Enterovirus-related diarrhoea in Guangdong, China: clinical features and implications in hand, foot and mouth disease and herpangina
BACKGROUND Viral gastroenteritis has been recognized as one of the most common illnesses that affects infants and young children all over the world. A wide variety of viruses associated with the disease are continually being reported. To investigate the epidemiological situation of diarrhea virus infection in Chiang Mai, Thailand, surveillance was conducted during January to December 2007. METHODS A total of 160 fecal specimens collected from pediatric patients admitted to the hospital with acute gastroenteritis were tested for the presence of group A, B, and C rotaviruses, norovirus, sapovirus, astrovirus, adenovirus, Aichi virus, enterovirus, bocavirus, and human parechovirus by RT-multiplex PCR. RESULTS Of 160 fecal specimens tested, 85 (53.1%) were positive for diarrhea viruses. Of these, group A rotavirus was the predominant with a prevalence of 27.5%, followed by norovirus GII (11.9%), sapovirus (3.1%), enterovirus (2.5%), human parechovirus (1.9%), and norovirus GI, astrovirus, adenovirus (each 0.6%). Mixed-infections of 2 or 3 viruses were observed in 7 (4.4%) patients. However, none of groups B and C rotaviruses and Aichi virus were detected in this study. Monthly distribution analysis revealed that all those diarrhea viruses were detected continually throughout the year at a low level of infection except for group A rotavirus and norovirus infections which appeared to peak in a cool season in January-March and December, respectively. CONCLUSIONS This surveillance revealed a wide variety of diarrhea viruses currently circulating in pediatric patients with acute gastroenteritis in Chiang Mai, Thailand.