Extended excretion of rotavirus after severe diarrhoea in young children.
Background Rotaviruses are the major cause of severe childhood diarrhoea.
Knowledge of the natural history of infection, including duration of intestinal virus shedding, is important in the understanding of transmission, sources of infection, and immune responses.
Methods We carried out a study of rotavirus excretion in 37 children admitted to hospital with severe rotavirus diarrhoea.
Sequential faecal specimens were collected from each child during 100 days of surveillance, and screened for rotavirus by EIA and by amplification of genome doublestranded RNA by reverse-transcription PCR.
IgA coproantibody was estimated by EIA.
Findings Duration of rotavirus excretion ranged from 4 to 57 days after onset of diarrhoea.
Excretion ceased within 10 days in 16 (43%) children, and within 20 days in 26 (70%) children.
Extended excretion was detected for 25-57 days in the remaining 11 (30%) children owing mainly to continued excretion of the primary infecting strain.
Extended excretion was significantly associated with antirotavirus IgA coproantibody boosts during 100 days of surveillance (p=0.001, log-rank test), and with recurrence of mild diarrhoea symptoms during convalescence (p=0.006, Fisher's exact test). interpretation Severe rotavirus disease in young children may be followed by extended excretion of rotavirus.
The risk of transmission to others may be greater than previously believed.
Extended excretion could also explain some cases of the postgastroenteritis syndrome.
Mots-clés Pascal : Diarrhée, Etiopathogénie, Excrétion, Rotavirus, Reoviridae, Virus, Facteur risque, Transmission homme homme, Transcription inverse, Réaction chaîne polymérase, Diagnostic, Australie, Océanie, Enfant, Homme, Appareil digestif pathologie, Intestin pathologie, Virose, Infection, Biologie moléculaire
Mots-clés Pascal anglais : Diarrhea, Etiopathogenesis, Excretion, Rotavirus, Reoviridae, Virus, Risk factor, Transmission from man to man, Reverse transcription, Polymerase chain reaction, Diagnosis, Australia, Oceania, Child, Human, Digestive diseases, Intestinal disease, Viral disease, Infection, Molecular biology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0321872
Code Inist : 002B05C02F. Création : 27/11/1998.