Multiple Norovirus Infections in a Birth Cohort in a Peruvian Periurban Community

作者：Mayuko Saito, Sonia Goel, Susan Espetia, Daniel E. Velásquez, Lilia Z. Cabrera, Sebastian Loli, Jean E. Crabtree, Robert E. Black, Margaret N. Kosek, William Checkley, Mirko Zimic, Caryn Bern, Vitaliano A. Cama, Robert H. Gilman, for the Norovirus Working Group in Peru, Lili Xiao, Dermot Kelleher, Henry J. Windle, Leen Jan Van Doorn, M. M. Morales-Suarez Varela, Manuela Verástegui, Maritza M. Calderon, A. Alva, Karisse Román · 发表于：Clinical Infectious Diseases · 年份：2013 · DOI：10.1093/cid/cit763 · 被引用次数：194 · 研究领域：Viral gastroenteritis research and epidemiology、Clostridium difficile and Clostridium perfringens research、Infant Nutrition and Health

BACKGROUND: Human noroviruses are among the most common enteropathogens globally, and are a leading cause of infant diarrhea in developing countries. However, data measuring the impact of norovirus at the community level are sparse. METHODS: We followed a birth cohort of children to estimate norovirus infection and diarrhea incidence in a Peruvian community. Stool samples from diarrheal episodes and randomly selected nondiarrheal samples were tested by polymerase chain reaction for norovirus genogroup and genotype. Excretion duration and rotavirus coinfection were evaluated in a subset of episodes. RESULTS: Two hundred twenty and 189 children were followed to 1 and 2 years of age, respectively. By 1 year, 80% (95% confidence interval [CI], 75%-85%) experienced at least 1 norovirus infection and by 2 years, 71% (95% CI, 65%-77%) had at least 1 episode of norovirus-associated diarrhea. Genogroup II (GII) infections were 3 times more frequent than genogroup 1 (GI) infections. Eighteen genotypes were found; GII genotype 4 accounted for 41%. Median excretion duration was 34.5 days for GII vs 8.5 days for GI infection (P = .0006). Repeat infections by the same genogroup were common, but repeat infections by the same genotype were rare. Mean length-for-age z score at 12 months was lower among children with prior norovirus infection compared to uninfected children (coefficient: -0.33 [95% CI, -.65 to -.01]; P = .04); the effect persisted at 24 months. CONCLUSIONS: Norovirus infection...