Pediatric Norovirus Gastroenteritis in Ireland: Seasonal Trends, Correlation with Disease Severity, Nosocomial Acquisiti
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ORIGINAL ARTICLE
Pediatric Norovirus Gastroenteritis in Ireland: Seasonal Trends, Correlation with Disease Severity, Nosocomial Acquisition and Viral Co-Infection Zakaria Barsoum 1 Received: 27 March 2020 / Accepted: 7 October 2020 # Dr. K C Chaudhuri Foundation 2020
Abstract Objectives To determine norovirus frequency, seasonal trends, disease severity and nosocomial acquisition in a region of Ireland. Methods From November 18th 2016 to November 18th 2017, all children up to 3 y of age who presented to Mayo University Hospital with vomiting and diarrhea, had their stool tested for norovirus and other viruses. Each week of the year was studied in relation to the total number of stool samples requested for norovirus testing, the number of positive stool samples, the calculated median of positive stool samples in two consecutive weeks and their calculated median percentage of positive stool samples in each two consecutive week period. Results During the study period, norovirus was the third leading cause of gastroenteritis (12%), norovirus G2 was the predominant strain; 61% were male; 56% older than 1 y, 78% of cases were severe. No nosocomial disease was detected. The fifth week of January was the week peak. Viral Co- infection was confirmed in four cases of which astrovirus was confirmed in two cases. Three seasons of norovirus gastroenteritis and four short episodes of norovirus infection were noted during 2016/2017. Conclusions Norovirus is a predominant cause of gastroenteritis. Co- infection with other viruses, mainly astrovirus may occur. Norovirus infections occur throughout the year with a peak in winter. Keywords Pediatric . Health services . Gastroenteritis (GE) . Norovirus (NoroV)
Introduction Noroviruses were first identified as viral causes of gastroenteritis (GE) in an outbreak in Norwalk, Ohio, and were previously referred to as the Norwalk-like viruses [1]. Caliciviruses contain a single-stranded RNA genome and have a relatively simple structure, containing one major (VP1) and one minor (VP2) capsid protein [2]. Noroviruses are subdivided into at least seven genogroups based upon sequence homology [3, 4]. Genogroups GI, GII, and GIV include human pathogens, and multiple genotypes are recognized within each genogroup [4]. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12098-020-03540-4) contains supplementary material, which is available to authorized users. * Zakaria Barsoum [email protected] 1
Department of Pediatrics, South West Acute Hospital, Enniskillen, Northern Ireland
Most epidemics of norovirus (NoroV) infection globally have been associated, until recently, with the emergence of novel genotype II.4 strains; these viruses have been associated with higher hospitalization and death rates than other NoroV genotypes, as would be expected from an emerging strain [5–9]. Two GII.4 variants were responsible for outbreaks of GE in Australia and New Zealand from 2005 to 2006, subsequently, one of these strains was also linked to approximately
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