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

Durga C. Rao, Harikrishna Reddy, K. Sudheendra, A. Raghavendra, Vembuli Varadharaj, Surekha Edula, Ramya Goparaju, Bharath Ratnakar, Arni S.R. Srinivasa Rao, Padmanabha P. Maiya, M. Ananda Babu

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)125-131
Number of pages7
JournalJournal of Clinical Virology
Volume61
Issue number1
DOIs
StatePublished - Sep 2014

Fingerprint

Enterovirus
Diarrhea
Enterovirus Infections
Rotavirus
Infection
Polymerase Chain Reaction
Infant Mortality
Poliomyelitis
Developing Countries
Sequence Analysis
Vaccines
Morbidity
Genes

Keywords

  • Acute diarrhea
  • Enterovirus (EV)
  • Non-polio enterovirus (NPEV)
  • Persistent diarrhea (PD)
  • Rotavirus

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

Cite this

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. / 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.

In: Journal of Clinical Virology, Vol. 61, No. 1, 09.2014, p. 125-131.

Research output: Contribution to journalArticle

Rao, DC, Reddy, H, Sudheendra, K, Raghavendra, A, Varadharaj, V, Edula, S, Goparaju, R, Ratnakar, B, Srinivasa Rao, ASR, Maiya, PP & Ananda Babu, M 2014, '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', Journal of Clinical Virology, vol. 61, no. 1, pp. 125-131. https://doi.org/10.1016/j.jcv.2014.05.015
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. / 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. In: Journal of Clinical Virology. 2014 ; Vol. 61, No. 1. pp. 125-131.
@article{5405849988814b1ea9a32c22d6631273,
title = "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 = "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.",
keywords = "Acute diarrhea, Enterovirus (EV), Non-polio enterovirus (NPEV), Persistent diarrhea (PD), Rotavirus",
author = "Rao, {Durga C.} and Harikrishna Reddy and K. Sudheendra and A. Raghavendra and Vembuli Varadharaj and Surekha Edula and Ramya Goparaju and Bharath Ratnakar and {Srinivasa Rao}, {Arni S.R.} and Maiya, {Padmanabha P.} and {Ananda Babu}, M.",
year = "2014",
month = "9",
doi = "10.1016/j.jcv.2014.05.015",
language = "English (US)",
volume = "61",
pages = "125--131",
journal = "Journal of Clinical Virology",
issn = "1386-6532",
publisher = "Elsevier",
number = "1",

}

TY - JOUR

T1 - 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

AU - Rao, Durga C.

AU - Reddy, Harikrishna

AU - Sudheendra, K.

AU - Raghavendra, A.

AU - Varadharaj, Vembuli

AU - Edula, Surekha

AU - Goparaju, Ramya

AU - Ratnakar, Bharath

AU - Srinivasa Rao, Arni S.R.

AU - Maiya, Padmanabha P.

AU - Ananda Babu, M.

PY - 2014/9

Y1 - 2014/9

N2 - 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.

AB - 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.

KW - Acute diarrhea

KW - Enterovirus (EV)

KW - Non-polio enterovirus (NPEV)

KW - Persistent diarrhea (PD)

KW - Rotavirus

UR - http://www.scopus.com/inward/record.url?scp=84905083394&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84905083394&partnerID=8YFLogxK

U2 - 10.1016/j.jcv.2014.05.015

DO - 10.1016/j.jcv.2014.05.015

M3 - Article

C2 - 24954472

AN - SCOPUS:84905083394

VL - 61

SP - 125

EP - 131

JO - Journal of Clinical Virology

JF - Journal of Clinical Virology

SN - 1386-6532

IS - 1

ER -