN norovirus ELISA (3rd generation) and RIDAQUICK norovirus immunochromatographic test on a collection of samples from Brazilian children with acute gastroenteritis, and compare them against the established 2nd generation IDEIA norovirus assay.

Study Design: Reverse transcriptase PCR, the study reference standard, was used to test 726 specimens for the presence of norovirus.

Epidemiology of rotavirus infection in children in Blantyre, Malawi, 1997-2007.

Acute gastroenteritis caused by rotavirus infection is an important cause of morbidity and mortality among infants and young children in Africa. From 1997 through 2007, we enrolled 3740 children <5 years of age with acute gastroenteritis who received hospital care at the Queen Elizabeth Central Hospital in Blantyre, Malawi. Group A rotavirus was detected in fecal specimens by enzyme immunoassay.

Detection of norovirus in mouthwash samples from patients with acute gastroenteritis.

Background: Norovirus infection is characteristically associated with vomiting which is known to contain a high concentration of viral particles. The oral cavity is therefore likely to become contaminated with norovirus during episodes of gastroenteritis.

Objective: To investigate the oral detection of norovirus in patients with norovirus gastroenteritis.

Molecular epidemiology of rotavirus diarrhea among children aged <5 years in nepal: predominance of emergent G12 strains during 2 years.

A 2-year surveillance was performed in Kathmandu, Nepal, by collection of stool specimens from 1139 children aged <5 years who were hospitalized for acute diarrhea from November 2005 through October 2007. Of the 1139 samples, 379 (33%) had rotavirus strains identified by enzyme-linked immunosorbent assay; the most prevalent G type was G12, accounting for 50% of typed strains in 2005-2006 and 29% in 2006-2007, followed by G1 (26%) in 2005-2006 and by G9 (28%) and G2 (20%) in 2006-2007. The most prevalent P type was P[8], accounting for 47% of strains in 2005-2006 and 35% in 2006-2007, followed by P[6] (37% in 2005-2006 and 33% in 2006-2007) and P[4] (10% in 2005-2006 and 24% in 2006-2007).

Incidence of rotavirus and all-cause diarrhea in northeast Brazil following the introduction of a national vaccination program.

Background & Aims: Rotavirus vaccines were introduced in Brazil in 2006; we evaluated their effects in the state of Sergipe, Brazil.

Methods: We performed a cross-sectional survey of children with diarrhea attending emergency services in Aracaju, Brazil, between October 2006 and April 2008 and a cluster sampling survey to assess vaccination coverage. Vaccine efficacy was assessed using the screening method.

Adenovirus infections within a family cohort in Iran.

Background: Adenovirus is one of the most frequent viruses associated with acute respiratory infections (ARI). There is limited information of its transmission within the community.

Methods: Cohorts of 50 families with > or =two children were visited weekly for 2 months to ascertain the presence ARI in Rasht, Iran.

Serotype g12 rotaviruses, Lilongwe, Malawi.

To assess diversity of rotavirus strains in Lilongwe, Malawi, we conducted a cross-sectional study of children with acute gastroenteritis, July 2005-June 2007. Serotype G12 was identified in 30 (5%) of 546 rotavirus-positive fecal specimens. The G12 strain possessed multiple electropherotypes and P-types, but their viral protein 7 sequences were closely related, indicating that reassortment has occurred.

Human astrovirus gastroenteritis in children, Madagascar, 2004-2005.

We report data regarding the molecular epidemiology of human astrovirus (HAstV) infections among children in Madagascar. In a 13-month study, 5 HAstV isolates were detected in fecal samples from 237 children (2.1%) by reverse transcription-PCR.

Predominance of rotavirus P[4]G2 in a vaccinated population, Brazil.

We identified 21 rotaviruses in 129 patients with diarrhea in a Brazilian city with high rotavirus vaccine coverage. All rotaviruses were genotype P[4]G2 with 1 mixed infection with P[NT]G9. Although virus predominance could have occurred randomly, the vaccine may be less protective against P[4]G2.

Molecular epidemiology of rotavirus diarrhea among children in Saudi Arabia: first detection of G9 and G12 strains.

In anticipation of rotavirus vaccine introduction in Saudi Arabia, this study was undertaken to determine the distribution of the G and P genotypes of rotaviruses in order to examine whether there was any emerging serotype or unusual strain circulating in children in Saudi Arabia. Of 984 stool specimens collected between 17 April 2004 and 16 April 2005, rotavirus was detected by an enzyme-linked immunosorbent assay in 187 (19%) diarrheal children less than 5 years of age. Of these, 160 (86%) were classified into G and P genotypes as follows: G1P[8] (44%), G2P[4] (20%), G9P[8] (11%), G12P[8] (4%), and G3P[8] (4%).

Norovirus gastroenteritis among children in Iraqi Kurdistan.

Of 260 children under age 5 years who were hospitalized with acute gastroenteritis in Kurdistan, Iraq, between April and May 2005, 78 (30%) tested positive for norovirus by RT-PCR. These comprised genogroups GI (23%), GII (74%) and GI + GII (3%). Among 28 noroviruses sequenced, GII/4 was the predominant genotype.