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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

Indrani Banerjee,1 Sasirekha Ramani,1 Beryl Primrose,2 Prabhakar Moses,3 Miren Iturriza-Gomara,4 James J. Gray,4 Shabbar Jaffar,5 Bindhu Monica,1 Jaya Prakash Muliyil,2 David W. Brown,4 Mary K. Estes,6 and Gagandeep Kang1*

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.

* Corresponding author. Mailing address: Department of GI Sciences, Christian Medical College, Vellore 632004, India. Phone: 0091-416-2282052. Fax: 0091-416-2232035. E-mail: gkang{at}cmcvellore.ac.in.

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.



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