Human Caliciviruses in Acute Gastroenteritis of Young Children in the Community

TLDR

Prospective surveillance of children aged 2 months to 2 years examined acute gastroenteritis episodes for rotavirus, adenovirus, astrovirus, and human caliciviruses (Norwalk‑like and Sapporo‑like) using PCR and RT‑PCR assays. In 832 episodes, viruses were detected in 60 % overall and 85 % of moderate‑to‑severe cases; human caliciviruses (29 %) matched rotavirus prevalence, with Norwalk‑like viruses accounting for 20 % of all cases and causing more severe disease than Sapporo‑like viruses (9 %), while astroviruses and adenoviruses were found in 10 % and 6 % respectively, underscoring that PCR/RT‑PCR markedly improves detection of these pathogens.

Abstract

Episodes of acute gastroenteritis in prospectively followed children between 2 months and 2 years of age were examined for rotaviruses, enteric adenoviruses, astroviruses, and human caliciviruses, including both Norwalk-like viruses (NLVs) and Sapporo-like viruses (SLVs), using PCR and reverse transcription (RT)—PCR assays. A virus was identified in 60% (502/832) of all episodes and in 85% of the moderately severe or severe episodes. Human caliciviruses were as common as rotaviruses, both being detected in 29% of the cases. NLVs accounted for a 20% etiologic share of all cases; the clinical picture was a moderately severe disease with vomiting as a predominant symptom. SLVs were detected in 9% of the cases, the clinical picture being a mild diarrheal disease. Astroviruses were found in 10% and enteric adenoviruses in 6% of the cases. Diagnosis with PCR and RT-PCR methods increases the detection of all gastroenteritis viruses, particularly human caliciviruses. As a group, human caliciviruses are common causative agents of gastroenteritis in children <2 years of age in Finland, and, of these, NLVs cause more severe disease than SLVs.