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Journal of Clinical Microbiology, July 2006, p. 2468-2474, Vol. 44, No. 7
0095-1137/06/$08.00+0     doi:10.1128/JCM.01882-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Comparative Study of the Epidemiology of Rotavirus in Children from a Community-Based Birth Cohort and a Hospital in South India

Department of Gastrointestinal Sciences,¹ Community Health,² Child Health Unit III, Christian Medical College, Vellore, India,³ Virus Reference Department, Centre for Infection, Health Protection Agency, London, United Kingdom,⁴ London School of Hygiene and Tropical Medicine, London, United Kingdom,⁵ Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas⁶

Received 9 September 2005/ Returned for modification 14 November 2005/ Accepted 6 May 2006

Rotavirus gastroenteritis is the major cause of severe dehydrating diarrhea in children worldwide. This study compares rotavirus diarrhea in 351 children in a community-based cohort and 343 children admitted to a hospital during the same period. Clinical information and fecal specimens were obtained during diarrheal episodes. Fecal samples were screened for VP6 antigen, and the positive samples were G and P typed by reverse transcription-PCR. Rotavirus was detected in 82/1,152 (7.1%) episodes of diarrhea in the community and 94/343 (27.4%) cases in the hospital. The median age of affected children (7.5 versus 10.5 months) and the mean severity of symptoms (Vesikari score, 7.6 ± 3.4 versus 11 ± 2.5) were lower in the community. A larger proportion of children in the community were breast-fed than were children admitted to the hospital (73% versus 34.8%). In the community, the genotypes identified in symptomatic patients, in order of frequency, were G1 (36.5%), G10 (17.1%), G2 (15.9%), and G9 (7.3%) and mixed infections (7.3%). The most common G-P combinations were G1P[8], G2P[4], G1P[4], and G10P[11]. The distribution of G types from hospitalized children was G1 (46.8%), G9 (19.1%), G2 (8.5%), G10 (1.1%), and 4.3% mixed infections. The most common G-P combinations were G1P[8] and G9P[8]. This study documents significant genetic heterogeneity of rotaviruses in the community and the hospital. G10P[11] strains resembling a vaccine candidate strain caused disease in the community, indicating the need for careful epidemiological studies as well as safety studies for the vaccine candidates.

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