Research paperMultiple enterovirus genotypes circulating in children hospitalized with acute gastroenteritis in Thailand
Introduction
Acute gastroenteritis is a major cause of morbidity and mortality among infants and young children around the world. It is the third leading cause of death in children < 5 years of age with the highest incidence occurring in developing countries where there are 2–2.5 million deaths annually worldwide (Kotloff et al., 2013, O'Ryan et al., 2005, Platts-Mills et al., 2015, Walker et al., 2013). Among the viral agents, rotavirus (RV), norovirus (NoV), astrovirus (AstV), and adenovirus (AdV) account for a significant number of cases of acute gastroenteritis (Clark and McKendrick, 2004, Monavari et al., 2017, Thongprachum et al., 2016, Zhou et al., 2017).
Enteroviruses (EVs) are small, non-enveloped, single-stranded RNA viruses which belong to the Picornaviridae family (Tapparel et al., 2013). To date, EVs are known to include 12 species, EV-A to EV-I and rhinovirus A to C. There are over one hundred EVs that can infect humans and those have been classified into 4 species, EV-A to D according to their molecular and antigenic properties. Human EV-A to D also represent a large number of serotypes among echovirus (E), coxsackievirus A (CV-A), CV-B, poliovirus (PV), and rhinovirus which are responsible for major public health concern. EVs are primarily transmitted by fecal-oral and respiratory routes. These viruses are circulating worldwide and infections are more common in summer and early autumn (Pallansch and Roos, 2007). EV infections are associated with several acute and chronic diseases with a wide range of clinical illness including those associated with gastrointestinal or respiratory tracts and the central nervous system (Abzug, 2014, Lee et al., 2013, Pallansch and Roos, 2007). EV infections are mostly asymptomatic, however, about 1.0% leads to severe disease with high morbidity and mortality in young children and infants (Abzug, 2014, Pallansch and Roos, 2007).
Although the impact of EV infection on diarrheal disease is not well documented, the diarrheic potential has been recognized and reported in a number of surveillance studies (Abe et al., 2000, Maslin et al., 2007, Patil et al., 2015, Phan et al., 2005, Rao et al., 2013, Scarcella et al., 2009, Silva et al., 2008). EV detection is often not included in pathogen surveillance of diarrhea, hence, the epidemiological study of EV infection in acute gastroenteritis patients is limited, particularly in Thailand. In this study, we reported the epidemiology and molecular characteristics of EV circulating in children hospitalized with acute gastroenteritis in Thailand during the 5 year period, from 2010 to 2014.
Section snippets
Specimen collection
Fecal samples were collected from pediatric patients younger than 5 years old who had been suffering from acute gastroenteritis and admitted to Chiang Mai University Hospital and Nakornping Hospital, Chiang Mai Province, Thailand during the period of January 2010 to December 2014. A total of 1266 stool samples were collected to include in this study. All specimens were stored at − 20 °C until investigation. The study was approved by the Ethical Committee for Human Rights Related to Human
Detection of EV in clinical specimens
The prevalence of EV detection in children with acute diarrhea during the period 2010 to 2014 are summarized in Table 1. During the 5-years study, a total of 1266 fecal samples tested, 73 (5.8%) were positive for EV as screening by RT-PCR amplification of the 5′UTR region. The prevalence of EV infection by year of study ranged from 0.9 to 8.6% with the highest detection rate in 2014 (8.6%) while the lowest frequency of infection was found in 2010 (0.9%). The prevalence rate of EV detection
Discussion
This study describes the epidemiology and molecular characteristics of EVs detected in pediatric patients hospitalized with acute gastroenteritis in Chiang Mai, northern Thailand over a 5-year period (2010–2014). The overall prevalence of EV infection in this population was 5.8%, ranging from 0.9% in 2010 to 8.6% in 2014, with an apparent progressive increase. Although the low EV prevalence detected in 2010 might be explained by the limited number of specimens tested, the increase observed in
Acknowledgements
This work was supported by the Faculty of Medicine and the Center of Excellence (Emerging and Re-emerging Diarrheal Viruses Research Center) (Grant No. ST6392 (11)/1089), Chiang Mai University, Chiang Mai, Thailand.
Competing of interest
The authors declare that they have no conflict of interest.
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