Saito, M, Goel-Apaza, S, Espetia, S et al. (11 more authors) (2014) Multiple norovirus infections in a birth cohort in a Peruvian periurban community. Clinical Infectious Diseases, 58 (4). 483 - 491. ISSN 1058-4838
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 non-diarrheal 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 one year, 80% [95% confidence interval (CI):75-85] experienced at least one norovirus infection and by 2 years, 71% [CI:65-77] had at least one episode of norovirus-associated diarrhea. Genogroup (G)II infections were three time more frequent than GI. Eighteen genotypes were found; GII genotype 4 accounted for 41%. Median excretion duration was 34.5 days for GII versus 8.5 days for GI infection (p=0.0006). 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: -0.65 to -0.01, p=0.04); 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.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | (c) The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work properly cited. |
Keywords: | Norovirus; infant diarrhea; gastroenteritis; birth cohort; natural infection |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Molecular Gastroenterology (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 21 Oct 2015 10:14 |
Last Modified: | 01 Mar 2019 12:16 |
Published Version: | http://dx.doi.org/10.1093/cid/cit763 |
Status: | Published |
Publisher: | Oxford University Press |
Identification Number: | 10.1093/cid/cit763 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:86683 |
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