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Journal of Clinical Microbiology, July 2003, p. 3158-3162, Vol. 41, No. 7
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.7.3158-3162.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Rotavirus Diarrhea Severity Is Related to the VP4 Type in Mexican Children

Departamento de Medicina Comunitaria e Hidratación Oral, Hospital Infantil de México Federico Gómez, Mexico City,¹ Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City,² Instituto Mexicano del Seguro Social, Mexico City,³ Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca, Morelos,⁴ Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City,⁵ Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León,⁶ Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, San Luis Potosí,⁷ Centro de Investigaciones Regionales "Hideyo Noguchi," Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico⁸

Received 16 April 2002/ Returned for modification 18 August 2002/ Accepted 8 February 2003

This report is of a community-based case control study to assess whether the severity of acute diarrhea by rotavirus (RV) in young children is associated with a particular VP7 (G) or VP4 (P) RV serotype. Five hundred twenty children younger than 2 years of age with diarrhea lasting less than 3 days were age and gender matched with 520 children with no diarrhea. The G and P serotypes were determined with specific monoclonal antibodies, and the VP4 serotype specificity in a subgroup was confirmed by genotyping. Infection with a G3 serotype led to a higher risk of diarrhea than infection with a G1 serotype. Infection with a G3-nontypeable-P serotype was associated with more severe gastroenteritis than infection with a G3 (or G1) P1A[8] serotype. A child with diarrhea-associated dehydration was almost five times more likely to be infected with a G3-nontypeable-P serotype than a child without dehydration (P < 0.001). Moreover, the two predominant monotypes within serotype P1A[8] had significantly different clinical manifestations. In this study, the severity of RV-associated diarrhea was related to different P serotypes rather than to G serotypes. The relationship between serotype and clinical outcomes seems to be complex and to vary among different geographic areas.

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