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Recurrence of Norovirus Gastroenteritis in children less than 3 years of age

Posted:  Monday, August 01, 2016

Gastroenteritis due to Norovirus is common in children less than 3 years of age

Gastroenteritis in children is commonly caused by norovirus. Common signs and symptoms of norovirus gastroenteritis are diarrhoea and vomiting. Information on norovirus infection and re-infection is lacking. A study published in the journal Plos One investigated the occurrence of norovirus gastroenteritis; re-infection by norovirus genogroups GI and GII; and genetic susceptibility to norovirus in children less than 3 years of age.

The birth cohort study enrolled 373 children who were followed-up for 3 years, to study the recurrence of diarrhoea episodes. For the study, faecal samples from 1856 diarrhoeal episodes and 147 vomiting-only episodes were collected and screened for the presence of norovirus.

Among the 373 children, 149 children had 207 episodes of diarrhoea associated with norovirus infection. Norovirus GI and GII were detected in 49 and 150 diarrhoeal episodes, respectively. Mixed infection by both norovirus GI and GII was detected in 8 diarrhoeal episodes. In 147 stool samples collected from 155 vomiting-only episodes, norovirus GI was detected in 7 samples and GII was detected in 23 samples. Mixed infections were not detected in these samples.

The first episode of diarrhoea caused by norovirus GI and GII occurred at an average age of 5 and 8 months, respectively. A higher rate of re-infection was observed in children with norovirus GII than norovirus GI. The occurrence of norovirus diarrhoea was higher in 1st year of life compared to 2nd or 3rd year of life. The duration of breastfeeding or household hygiene did not have any effect on the rate or severity of diarrhoea in children. A higher proportion of stunted and wasted children had multiple norovirus infections. Norovirus GI or GII infection was not associated with the ABO blood group. Outbreaks of norovirus diarrhoea in children occurred throughout the year, with a slight increase in incidence during the summer season.

This was the first report documenting norovirus disease, re-infection, and genetic susceptibility in an Asian population. The findings of the study indicate that norovirus gastroenteritis is common in children from southern India. Re-infection was also commonly reported in children infected with norovirus. Further research is required to assess the rate of infection and to the assess protective effect of prior infections on subsequent diarrhoea episodes.

News source - Menon VK, George S, Sarkar R, Giri S, Samuel P, Vivek R, Saravanabavan A, Liakath FB, Ramani S, Iturriza-Gomara M, Gray JJ. Norovirus Gastroenteritis in a Birth Cohort in Southern India. PloS one. 2016 Jun 10; 11(6):e0157007.