Epidemiology And Clinical Characters Of Group A Rotavirus Diarrhea In Suzhou

Objective To study the clinical epidemiological characters of rotavirus diarrhea among children under 5 years in Suzhou to provide basic information for putting into using the vaccine of rotavirus and for effective controlling the incidence of rotavirus diarrhea in the future.Methods We investigated the diarrhea infants and young children under 5 years in Suzhou Children's Hospital from Sep. 2001 to Jan. 2003, filled the questionary informs and collected stool specimens. Enzyme Linked Immune-absorbent Assay (ELISA) was used to detect rotavirus double stranded RNA (dsRNA). Serotypes of rotavirus strains were identified with ELISA of serotype-specific monoclonal antibody and/or a nested reverse transcription-polymerase chain reaction (RT-PCR) of serotype-specific primers. All data were computerized and analysed by Foxpro+ and SAS.Results During the 17 months of study period, 512 (43.32%) were positive for rotavirus in 1182 fecal specimens were selected. The peak season for rotavirus diarrhea was from Nov. to Jan. of the next year in Suzhou. The youngest infant with rotavirus diarrhea was only 8 days newborn and the number of 4-24 months was 91.01% in all children with rotavirus diarrhea. Male and female ratio was 1.78:1. The most prevalent rotavirus G serotype was G3 (53.7%), followed by Gl (20.3%), G2 (4.5%), G9 (1.0%) and G4 (0.6%). Two P genotypes (P[8], P[4] ) were identified. P4 (61.8%) was the most common serotype, and P[8] was 19.1%, 8.2% was mixed rotavirusinfection of P[4] & P[8]. P[6], P[9] and P[10] were not detected. 12 different P/G combinations were identified. P[4]G3 (30.9%) was the dominant strain. The four common worldwide strains (P[8]G1, P[4]G2, P[8]G3 and P[8]G4) were detected merely for 25.7% of the total. Rotavirus led to more watery stool, vomiting, dehydration, upper respiration infection and injury of liver function. There was no relationship between different G-serotypes and severe diarrhea. 96.3% patients with severe rotavirus diarrhea were from 7 to24 months' infants. Non-lactose formalu and injection of interferon were effective for shorting the illness time.Conclusion Rotavirus was one of the most important pathogens for diarrhea in infants and young children in Suzhou. The epidemiology was similar to that of other regions in the world, but rotavirus serotype G3 and genetype P[4] were prevalent strains in Suzhou. It was uncommon and different from the predominant G1 and P[8] in other places throughout China. The dehydration, upper respiration infection and injury of liver function were the most clinical manifestation. But, there was no relationship between severe rotavirus diarrhea and different G-serotypes. Non-lactose formalu was the best food and interferon had a definite therapeutic effectiveness for these infants and young children with rotavirus diarrhea.