Cargando…

2507. Active Norovirus Surveillance in Children Under 5 Years With Diarrhea Following Rotavirus Vaccine Introduction in Argentina

BACKGROUND: Acute diarrhea is one of the main causes of infant mortality. Argentina introduced massive rotavirus vaccination in 2015. This introduction in several countries, has changed the distribution of enteropathogens and has been described a decrease in the rotavirus prevalence at the expense o...

Descripción completa

Detalles Bibliográficos
Autores principales: Gentile, Angela, Stupka, Juan Andrés, Degiuseppe, Juan Ignacio, Juarez, Maria Del Valle, Lucion, Maria Florencia, Turco, Marisa, Sabbaj, Liliana, Rapaport, Solana, Areso, Maria Soledad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253556/
http://dx.doi.org/10.1093/ofid/ofy210.2159
_version_ 1783373522815418368
author Gentile, Angela
Stupka, Juan Andrés
Degiuseppe, Juan Ignacio
Juarez, Maria Del Valle
Lucion, Maria Florencia
Turco, Marisa
Sabbaj, Liliana
Rapaport, Solana
Areso, Maria Soledad
author_facet Gentile, Angela
Stupka, Juan Andrés
Degiuseppe, Juan Ignacio
Juarez, Maria Del Valle
Lucion, Maria Florencia
Turco, Marisa
Sabbaj, Liliana
Rapaport, Solana
Areso, Maria Soledad
author_sort Gentile, Angela
collection PubMed
description BACKGROUND: Acute diarrhea is one of the main causes of infant mortality. Argentina introduced massive rotavirus vaccination in 2015. This introduction in several countries, has changed the distribution of enteropathogens and has been described a decrease in the rotavirus prevalence at the expense of an increase in norovirus (NoV) activity. NoV is reported to be emerging as one of the main agents producing acute diarrhea in the community. In Argentina, there are few experiences estimating its prevalence in cases of acute diarrhea in children. The aim of this study was to analyze the role of NoV in outpatient children <5 years of age with acute diarrhea and their epidemiological pattern. METHODS: Prospective, cross-sectional study of outpatients <5 years attended for acute diarrhea in Children’s Hospital “R. Gutiérrez” between June 2017 and March 2018. Active epidemiological surveillance was performed with a specific case reporting form. Stool samples were collected and tested for NoV (RT-qPCR), clinical and epidemiological data were recorded. RESULTS: A total of 136 patients were included and 125 stools were processed. The median of age was 20 months (IQR: 12–31) and 59% were male; the most common symptom was fever and vomits in 70% and 55%, respectively. A 55% had watery diarrhea and 43% mucohaemorrhagic diarrhea. The severity of the diarrhea (Vesikary Scale) was moderate; 54% (n = 73) and 97% of patients were normohydrated; 24% had a household member with diarrhea. Analyzing vaccination history, 74% had received rotavirus vaccine, 89% of them with 2 doses. From 125 samples tested, 29% (n = 36) were NoV positive and, comparing with the negative cases, were younger (19 vs. 22 months; P < 0.001) and were associated with higher prevalence of rotavirus vaccination (91% vs. 65%; P = 0.004). No statistically difference was found in gender, clinical presentation or severity. CONCLUSION: NoV was detected at high frequencies (29%) presenting moderate acute diarrhea, mainly in children that received rotavirus vaccine. Regarding sporadic acute diarrhea cases in children, it is important to consider the role of NoV as a frequent etiological agent. Further surveillance studies at larger populations are needed to elucidate the prevalence, clinical manifestations and risk factors associated with NoV diarrhea in children. DISCLOSURES: All authors: No reported disclosures.
format Online
Article
Text
id pubmed-6253556
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-62535562018-11-28 2507. Active Norovirus Surveillance in Children Under 5 Years With Diarrhea Following Rotavirus Vaccine Introduction in Argentina Gentile, Angela Stupka, Juan Andrés Degiuseppe, Juan Ignacio Juarez, Maria Del Valle Lucion, Maria Florencia Turco, Marisa Sabbaj, Liliana Rapaport, Solana Areso, Maria Soledad Open Forum Infect Dis Abstracts BACKGROUND: Acute diarrhea is one of the main causes of infant mortality. Argentina introduced massive rotavirus vaccination in 2015. This introduction in several countries, has changed the distribution of enteropathogens and has been described a decrease in the rotavirus prevalence at the expense of an increase in norovirus (NoV) activity. NoV is reported to be emerging as one of the main agents producing acute diarrhea in the community. In Argentina, there are few experiences estimating its prevalence in cases of acute diarrhea in children. The aim of this study was to analyze the role of NoV in outpatient children <5 years of age with acute diarrhea and their epidemiological pattern. METHODS: Prospective, cross-sectional study of outpatients <5 years attended for acute diarrhea in Children’s Hospital “R. Gutiérrez” between June 2017 and March 2018. Active epidemiological surveillance was performed with a specific case reporting form. Stool samples were collected and tested for NoV (RT-qPCR), clinical and epidemiological data were recorded. RESULTS: A total of 136 patients were included and 125 stools were processed. The median of age was 20 months (IQR: 12–31) and 59% were male; the most common symptom was fever and vomits in 70% and 55%, respectively. A 55% had watery diarrhea and 43% mucohaemorrhagic diarrhea. The severity of the diarrhea (Vesikary Scale) was moderate; 54% (n = 73) and 97% of patients were normohydrated; 24% had a household member with diarrhea. Analyzing vaccination history, 74% had received rotavirus vaccine, 89% of them with 2 doses. From 125 samples tested, 29% (n = 36) were NoV positive and, comparing with the negative cases, were younger (19 vs. 22 months; P < 0.001) and were associated with higher prevalence of rotavirus vaccination (91% vs. 65%; P = 0.004). No statistically difference was found in gender, clinical presentation or severity. CONCLUSION: NoV was detected at high frequencies (29%) presenting moderate acute diarrhea, mainly in children that received rotavirus vaccine. Regarding sporadic acute diarrhea cases in children, it is important to consider the role of NoV as a frequent etiological agent. Further surveillance studies at larger populations are needed to elucidate the prevalence, clinical manifestations and risk factors associated with NoV diarrhea in children. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2018-11-26 /pmc/articles/PMC6253556/ http://dx.doi.org/10.1093/ofid/ofy210.2159 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ 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/4.0/), 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 is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Gentile, Angela
Stupka, Juan Andrés
Degiuseppe, Juan Ignacio
Juarez, Maria Del Valle
Lucion, Maria Florencia
Turco, Marisa
Sabbaj, Liliana
Rapaport, Solana
Areso, Maria Soledad
2507. Active Norovirus Surveillance in Children Under 5 Years With Diarrhea Following Rotavirus Vaccine Introduction in Argentina
title 2507. Active Norovirus Surveillance in Children Under 5 Years With Diarrhea Following Rotavirus Vaccine Introduction in Argentina
title_full 2507. Active Norovirus Surveillance in Children Under 5 Years With Diarrhea Following Rotavirus Vaccine Introduction in Argentina
title_fullStr 2507. Active Norovirus Surveillance in Children Under 5 Years With Diarrhea Following Rotavirus Vaccine Introduction in Argentina
title_full_unstemmed 2507. Active Norovirus Surveillance in Children Under 5 Years With Diarrhea Following Rotavirus Vaccine Introduction in Argentina
title_short 2507. Active Norovirus Surveillance in Children Under 5 Years With Diarrhea Following Rotavirus Vaccine Introduction in Argentina
title_sort 2507. active norovirus surveillance in children under 5 years with diarrhea following rotavirus vaccine introduction in argentina
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253556/
http://dx.doi.org/10.1093/ofid/ofy210.2159
work_keys_str_mv AT gentileangela 2507activenorovirussurveillanceinchildrenunder5yearswithdiarrheafollowingrotavirusvaccineintroductioninargentina
AT stupkajuanandres 2507activenorovirussurveillanceinchildrenunder5yearswithdiarrheafollowingrotavirusvaccineintroductioninargentina
AT degiuseppejuanignacio 2507activenorovirussurveillanceinchildrenunder5yearswithdiarrheafollowingrotavirusvaccineintroductioninargentina
AT juarezmariadelvalle 2507activenorovirussurveillanceinchildrenunder5yearswithdiarrheafollowingrotavirusvaccineintroductioninargentina
AT lucionmariaflorencia 2507activenorovirussurveillanceinchildrenunder5yearswithdiarrheafollowingrotavirusvaccineintroductioninargentina
AT turcomarisa 2507activenorovirussurveillanceinchildrenunder5yearswithdiarrheafollowingrotavirusvaccineintroductioninargentina
AT sabbajliliana 2507activenorovirussurveillanceinchildrenunder5yearswithdiarrheafollowingrotavirusvaccineintroductioninargentina
AT rapaportsolana 2507activenorovirussurveillanceinchildrenunder5yearswithdiarrheafollowingrotavirusvaccineintroductioninargentina
AT aresomariasoledad 2507activenorovirussurveillanceinchildrenunder5yearswithdiarrheafollowingrotavirusvaccineintroductioninargentina