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Journal of Clinical Microbiology, August 2008, p. 2573-2580, Vol. 46, No. 8
0095-1137/08/$08.00+0     doi:10.1128/JCM.00505-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Pediatric Norovirus Diarrhea in Nicaragua{triangledown}

Filemon Bucardo,1,2,3 Johan Nordgren,2,4 Beatrice Carlsson,2 Margarita Paniagua,1,3 Per-Eric Lindgren,4 Felix Espinoza,1 and Lennart Svensson2*

Department of Microbiology, University of León, UNAN-León, Nicaragua,1 Division of Molecular Virology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden,2 Microbiology, Tumor and Cell Biology Centre, Karolinska Institutet, S-171 77 Stockholm, Sweden,3 Division of Medical Microbiology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden4

Received 14 March 2008/ Returned for modification 17 April 2008/ Accepted 6 June 2008

Information about norovirus (NoV) infections in Central America is limited. Through a passive community and hospital pediatric diarrhea surveillance program, a total of 542 stool samples were collected between March 2005 and February 2006 in León, Nicaragua. NoV was detected in 12% (65/542) of the children; of these, 11% (45/409) were in the community and 15% (20/133) were in the hospital, with most strains (88%) belonging to genogroup II. NoV infections were age and gender associated, with children of <2 years of age (P < 0.05) and girls (P < 0.05) being most affected. Breast-feeding did not reduce the number of NoV infections. An important proportion (57%) of NoV-infected children were coinfected with diarrheagenic Escherichia coli. A significant proportion (18/31) of NoV-positive children with dehydration required intravenous rehydration. Nucleotide sequence analysis (38/65) of the N-terminal and shell region in the capsid gene revealed that at least six genotypes (GI.4, GII.2, GII.4, GII.7, GII.17, and a potentially novel cluster termed "GII.18-Nica") circulated during the study period, with GII.4 virus being predominant (26/38). The majority (20/26) of those GII.4 strains shared high nucleotide homology (99%) with the globally emerging Hunter strain. The mean viral load was approximately 15-fold higher in children infected with GII.4 virus than in those infected with other G.II viruses, with the highest viral load observed for the group of children infected with GII.4 and requiring intravenous rehydration. This study, the first of its type from a Central American country, suggests that NoV is an important etiological agent of acute diarrhea among children of <2 years of age in Nicaragua.

* Corresponding author. Mailing address: Division of Molecular Virology, Department of Clinical and Experimental Medicine, Medical Faculty, Linköping University, SE-581 85 Linköping. Sweden. Phone: 46 13 228803. Fax: 46 13 221375. E-mail: lensv{at}imk.liu.se

{triangledown} Published ahead of print on 18 June 2008.

Journal of Clinical Microbiology, August 2008, p. 2573-2580, Vol. 46, No. 8
0095-1137/08/$08.00+0     doi:10.1128/JCM.00505-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Bok, K., Abente, E. J., Realpe-Quintero, M., Mitra, T., Sosnovtsev, S. V., Kapikian, A. Z., Green, K. Y. (2009). Evolutionary Dynamics of GII.4 Noroviruses over a 34-Year Period. J. Virol. 83: 11890-11901 [Abstract] [Full Text]  
  • Vilchez, S., Reyes, D., Paniagua, M., Bucardo, F., Mollby, R., Weintraub, A. (2009). Prevalence of diarrhoeagenic Escherichia coli in children from Leon, Nicaragua. J Med Microbiol 58: 630-637 [Abstract] [Full Text]  


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