Significantly Longer Shedding of Norovirus Compared to Rotavirus and Adenovirus in Children with Acute Gastroenteritis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Study Objective and Outcome Measures
2.3. Specimen Collection
2.4. Detection of Gastroenteritis Viruses
2.5. Virus Quantification
2.6. Statistical Analysis
3. Results
3.1. Norovirus Shedding in Stool Samples
3.2. Rotavirus Shedding in Stool Samples
3.3. Adenovirus Shedding in Stool Samples
3.4. Comparison of Viral Load and Detection Rate among the Three Viruses
3.5. Co-Infection of Mixed Viruses in Children with AGE
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Adenovirus | Norovirus | Rotavirus | |
---|---|---|---|
Day 0, Day 5, and Day 28 serial stool samples, n | 66 | 129 | 54 |
Day 0 and Day 5 serial stool samples, n | 40 | 58 | 62 |
Day 5 and Day 28 serial stool samples, n | 0 | 14 | 6 |
Total stool samples, n | 106 | 201 | 122 |
Total children, n | 42 | 79 | 52 |
Viral Load (Log GE Copies/g Stool) | Serial Samples | Serial Samples | Serial Samples | |||||
---|---|---|---|---|---|---|---|---|
Day 0 | Day 5 | Day 28 | Day 0 | Day 5 | Day 5 | Day 28 | ||
Adenovirus | Median (range) | 11.7 (5.3–13.3) | 8.1 (4.4–11.8) | 0 (0–8.2) | 12.3 (4.3–13.3) | 9.0 (0–12.0) | N/A | |
Norovirus | Median (range) | 9.9 (0–10.8) | 9.6 (0–10.6) | 5.1 (0–7.6) | 9.9 (5.5–10.8) | 9.5 (0–10.3) | 10.3 (9.6–11.2) | 5.2 (0–7.3) |
Rotavirus | Median (range) | 12.3 (0–13.4) | 9.5 (6.1–12.5) | 3.3 (0–5.6) | 12.3 (6.2–13.9) | 8.5 (0–13.1) | 5.1 (4.6–5.9) | 0 (0–3.8) |
Baseline Viral Load | Day 5 | Day 28 | ||||
---|---|---|---|---|---|---|
Adjusted Mean Difference of Log 10 Copies of Viral Load (95%CI) | P | Adjusted Mean Difference of Log 10 Copies of Viral Load (95%CI) | P | Adjusted Mean Difference of Log 10 Copies of Viral Load (95%CI) | P | |
Virus infected | Overall significance <0.0001 | Overall significance <0.0001 | Overall significance <0.0001 | |||
Rotavirus | 1.77 (0.86, 2.68) | <0.0005 | −0.93 (−1.65, −0.22) | <0.05 | −2.59 (−4.06, −1.13) | <0.001 |
Adenovirus | 1.84 (0.95, 2.73) | <0.0001 | −1.53 (−2.25, −0.8) | <0.0001 | −4.28 (−5.6, −2.95) | <0.0001 |
Norovirus | reference | reference | reference | |||
Age (per 1 month older) | −0.01 (−0.05, 0.02) | 0.417 | −0.006 (−0.03, 0.02) | 0.640 | −0.09 (−0.14, −0.03) | <0.005 |
Baseline duration of illness (per 1 hour greater) | −0.001 (−0.02, 0.02) | 0.912 | −0.024 (−0.04, −0.01) | <0.005 | −0.001 (−0.03, 0.03) | 0.955 |
Baseline MVS score (per 1 score greater) | 0.23 (0.02, 0.43) | 0.029 | 0.11 (−0.04, 0.27) | 0.159 | 0.22 (−0.08, 0.52) | 0.160 |
Baseline viral load (per 1 unit in log copies greater) | N/A | N/A | 0.46 (0.34, 0.58) | <0.0001 | 0.41 (0.12, 0.7) | <0.01 |
Virus Detected | Viral Load (Log GE Copies/g Stool) | ||||||||
---|---|---|---|---|---|---|---|---|---|
Adenovirus | Rotavirus | Norovirus | |||||||
Day 0 | Day 5 | Day 28 | Day 0 | Day 5 | Day 28 | Day 0 | Day 5 | Day 28 | |
Patient 1 | 13.2 | 11.5 | - | 6.6 | 0 | - | - | - | - |
Patient 2 | 13.3 | 10.4 | - | 10.3 | 13 | - | - | - | - |
Patient 3 | 5.6 | 6.1 | 0 | 12.9 | 12.5 | 4.4 | - | - | - |
Patient 4 | 6.2 | 5.0 | 0 | 12.3 | 11.1 | 0 | - | - | - |
Patient 5 | - | - | - | 13.1 | 11.4 | - | 5.5 | 0 | - |
Patient 6 | - | - | - | 12.7 | 6.4 | - | 6.5 | 0 | - |
Patient 7 | - | - | - | 12.9 | 7.9 | 4.1 | 6.6 | 6.3 | 0 |
Patient 8 | - | - | - | 0 | 11.8 | 5.6 | 10.3 | 0 | 0 |
Patient 9 | 4.3 | 5.2 | - | - | - | - | 10.8 | 9.1 | - |
Patient 10 | 5.6 | 0 | - | - | - | - | 9.5 | 10.2 | - |
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Qiu, Y.; Freedman, S.B.; Williamson-Urquhart, S.; Farion, K.J.; Gouin, S.; Poonai, N.; Schuh, S.; Finkelstein, Y.; Xie, J.; Lee, B.E.; et al. Significantly Longer Shedding of Norovirus Compared to Rotavirus and Adenovirus in Children with Acute Gastroenteritis. Viruses 2023, 15, 1541. https://doi.org/10.3390/v15071541
Qiu Y, Freedman SB, Williamson-Urquhart S, Farion KJ, Gouin S, Poonai N, Schuh S, Finkelstein Y, Xie J, Lee BE, et al. Significantly Longer Shedding of Norovirus Compared to Rotavirus and Adenovirus in Children with Acute Gastroenteritis. Viruses. 2023; 15(7):1541. https://doi.org/10.3390/v15071541
Chicago/Turabian StyleQiu, Yuanyuan, Stephen B. Freedman, Sarah Williamson-Urquhart, Ken J. Farion, Serge Gouin, Naveen Poonai, Suzanne Schuh, Yaron Finkelstein, Jianling Xie, Bonita E. Lee, and et al. 2023. "Significantly Longer Shedding of Norovirus Compared to Rotavirus and Adenovirus in Children with Acute Gastroenteritis" Viruses 15, no. 7: 1541. https://doi.org/10.3390/v15071541
APA StyleQiu, Y., Freedman, S. B., Williamson-Urquhart, S., Farion, K. J., Gouin, S., Poonai, N., Schuh, S., Finkelstein, Y., Xie, J., Lee, B. E., Chui, L., Pang, X., & on behalf of the Pediatric Emergency Research Canada Probiotic Regimen for Outpatient Gastroenteritis Utility of Treatment (PROGUT) Trial Group. (2023). Significantly Longer Shedding of Norovirus Compared to Rotavirus and Adenovirus in Children with Acute Gastroenteritis. Viruses, 15(7), 1541. https://doi.org/10.3390/v15071541