Non-polio enterovirus association with persistent diarrhea in children as revealed by a follow-up study of an Indian cohort during the first two years of life

Abstract Background We recently reported significant association of non-polio enteroviruses (NPEVs) with acute diarrhea in children. Persistent diarrhea (PD) remains a major cause of morbidity and mortality in infants below two years of age in developing countries. Understanding age-dependent freque...

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Bibliographic Details
Published in:Journal of clinical virology 2014-09, Vol.61 (1), p.125-131
Main Authors: Rao, Durga C, Reddy, Harikrishna, Sudheendra, K, Raghavendra, A, Varadharaj, Vembuli, Edula, Surekha, Goparaju, Ramya, Ratnakar, Bharath, Srinivasa Rao, Arni S.R, Maiya, Padmanabha P, Ananda Babu, M
Format: Article
Language:English
Subjects:
Acute diarrhea
Allergy and Immunology
Child, Preschool
Cohort Studies
Diarrhea - virology
Enterovirus
Enterovirus (EV)
Enterovirus Infections - virology
Feces - virology
Female
Follow-Up Studies
Humans
India
Infant
Infant, Newborn
Infectious Disease
Male
Molecular Sequence Data
Non-polio enterovirus (NPEV)
Persistent diarrhea (PD)
Reverse Transcriptase Polymerase Chain Reaction
RNA, Viral - genetics
Rotavirus
Sequence Analysis, DNA
Viral Structural Proteins - genetics
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Summary:Abstract Background We recently reported significant association of non-polio enteroviruses (NPEVs) with acute diarrhea in children. Persistent diarrhea (PD) remains a major cause of morbidity and mortality in infants below two years of age in developing countries. Understanding age-dependent frequency and duration of NPEV infections is important to determine their association with persistent diarrhea and disease burden. Objectives A cohort of 140 infants was followed for 6 months to 2 years of age to determine the frequency, duration, and association with PD of NPEV infections in comparison with rotavirus and other agents. Study design Stool samples were collected every 14 days, and diarrheal episodes and their duration were recorded. Enteroviruses were characterized by RT-PCR and VP1 gene sequence analysis, rotavirus by electropherotyping, and other agents by PCR. Results Of 4545 samples, negative for oral polio vaccine strains, 3907 (85.96%) and 638 (14.04%) were NPEV-negative and NPEV-positive, respectively, representing 403 (8.87%) infection episodes. About 68% of NPEV infections occurred during the first year with every child having at least one episode lasting between four days and four months. Approximately 38% and 22% of total diarrheal episodes were positive for NPEV and RV, respectively. While about 18% of NPEV infection episodes were associated with diarrhea, 6% being persistent, 13% of total diarrheal episodes were persistent involving infections by monotype NPEV strains or sequential infections by multiple strains and other agents. Conclusions This is the first report revealing NPEVs as the single most frequently and persistently detected viral pathogen in every PD episode.
ISSN:1386-6532
1873-5967
DOI:10.1016/j.jcv.2014.05.015