Molecular epidemiology of enteric viruses in children with sporadic gastroenteritis in Valencia, Venezuela.

The epidemiology and clinical symptoms in infants and young children with acute sporadic viral gastroenteritis due to viral etiologies other than rotaviruses have not been studied thoroughly in developing countries. Fecal specimens from 480 children <5 years of age who were admitted to a large children's hospital in the city of Valencia, Venezuela, with acute diarrhea during January to December 2003 were collected and screened by ELISA and RT-PCR for rotavirus, adenovirus, norovirus, sapovirus, and astrovirus. Viral isolates were partially characterized by phylogenetic analysis. Norovirus viral load was determined by qRT-PCR. Viruses were identified in 205 (43%) of the 480 stool samples collected. Rotavirus was the virus detected most frequently (21%), followed by norovirus (13%), adenovirus (5%), sapovirus (3%), and astrovirus (2%). Viral infection rates were highest in the 6- to 11-month-old group (49%) and lowest in children >24 months old. Norovirus GII was more prevalent (90%) than GI (10%). Enteric adenovirus (serotypes 40/41) was present in 43% of the adenovirus-positive samples. Rotavirus infection caused more severe clinical symptoms than the other viruses detected, with more vomiting (84%) and dehydration (11%) that led to hospital admission of 20% of the children with acute gastroenteritis. Rotavirus and norovirus showed marked and opposite seasonal patterns. No association was observed between disease severity and viral load in children infected with norovirus. These results not only confirm the impact of rotavirus infection in Venezuela but also indicate that other enteric viruses, especially noroviruses, contribute significantly to sporadic acute gastroenteritis and to the burden of disease.