scholarly journals The Rise in Norovirus-Related Acute Gastroenteritis During the Fight Against the COVID-19 Pandemic in Southern China

2022 ◽  
Vol 9 ◽  
Author(s):  
Ying Lu ◽  
Zhoubin Zhang ◽  
Huaping Xie ◽  
Wenzhe Su ◽  
Hui Wang ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Attack Rate ◽  
Southern China ◽  
Initial Period ◽  
Median Number ◽  
Epidemiological Surveillance ◽  
Viral Gastroenteritis ◽  
Cumulative Number ◽  
Infectious Diarrhea ◽  
New School

Background: There has been a significant decline in the morbidity of almost all infectious diseases during the COVID-19 pandemic. However, while the incidence of norovirus-related acute gastroenteritis declined in Guangzhou, China during the initial period of the pandemic, incidence increased significantly once the new school year began in September 2020.Methods: Norovirus-related acute gastroenteritis clusters and outbreaks were assessed in Guangzhou from 2015 to 2020. Medians and interquartile ranges were compared between groups using the Mann–Whitney U-test, and attack rates were calculated.Results: While 78,579 cases of infectious diarrhea were reported from 2015 to 2019, with an average of 15,716 cases per year, only 12,065 cases of infectious diarrhea were reported in 2020. The numbers of sporadic cases and outbreaks reported from January to August 2020 were lower than the average numbers reported during the same time period each year from 2015 to 2019 but began to increase in September 2020. The number of cases in each reported cluster ranged from 10 to 70 in 2020, with a total of 1,280 cases and an average attack rate of 5.85%. The median number of reported cases, the cumulative number of cases, and the attack rate were higher than the average number reported each year from 2015 to 2019. The intervention time in 2020 was also higher than the average intervention time reported during 2015–2019. The main norovirus genotypes circulating in Guangzhou during 2015–2020 included genogroup 2 type 2 (GII.2) (n = 79, 26.69%), GII.17 (n = 36, 12.16%), GII.3 (n = 27, 9.12%), GII.6 (n = 8, 2.7%), GII.4 Sydney_2012 (n = 7, 2.36%), and GII.4 (n = 6, 2.03%).Conclusions: Our findings illustrate the importance of maintaining epidemiological surveillance for viral gastroenteritis during the COVID-19 pandemic. Local disease prevention and control institutions need to devote sufficient human resources to control norovirus clusters.

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.

Lack Of Anti-Xa Assay Standardization Results In Significant Dose Variation In Neonates and Children Receiving Enoxaparin

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2379-2379
Author(s):  
Lindsey A. Greene ◽  
Connie Law ◽  
Mike Jung ◽  
Sara Walton ◽  
Leslie J. Raffini
Keyword(s):  
Conflicts Of Interest ◽  
Median Number ◽  
Therapeutic Monitoring ◽  
Dose Titration ◽  
Controlled Clinical Trial ◽  
Cumulative Number ◽  
Significant Difference ◽  
Pharmacokinetic Properties ◽  
The Mean ◽  
Dose Variation

Abstract Introduction Due to favorable pharmacokinetic properties, enoxaparin is the most frequently used anticoagulant in children. Unlike adults, a developing hemostatic system provides rationale for therapeutic monitoring with an anti-Xa goal of 0.5-1 units/ml. However, accepted therapeutic ranges are not well correlated with clinical outcomes (i.e. thrombosis or hemorrhage) and there is no assay standardization. In 2011 the coagulation laboratory at the Children's Hospital of Philadelphia (CHOP) changed anti-Xa laboratory assays resulting in anti-Xa levels that were on average, 33% higher than the prior assay (Figure 1). We describe how this change in assay influenced therapeutic enoxaparin dose (mg/kg) at our center. Methods The coagulation laboratory performed simultaneous anti-Xa measurements using the Stachrom (old) assay and Rotachrom (new) assay on 19 subjects from split plasma samples. The new assay was then implemented into clinical practice. Information on anti-Xa values and enoxaparin dosing during the initiation of anticoagulation was retrospectively compiled for the 6 months pre and post assay change. Data on enoxaparin dosing and anti-Xa values was collected on 109 children in the old assay phase and 104 children in the new assay phase. Therapeutic enoxaparin dose was defined as the first dose resulting in an anti-Xa value 0.5- 1 unit/ml. All subjects initiated on anticoagulation during this 12 month period were included. Anti-Xa levels were obtained per CHOP standard clinical monitoring: until therapeutic, after dose adjustment, and every other week while inpatient with some subjects more frequently evaluated per provider discretion. Cumulative number of inpatient anti-Xa values obtained was determined for each subject. Enoxaparin dosing and cumulative anti-Xa values pre and post assay changes in each cohort were analyzed using a t-test. Results Using 19 split samples there was strong correlation between the two assays (r=0.96), however, the means between the two assays differed significantly (p <0.0001) with new assay findings being, on average, 33% higher (Figure 1). There was a significant decrease in the new assay mean therapeutic enoxaparin dose (mg/kg) in subjects <3 months (p=0.01) and 3 months–2 years (p<0.0001), but not in subjects >2 years (p=0.18) (Table 1). However, the mean first therapeutic anti-Xa value was significantly higher in subjects > 2 yrs post-assay change (p=0.001). Among all 213 subjects, a total of 1,061 inpatient anti-Xa values were obtained, with a median of 3 (range: 1-32) per subject. Median number of anti-Xa values obtained to achieve therapeutic range was 2 (range: 1-6) prior to assay change and 1 (range: 1-7) post assay change with a significant difference (p=0.004) observed between the groups. Conclusions Using split patient samples, the Rotachrom assay demonstrated significantly higher anti-Xa values than the Stachrom assay. Once the Rotachrom assay was clinically implemented, there was a significant difference in weight based enoxaparin dosing in subjects < 2 years, and higher anti-Xa levels in subjects > 2 yrs. These observations demonstrate enoxaparin dose titration to achieve therapeutic anti-Xa is vulnerable to assay variability. Since these assays are not well standardized, this practice is likely to provide false reassurance of efficacy and safety. The large number of anti-Xa levels obtained may represent unnecessary venipuncture as well as misappropriation of time and resources. It is possible the majority of neonates and children may be safely and effectively treated with weight based dosing without monitoring. These data support a randomized controlled clinical trial in neonates and children comparing safety and efficacy of enoxaparin weight based dosing to dosing titrated to achieve therapeutic anti-Xa. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Human norovirus GII.4 Hong Kong variant shares common ancestry with GII.4 Osaka and emerged in Thailand in 2016

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256572
Author(s):  
Watchaporn Chuchaona ◽  
Jira Chansaenroj ◽  
Jiratchaya Puenpa ◽  
Sarawut Khongwichit ◽  
Sumeth Korkong ◽  
...  
Keyword(s):  
Hong Kong ◽  
Nucleotide Sequence ◽  
Acute Gastroenteritis ◽  
Age Groups ◽  
Epidemiological Surveillance ◽  
Common Ancestry ◽  
Amino Acid Residues ◽  
Human Norovirus ◽  
Susceptible Population ◽  
Norovirus Gii

Human norovirus is a leading cause of non-bacterial acute gastroenteritis, which affects all age groups and are found globally. Infections are highly contagious and often occur as outbreaks. Periodic emergence of new strains are not uncommon and novel variants are named after the place of first reported nucleotide sequence. Here, we identified human norovirus GII.4 Hong Kong variant in stool samples from Thai patients presented with acute gastroenteritis. Comparison of amino acid residues deduced from the viral nucleotide sequence with those of historical and contemporary norovirus GII.4 strains revealed notable differences, which mapped to the defined antigenic sites of the viral major capsid protein. Time-scaled phylogenetic analysis suggests that GII.4 Hong Kong shared common ancestry with GII.4 Osaka first reported in 2007, and more importantly, did not evolve from the now-prevalent GII.4 Sydney lineage. As circulation of norovirus minor variants can lead to eventual widespread transmission in susceptible population, this study underscores the potential emergence of the GII.4 Hong Kong variant, which warrants vigilant molecular epidemiological surveillance.

scholarly journals Gastroenteritis in adults

2018 ◽  
Vol 5 (11) ◽  
pp. 4959
Author(s):  
Burair Al Jassas ◽  
Marwan Khayat ◽  
Hussin Alzahrani ◽  
Aghareed Asali ◽  
Salem Alsohaimi ◽  
...  
Keyword(s):  
United States ◽  
Abdominal Pain ◽  
Acute Gastroenteritis ◽  
Viral Infections ◽  
Diarrheal Disease ◽  
The United States ◽  
Viral Gastroenteritis ◽  
Search Terms ◽  
Bacterial Gastroenteritis ◽  
Comprehensive Search

Gastroenteritis is the inflammation of intestines and stomach which presents with vomiting, fever, abdominal pain and diarrhea. It could be persistent, acute, or chronic, and can also be classified as infectious or non-infectious. Despite improvement in management, the mortality can reach up to 17,000. In this study, our aim was to understand the various etiologies that cause gastroenteritis in adults, and also discuss methods of management. We conducted this review using a comprehensive search of MEDLINE, PubMed and EMBASE from January 1994 to March 2017. The following search terms were used: acute gastroenteritis, diarrheal disease, viral gastroenteritis, bacterial gastroenteritis, diagnoses of gastroenteritis. Each year, more than 350 million cases of acute gastroenteritis occur in the United States only. The largest portion of gastroenteritis cases is due to viral infections. Therefore, the empiric use of antibiotics is usually not recommended. However, in selected patients, empiric antibiotics therapy is indicated and is associated with significant improvement and decrease in mortality. The primary goal of management of gastroenteritis is treating dehydration.

scholarly journals Viral gastroenteritis in Tocantins, Brazil: characterizing the diversity of human adenovirus F through next-generation sequencing and bioinformatics

2020 ◽  
Vol 101 (12) ◽  
pp. 1280-1288
Author(s):  
Roozbeh Tahmasebi ◽  
Adriana Luchs ◽  
Kaelan Tardy ◽  
Philip Michael Hefford ◽  
Rory J. Tinker ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Low Income ◽  
Acute Gastroenteritis ◽  
Viral Gastroenteritis ◽  
Large Set ◽  
Next Generation ◽  
Genome Database ◽  
Detection Rates ◽  
Genome Data ◽  
Generation Sequencing

Human enteric adenovirus species F (HAdV-F) is one of the most common pathogens responsible for acute gastroenteritis worldwide. Brazil is a country with continental dimensions where continuous multiregional surveillance is vital to establish a more complete picture of the epidemiology of HAdV-F. The aim of the current study was to investigate the molecular epidemiology of HAdV-F using full-genome data in rural and low-income urban areas in northern Brazil. This will allow a genetic comparison between Brazilian and global HAdV-F strains. The frequency of HAdV-F infections in patients with gastroenteritis and molecular typing of positive samples within this period was also analysed. A total of 251 stool samples collected between 2010 and 2016 from patients with acute gastroenteritis were screened for HAdV-F using next-generation sequencing techniques. HAdV-F infection was detected in 57.8 % (145/251) of samples. A total of 137 positive samples belonged to HAdV-F41 and 7 to HAdV-F40. HAdV-F40/41 dual infection was found in one sample. Detection rates did not vary significantly according to the year. Single HAdV-F infections were detected in 21.9 % (55/251) of samples and mixed infections in 37.4 % (94/251), with RVA/HAdV-F being the most frequent association (21.5 %; 54/251). Genetic analysis indicated that the HAdV-F strains circulating in Brazil were closely related to worldwide strains, and the existence of some temporal order was not observed. This is the first large-scale HAdV-F study in Brazil in which whole-genome data and DNA sequence analyses were used to characterize HAdV-F strains. Expanding the viral genome database could improve overall genotyping success and assist the National Center for Biotechnology Information (NCBI)/GenBank in standardizing the HAdV genome records by providing a large set of annotated HAdV-F genomes.

scholarly journals High prevalence of circulating DS-1-like human rotavirus A and genotype diversity in children with acute gastroenteritis in Thailand from 2016 to 2019

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10954
Author(s):  
Siripat Pasittungkul ◽  
Fajar Budi Lestari ◽  
Jiratchaya Puenpa ◽  
Watchaporn Chuchaona ◽  
Nawarat Posuwan ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Viral Gastroenteritis ◽  
Seasonal Incidence ◽  
Rotavirus Infection ◽  
Rotavirus A ◽  
Human Rotavirus ◽  
Genotype Diversity ◽  
Stool Samples

Background Human rotavirus A (RVA) infection is the primary cause of acute gastroenteritis (AGE) in infants and young children worldwide, especially in children under 5 years of age and is a major public health problem causing severe diarrhea in children in Thailand. This study aimed to investigate the prevalence, genotype diversity, and molecular characterization of rotavirus infection circulating in children under 15 years of age diagnosed with AGE in Thailand from January 2016 to December 2019. Methods A total of 2,001 stool samples were collected from children with gastroenteritis (neonates to children <15 years of age) and tested for RVA by real-time polymerase chain reaction (RT-PCR). Amplified products were sequenced and submitted to an online genotyping tool for analysis. Results Overall, 301 (15.0%) stool samples were positive for RVA. RVA occurred most frequently among children aged 0-24 months. The seasonal incidence of rotavirus infection occurred typically in Thailand during the winter months (December-March). The G3P[8] genotype was identified as the most prevalent genotype (33.2%, 100/301), followed by G8P[8] (10.6%, 32/301), G9P[8] (6.3%, 19/301), G2P[4] (6.0%, 18/301), and G1P[6] (5.3%, 16/301). Uncommon G and P combinations such as G9P[4], G2P[8], G3P[4] and G3P[9] were also detected at low frequencies. In terms of genetic backbone, the unusual DS-1-like G3P[8] was the most frequently detected (28.2%, 85/301), and the phylogenetic analysis demonstrated high nucleotide identity with unusual DS-1-like G3P[8] detected in Thailand and several countries. Conclusions A genetic association between RVA isolates from Thailand and other countries ought to be investigated given the local and global dissemination of rotavirus as it is crucial for controlling viral gastroenteritis, and implications for the national vaccination programs.

scholarly journals A review of COVID-19 transmission dynamics and clinical outcomes on cruise ships worldwide, January to October 2020

2022 ◽  
Vol 27 (1) ◽  
Author(s):  
Kathryn S Willebrand ◽  
Lauren Pischel ◽  
Amyn A Malik ◽  
Samuel M Jenness ◽  
Saad B Omer
Keyword(s):  
Attack Rate ◽  
The United States ◽  
Median Number ◽  
Transmission Dynamics ◽  
Mitigation Measures ◽  
Confined Space ◽  
Susceptible Population ◽  
Comprehensive Review ◽  
Cruise Ships ◽  
Epidemiological Information

Background Cruise ships provide an ideal setting for transmission of SARS-CoV-2, given the socially dense exposure environment. Aim To provide a comprehensive review of COVID-19 outbreaks on cruise ships. Methods PubMed was searched for COVID-19 cases associated with cruise ships between January and October 2020. A list of cruise ships with COVID-19 was cross-referenced with the United States Centers for Disease Control and Prevention’s list of cruise ships associated with a COVID-19 case within 14 days of disembarkation. News articles were also searched for epidemiological information. Narratives of COVID-19 outbreaks on ships with over 100 cases are presented. Results Seventy-nine ships and 104 unique voyages were associated with COVID-19 cases before 1 October 2020. Nineteen ships had more than one voyage with a case of COVID-19. The median number of cases per ship was three (interquartile range (IQR): 1–17.8), with two notable outliers: the Diamond Princess and the Ruby Princess, which had 712 and 907 cases, respectively. The median attack rate for COVID-19 was 0.2% (IQR: 0.03–1.5), although this distribution was right-skewed with a mean attack rate of 3.7%; 25.9% (27/104) of voyages had at least one COVID-19-associated death. Outbreaks involving only crew occurred later than outbreaks involving guests and crew. Conclusions In the absence of mitigation measures, COVID-19 can spread easily on cruise ships in a susceptible population because of the confined space and high-density contact networks. This environment can create superspreader events and facilitate international spread.

scholarly journals Etiology of Acute Gastroenteritis in Hospitalized Children in Melbourne, Australia, from April 1980 to March 1993

1998 ◽  
Vol 36 (1) ◽  
pp. 133-138 ◽  
Author(s):  
Graeme L. Barnes ◽  
Eric Uren ◽  
Kerrie B. Stevens ◽  
Ruth F. Bishop
Keyword(s):  
Acute Gastroenteritis ◽  
Developed Countries ◽  
Enteric Pathogen ◽  
Infectious Diarrhea ◽  
New Techniques ◽  
Enteric Adenovirus ◽  
Group A Rotaviruses ◽  
Group A ◽  
Long Term Studies

Acute infectious diarrhea is common in children. Control requires knowledge of causes. Few comprehensive long-term studies of etiology have been undertaken in developed countries. This report is of a 13-year survey of 4,637 children from 0 to 14 years of age, admitted to a large children’s hospital for treatment of gastroenteritis, in which viruses, bacteria, and parasites were sought. A recognized enteric pathogen was identified in 56.6% of children. Group A rotaviruses occurred in 39.6% of children overall and in 55% of children 12 to 23 months of age. They were a frequent cause (18.7%) of acute gastroenteritis in children under 6 months and in those aged 5 to 13 years (16%). Rotaviruses were almost entirely responsible for winter admission peaks. Enteric adenovirus types 40 and 41 (6% overall) were more frequent in children under 12 months (9.4%).Salmonella spp. (5.8%) and Campylobacter jejuni (3.4%) were more common in children over 5 years (13.1% and 6.7%, respectively). The 43.5% of cases (60% in children under 6 months) where no enteric pathogen was identified are cause for concern. The involvement of small viruses (including caliciviruses and astroviruses) may be clarified when molecular biology techniques are utilized to address this gap in our knowledge. This comprehensive 13-year study of the cause of acute infectious diarrhea in children in developed countries reinforces the importance of rotavirus and highlights a large group for whom the etiology remains unknown, an issue of particular concern with babies under 6 months of age. New techniques have the potential to identify old and new pathogens causing disease in these vulnerable infants.

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