Journal Article

Diversity of circulating rotavirus strains in children hospitalized with diarrhea in India, 2005–2009

Arora, Rashmi, Jadhav, Alka, Kang, Gagandeep, Krishnan, Triveni, Agarwal, Indira, Mathew, Ann, Saxena, Vinay Kumar, Arora, Ritu, Chhabra, Preeti, Bhatt, Jyoti, S. Venkatasubramaniam, Fadnis, Prachi, Chitamabar, Shobha, Moses, Prabhakar D., Gentsch, Jon R., Gupte, Mohan D., Bose, Anuradha, Ramani, Sasirekha, Simon, Anna, Parashar, Umesh D., Sowmynarayanan, Thuppal V., Singh, Ng Brajachand, Shetty, Sushmita J., Mathur, Meenakshi, Anita, Sr, Naik, Trilok Nath, Roy, Soumyabrata, Mukherjee, Anupam, Deshpande, Jagdish, Desai, Rishi

2013

Overview

•2899 (40%) out of 7285 stool samples were rotavirus positive from 2005 to 2009.•G12 infections rose to 39% in Northern India and to 24% in the Western India.•8% of rotavirus detections had multiple G-types and 3% had multiple P-types. India accounts for 22% of the 453,000 global rotavirus deaths among children <5 years annually. The Indian Rotavirus Strain Surveillance Network provides clinicians and public health partners with valuable rotavirus disease surveillance data. Our analysis offers policy-makers an update on rotavirus disease burden with emphasis on regional shifts in rotavirus strain epidemiology in India. Children <5 years requiring hospitalization for acute gastroenteritis were selected from 10 representative hospitals in 7 cities throughout India between November 2005 through June 2009. We used a modified World Health Organization protocol for rotavirus surveillance; stool specimens were collected and tested for rotavirus using enzyme immunoassay and reverse-transcription polymerase chain reaction. A total of 7285 stool specimens collected were tested for rotavirus, among which 2899 (40%) were positive for rotavirus. Among the 2899 rotavirus detections, a G-type could not be determined for 662 (23%) and more than one G type was detected in 240 (8%). Of 1997 (69%) patients with only one G-type, the common types were G1 (25%), G2 (21%), G9 (13%), and G12 (10%). The proportion of rotavirus infections attributed to G12 infections rose from 8% to 39% in the Northern region and from 8% to 24% in the Western region. This study highlights the large, ongoing burden of rotavirus disease in India, as well as interesting regional shifts in rotavirus strain epidemiology, including an increasing detection of G12 rotavirus strains in some regions. While broad heterotypic protection from rotavirus vaccination is expected based on pre- and post-licensure data from other settings, effectiveness assessments and rotavirus strain monitoring after vaccine introduction will be important.

• Publisher: Elsevier Ltd,Elsevier,Elsevier Limited
• Subject: Allergy and Immunology / Applied microbiology / Biological and medical sciences / burden of disease / Calendars / Child, Preschool / children / cities / Diarrhea / Diarrhea - epidemiology / Diarrhea - virology / Disease / disease surveillance / enzyme immunoassays / Epidemiology / feces / Fundamental and applied biological sciences. Psychology / G12 / Gastroenteritis / Gastroenteritis - epidemiology / Gastroenteritis - virology / Gastroenterology. Liver. Pancreas. Abdomen / Genotype / Hospitalization / hospitals / Humans / Immunization / India / India - epidemiology / Infant / Medical sciences / Microbiology / Miscellaneous / Other diseases. Semiology / patients / Polymerase Chain Reaction / Public health / reverse transcriptase polymerase chain reaction / Rotavirus / Rotavirus - classification / Rotavirus - genetics / Rotavirus - isolation & purification / Rotavirus Infections - epidemiology / Rotavirus Infections - virology / Stomach. Duodenum. Small intestine. Colon. Rectum. Anus / Strain / Testing laboratories / Vaccination / Vaccines / Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects) / Virology / Viruses / World Health Organization