scholarly journals Aetiological importance of viruses causing acute gastroenteritis in humans

2012 ◽  
Vol 33 (2) ◽  
pp. 49
Author(s):  
Geoffrey Higgins ◽  
Sonia Schepetiuk ◽  
Rod Ratcliff
Keyword(s):  
Acute Gastroenteritis ◽  
Age Groups ◽  
Molecular Techniques ◽  
Severe Illness ◽  
Controlled Trials ◽  
Enteric Adenoviruses

Acute gastroenteritis (AGE) is a common illness affecting all age groups worldwide causing 2.2 million deaths annually. Viruses including rotaviruses, noroviruses, enteric adenoviruses and astroviruses are the major cause of AGE, with rotavirus causing the majority of severe illness. Advances in molecular techniques have led to the identification of many more viruses in faeces. Proving an association with AGE will require prospective controlled trials which so far are few in number.

scholarly journals 1101. Comparison of Clinical Characteristics and Demographics of GII.4 vs. Other GII Noroviruses Associated With Sporadic Acute Gastroenteritis in Children in Nashville, TN, 2012–2015

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S330-S330
Author(s):  
Einas Batarseh ◽  
Lubna Hamdan ◽  
Bhinnata Piya ◽  
Laura Stewart ◽  
James D Chappell ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Clinical Characteristics ◽  
Age Groups ◽  
Severe Illness ◽  
Genotype Distribution ◽  
Research Support ◽  
Inpatient Settings ◽  
Prevalent Strain ◽  
Stool Specimens ◽  
Sporadic Acute Gastroenteritis

Abstract Background Norovirus is a leading cause of acute gastroenteritis (AGE) in all age groups. Although at least 28 different genotypes infecting humans have been reported, most outbreaks over the last 15 years have been caused by genogroup II (GII) viruses, of which GII.4 viruses have caused more than 50%. Since clinical differences between different genotypes are poorly understood, we sought to compare clinical characteristics in children infected with GII.4 and non-GII.4 viruses. Methods Children between 15 days and 17 years who presented with AGE defined as diarrhea (≥3 loose stools in a 24 hour period) or vomiting (≥1 episodes in a 24 hour period) within 10 days duration were recruited in outpatient, emergency, and inpatient settings in Nashville, TN, during 2012–2015. Stool specimens were tested by RT-qPCR for GI and GII norovirus. Norovirus-positive specimens were genotyped by sequencing of a partial region of the capsid gene. In this study, we excluded children infected with GI, mixed GI/GII and non-typeable GII viruses. Results Of 3,705 AGE subjects enrolled, 2,892 (78%) specimens were collected, 637 (22%) tested norovirus-positive (567 [89%] GII, 62 [10%] GI, and 8 [1%] mixed GI/GII). Of the 567 GII viruses, 461 (81%) were able to be genotyped and of those 238/461 (51.6%) were typed as GII.4 and 223/461 (48.3%) were typed as other GII genotypes (non-GII.4, primarily GII.3 [65/ 461, 14.1%], GII.6 [48/461, 10.4%] and GII.7 [36/461, 7.8%]). Over three AGE seasons, GII.4 represented 64/117 (54%), 79/178 (44%), and 71/166 (57%), of the GII infections, respectively. Compared with non-GII.4 subjects, GII.4 subjects were more likely to be younger (15.5 vs. 21.3 months, P < 0.01), and less likely to attend daycare (23% vs. 39%, P < 0.01). GII.4 subjects also were more likely to present with diarrhea (75% vs. 57%, P < 0.01) and had higher median modified Vesikari score (7 vs. 6, P < 0.01). Conclusion Children infected with GII.4 viruses were younger, less likely to attend child care, more likely to present with diarrhea, and had a more severe illness compared with those with non-GII.4 infections. These data provide important information on the genotype distribution of norovirus in children with AGE in Tennessee and highlight GII.4 as the most prevalent strain. Disclosures N. Halasa, sanofi pasteur: Investigator, Research support. GSK: Consultant, Consulting fee. Moderna: Consultant, Consulting fee.

scholarly journals Characteristics of Campylobacter and Salmonella Infections and Acute Gastroenteritis in Older Adults in Australia, Canada, and the United States

2019 ◽  
Vol 69 (9) ◽  
pp. 1545-1552 ◽  
Author(s):  
Alice E White ◽  
Nadia Ciampa ◽  
Yingxi Chen ◽  
Martyn Kirk ◽  
Andrea Nesbitt ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
Acute Gastroenteritis ◽  
Age Groups ◽  
Signs And Symptoms ◽  
The United States ◽  
Bloody Diarrhea ◽  
Severe Illness ◽  
Salmonella Infections ◽  
Enteric Infections

Abstract Background The early detection of enteric infections in older adults is challenging because typical signs and symptoms of disease may be less common, absent, or overlooked. Understanding illness characteristics of enteric infections among older adults could improve the timeliness and accuracy of clinical diagnoses, thereby improving patient outcomes and increasing cases reported to surveillance. Methods Here, we describe illness characteristics (percentage reporting bloody diarrhea, fever, vomiting, abdominal pain; percentage hospitalized; duration of hospitalization; and duration of illness) among older adults (≥65 years) with acute gastroenteritis and culture-confirmed Campylobacter and nontyphoidal Salmonella infections in Australia, Canada, and the United States and compare these characteristics with those among younger people (<5 years, 5–24 years, and 25–64 years). Results A significant negative correlation was found between all symptoms and increasing age group, except for bloody diarrhea in cases of acute gastroenteritis. Adults aged ≥85 years reported bloody diarrhea in only 9% of nontyphoidal Salmonella and 4% of Campylobacter infections compared with 59% and 55% among children aged <5 years. Conversely, a greater percentage of older adults (≥65) than younger persons (<5, 5–24, 25–64) reported being hospitalized, with an increasing linear relationship in age groups 65 years and older. Conclusions Although older adults are more likely to have severe illness and be hospitalized, we found that the proportion of persons reporting symptoms typically associated with enteric infections decreases with age. These findings have implications for clinical recognition and treatment of gastrointestinal illness, as well as for public health research.

scholarly journals Human Astrovirus Outbreak in a Daycare Center and Propagation among Household Contacts

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1100
Author(s):  
Ignacio Parrón ◽  
Elsa Plasencia ◽  
Thais Cornejo-Sánchez ◽  
Mireia Jané ◽  
Cristina Pérez ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Age Groups ◽  
Rt Pcr ◽  
Daycare Center ◽  
Infected People ◽  
Conditioning Factors ◽  
Household Contacts ◽  
Human Astrovirus ◽  
Asymptomatic Infections ◽  
Clinical Cases

We investigated an outbreak of acute gastroenteritis due to human astrovirus in a daycare center, describing the transmission mechanism, the most affected age groups, conditioning factors and the extent of the outbreak among household contacts of the daycare center attenders. Data were collected from persons exposed at the daycare center and their home contacts. Fecal samples from affected and non-affected daycare center attenders were analyzed for viruses causing acute gastroenteritis by RT-PCR. The percentage of households affected and the attack rates (AR) were calculated. The attack rates were compared using the rate ratio (RR) with 95% confidence intervals. Information was obtained from 245 people (76 attenders and 169 contacts) of whom 49 were clinical cases. Five HAstV-4, two HAstV-8 and three non-typable HAstV cases were identified (six from clinical cases and four from asymptomatic infected people). The global AR was 20% (41.2% in children aged < 2 years). Data were obtained from 67 households: 20 households of affected attenders and 47 of non-affected attendees. Household contacts of affected attenders had a higher AR (74.3%) than that of non-affected attendees (2.4%). We found asymptomatic infections amongst daycare attendees. The transmission of HAstV during the outbreak was not limited to the daycare center but extended to household contacts of both affected and non-affected attenders.

scholarly journals Distribution and titres of rotavirus antibodies in different age groups

1977 ◽  
Vol 79 (3) ◽  
pp. 365-372 ◽  
Author(s):  
M. M. Elias
Keyword(s):  
Indirect Immunofluorescence ◽  
Acute Gastroenteritis ◽  
Neutralizing Antibodies ◽  
Complement Fixation ◽  
Age Groups ◽  
Newborn Infants ◽  
Older Age ◽  
Human Rotavirus ◽  
Hospital Patients

SUMMARYThree hundred and fifty-seven sera selected at random from hospital patients of all ages were examined for rotavirus antibodies using indirect immunofluorescence (FA) and complement fixation tests (CFT). Three hundred and fourteen of these were also tested for neutralizing antibodies to human rotavirus. Sera from patients admitted with a diagnosis of acute gastroenteritis were excluded from this survey.FA antibodies were found in newborn infants but fell to undetectable titres at 3 months. The highest titres were found in children between the ages of one and three years. In older age groups, the modal titre fell gradually with increasing age until, in sera from those above 70 years of age, FA antibodies were almost undetectable. The same pattern was observed with neutralizing antibodies. A high modal titre of CF antibodies was only found in sera from those aged one to three years.

Molecular epidemiology of norovirus from patients with acute gastroenteritis in northwestern Spain

2014 ◽  
Vol 143 (2) ◽  
pp. 316-324 ◽  
Author(s):  
C. F. MANSO ◽  
J. L. ROMALDE
Keyword(s):  
Phylogenetic Analysis ◽  
Molecular Epidemiology ◽  
Genetic Drift ◽  
Acute Gastroenteritis ◽  
Age Groups ◽  
Capsid Gene ◽  
High Prevalence ◽  
High Incidence ◽  
Northwestern Spain

SUMMARYThe high incidence of norovirus (NoV) infections seems to be related to the emergence of new variants that evolved by genetic drift of the capsid gene. In this work, that represents a first effort to describe the molecular epidemiology of NoV in the northwest of Spain, a total of eight different NoV genotypes (GII.1, GII.3, GII.4, GII.6, GII.7, GII.12, GII.13, GII.14) were detected. The major genotypes observed were GII.4 (45·42%) and GII.14 (34·9%), being detected in all age groups. In addition, and although most of GII.4 sequences belonged to 2006b (7·2%) and 2010 (50·35%) variants, the presence of new NoV variants was observed. Phylogenetic analysis revealed that a high number of GII.4 sequences (35·24%) could be assigned to the newly emerging Sydney 2012 variant, even during late 2010. The high prevalence of NoV GII.14 observed in this study may indicate the emergence of this genotype in Spain.

Investigation of Children with Acute Gastroenteritis by Multiplex PCR Method in Central Part of Turkey

2022 ◽  
Author(s):  
Fatih Yılmaz ◽  
Havva Kaya ◽  
Mehmet Özdemir
Keyword(s):  
Multiplex Pcr ◽  
Acute Gastroenteritis ◽  
Hospital Admissions ◽  
Age Groups ◽  
Viral Gastroenteritis ◽  
Viral Agent ◽  
Mortality And Morbidity ◽  
Stool Samples ◽  
Pcr Method ◽  
Norovirus Gii

Abstract Objective Gastroenteritis is a disease that affects all age groups, especially children, and causes high mortality and morbidity in all countries. The most common agents of acute gastroenteritis are viral agents. As a result, millions of diarrhea attacks and hospital admissions occur worldwide every year due to viral gastroenteritis. This study uses the multiplex polymerase chain reaction (PCR) method to investigate the viruses that are the causative agents of viral gastroenteritis in the pediatric patient group in Konya, Turkey. Methods Stool samples of 94 patients aged 0 to 18 years sent from Emergency clinics and Pediatric outpatient clinics, Meram Medical Faculty Hospital Pediatric clinics, Konya Necmettin Erbakan University to Medical Microbiology Laboratory with a diagnosis of gastroenteritis between February and December 2018 were included in the study. Stool samples were stored at –80°C until the time of the analysis. Deoxyribonucleic acid/ribonucleic acid isolation from stool samples was performed with EZ1 Virus Mini Kit v2.0 (Qiagen, Hilden, Germany) using an automatic extraction system (BioRobot EZ1 system, Qiagen). The presence of astrovirus, rotavirus, adenovirus, norovirus (GI, GII), and sapovirus agents was investigated by the multiplex PCR method (Fast Track Diagnostics, Luxembourg) viral gastroenteritis kit. Results Viral gastroenteritis agents were detected in 56.3% of the patients. One viral agent was detected in 47 (50%) of these patients and at least two viral agents in 6 (6.3%) of them. Norovirus GII was detected in 20 (21.2%) of the children included in the study, adenovirus in 13 (13.8%), rotavirus in 11 (12.8%), astrovirus in 11 (11.7%), sapovirus in 4 (4.2%), and norovirus GI in 1 (1.06%). When the distribution of viral agents was examined by months, the most number of agents were observed (21; 35%) in May, followed by April and June (12; 20%). Considering the distribution of the prevalence of the agents by age, it was seen to be mainly between 0 and 12 months (42%). Conclusion Considering that the most common viral agent in our region is norovirus GII, it will be useful to investigate the norovirus that is not routinely examined in children who are admitted to clinics with the complaint of gastroenteritis. It will be appropriate to examine routinely adenovirus, rotavirus, and norovirus in the laboratory, especially in children with diarrhea and vomiting in the winter and spring months.

The Comparison of Susceptibility to SARS-CoV-2 Infection between Pediatric and Adults

2021 ◽  
Author(s):  
Milad Zandi ◽  
Saber Soltani ◽  
Mona Fani ◽  
Haniye Shafipour ◽  
Samaneh Abbasi
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Mortality Rate ◽  
Age Groups ◽  
Severe Illness ◽  
Converting Enzyme ◽  
Angiotensin Converting Enzyme 2 ◽  
The World ◽  
Smoking Susceptibility ◽  
The Relationship

SARS-CoV-2 causes coronavirus disease 2019 (COVID-19) and is responsible for the recent pandemic in the world. It has been recently recognized as a challenge for public health and a significant cause of severe illness in all age groups. Young children and older people are susceptible to SARS-CoV-2 infection. However, children usually present mild symptoms compared to adult patients. The relationship between age, severity, and COVID-19 transmission is compared to determine whether there is any reasonable relationship between age and COVID-19. It should be mentioned that some risk factors may increase the probability of developing severe COVID-19 by advancing age, such as pathophysiological changes in the respiratory system, angiotensin-converting enzyme 2 expression in the nasopharynx, and smoking. Susceptibility to SARS-CoV-2 infection is independent of age, but the mortality rate of COVID-19 depends on age.

scholarly journals Outcomes of older patients with follicular lymphoma using individual data from 5922 patients in 18 randomized controlled trials

2021 ◽  
Vol 5 (6) ◽  
pp. 1737-1745
Author(s):  
Carla Casulo ◽  
Jesse G. Dixon ◽  
Fang-Shu Ou ◽  
Eva Hoster ◽  
Bruce A. Peterson ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Follicular Lymphoma ◽  
Randomized Controlled Trials ◽  
Age Groups ◽  
Progression Free Survival ◽  
Controlled Trials ◽  
Early Disease ◽  
End Points ◽  
Randomized Controlled ◽  
Disease Outcomes

Abstract Limited data exist to describe the clinical features and outcomes for elderly patients with follicular lymphoma (FL). The Follicular Lymphoma Analysis of Surrogacy Hypothesis (FLASH) group performed a prospectively planned pooled analysis of individual patient data from first-line randomized controlled trials (RCTs) and examined associations between age (≤70 vs &gt;70 years), clinical characteristics, and FL outcomes. We identified 18 multicenter clinical RCTs in the FLASH database that enrolled elderly patients (&gt;70 years). Primary end points were early disease outcomes, CR24 and CR30, and progression-free survival (PFS) at 24 months (PFS24). Secondary end points were PFS and overall survival (OS). We identified 5922 previously untreated FL patients from 18 RCTs. Patients age &gt;70 years (vs ≤70 years) more commonly had elevated lactate dehydrogenase, hemoglobin &lt;12 g/dL, ECOG PS ≥2, and elevated β2-microglobulin. Median follow-up was 5.6 years. Patients &gt;70 years did not differ from patients ≤70 years in rates of CR24, CR30, or PFS24. With a median OS of 14.6 years for all patients, median OS was 7.4 and 15.7 years for patients &gt;70 and ≤70 years of age, respectively (hazard ratio = 2.35; 95% confidence interval = 2.03-2.73; P &lt; .001). Age &gt;70 years was a significant predictor of OS and PFS due to higher rates of death without progression, but not PFS24, CR24, or CR30. FL patients &gt;70 years treated on trials have similar early disease outcomes to younger patients. There is no disease-specific outcome difference between age groups. Age alone should not disqualify patients from standard treatments or RCTs.

scholarly journals 1624. Primary Care Physician Knowledge, Attitudes, and Diagnostic Testing Practices for Norovirus and Acute Gastroenteritis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S592-S593
Author(s):  
Cristina Cardemil ◽  
Sean O’Leary ◽  
Brenda Beaty ◽  
Kathryn Ivey ◽  
Megan Lindley ◽  
...  
Keyword(s):  
Primary Care ◽  
Acute Gastroenteritis ◽  
Diagnostic Testing ◽  
Age Groups ◽  
Mail Survey ◽  
Care Physician ◽  
Knowledge Gaps ◽  
Vaccine Introduction ◽  
Physician Knowledge ◽  
Testing Practices

Abstract Background Norovirus is a leading cause of acute gastroenteritis (AGE) across the age spectrum; candidate vaccines are in clinical trials. While norovirus diagnostic testing is increasingly available, stool testing may not be performed routinely, which can hamper surveillance and burden of disease estimates. Our objectives were to understand physicians’ stool testing practices in outpatients with AGE, and physician knowledge of norovirus, in order to improve surveillance and prepare for vaccine introduction. Methods Internet and mail survey on AGE and norovirus conducted January to March 2018 among national networks of primary care pediatricians (Peds), family practice (FP) and general internal medicine (GIM) physicians. Results The response rate was 59% (820/1,383). During peak AGE season, physicians estimated they ordered stool tests for a median of 15% (interquartile range: 5–33%) of their outpatients with AGE. Stool tests were more often available for ova and parasites, Clostridioides difficile, and bacterial culture (>95% for all specialties) than for norovirus (6–33% across specialties); even when available, norovirus-specific tests were infrequently ordered. Most providers were unaware that norovirus is a leading cause of AGE across all age groups (Peds 80%, FP 86%, GIM 89%) or that alcohol-based hand sanitizers are ineffective against norovirus (Peds 51%, FP 66%, GIM 62%). Conclusion Physicians infrequently order stool tests for outpatients with AGE, and have knowledge gaps on norovirus prevalence and hand hygiene for prevention. Understanding the limitations of surveillance that relies on physician-ordered stool diagnostics, and closing physician knowledge gaps, can help support norovirus vaccine introduction. Disclosures All authors: No reported disclosures.

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