Comparison of Clinical Features of Norovirus and Rotavirus Gastroenteritis in Hospitalized Children and Norovirus Genotype Analysis

Joon Hwan Song; Dong Sin Sun; Joon Soo Park; Young Jin Choi; Hae Seon Nam; Yong Bae Kim; Eun Hye Jung; Kyung Ah Baek; Kwi Sung Park

doi:10.3947/ic.2010.42.3.143

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Song, Sun, Park, Choi, Nam, Kim, Jung, Baek, and Park: Comparison of Clinical Features of Norovirus and Rotavirus Gastroenteritis in Hospitalized Children and Norovirus Genotype Analysis

Original Article

Infection & Chemotherapy

Infection & Chemotherapy 2010; 42(3): 143-148.

Published online: 30 June 2010

DOI: https://doi.org/10.3947/ic.2010.42.3.143

Comparison of Clinical Features of Norovirus and Rotavirus Gastroenteritis in Hospitalized Children and Norovirus Genotype Analysis

Joon Hwan Song¹, Dong Sin Sun¹, Joon Soo Park¹, Young Jin Choi², Hae Seon Nam³, Yong Bae Kim⁴, Eun Hye Jung⁵, Kyung Ah Baek⁵, Kwi Sung Park⁵

¹Department of Pediatrics, College of Medicine, Soonchunhyang University, Cheonan, Korea.

²Department of Clinical Pathology, College of Medicine, Soonchunhyang University, Cheonan, Korea.

³Department of Parasitology, College of Medicine, Soonchunhyang University, Cheonan, Korea.

⁴Department of Preventive Medicine, College of Medicine, Soonchunhyang University, Cheonan, Korea.

⁵Chungcheongnam-Do Health and Environment Research Institute, Daejeon, Korea.

Corresponding author: Joon Soo Park, M.D., Ph.D. Department of Pediatrics, Soonchunhyang University Cheonan Hospital, 23-20, Bongmyung-dong, Cheonan 330-721, Korea. Tel: +82-41-570-2163, Fax: +82-41-572-4996, allergist@korea.com

Received 5 April 2009 Revised 8 March 2010 Accepted 9 March 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Norovirus is one of the most prevalent pathogens causing acute gastroenteritis in children. We compared the clinical features of noroviral gastroenteritis to those of rotaviral gastroenteritis and analyzed the noroviruses' genotype frequencies.

Materials and Methods

Stool samples were obtained form 433 children hospitalized with acute gastroenteritis from May 2008 through February 2009 at Soonchunhyang University Cheonan Hospital and examined for the presence of norovirus or rotavirus. We then analyzed the clinical features of noroviral gastroenteritis in comparison with rotaviral gastroenteritis and observed the capsid protein gene sequences from the isolated norovirus for genotyping.

Results

Norovirus was isolated from 69 patients (16.4%) and rotavirus from 49 patients (11.6%). The noroviral gastroenteritis patients experienced vomiting (77.4%), diarrhea (73.2%), and respiratory symptoms (53.6%); the rotaviral gastroenteritis patients experienced diarrhea (71.4%), dehydration (69.3%), and vomiting (65.3%). Dehydration in patients with noroviral gastroenteritis (43.4%) was rare compared with rotavirus (69.3%) (P=0.008). The isolated norovirus belonged primarily to the GII.4 genogroup (85.5%). Our phylogenetic analysis of the GII.4 isolates revealed 3 clusters, including novel cluster C.

Conclusions

Vomiting was the most common symptom in noroviral gastroenteritis patients. Dehydration in noroviral gastroenteritis patients was less common compared with rotavirus gastroenteritis patients. The majority of the norovirus strains isolated from children with acute gastroenteritis belonged to the GII.4 genogroup.

Keywords: Norovirus, Rotavirus, Gastroenteritis, Child

Figures and Tables

Figure 1

Comparison of clinical features of children hospitalized with acute gastroenteritis due to norovirus with rotavirus in Cheonan from May 2008 through February 2009.

Figure 2

Comparison of monthly detection rate of norovirus and rotavirus from children hospitalized with acute gastroenteritis in Cheonan from May 2008 through February 2009.

Figure 3

Phylogenetic analysis of SCH (SoonChunHyang) isolates and reference strains of Norovirus GII.4. Nucleotide sequences encoding the capsid were analyzed by the Neighbor-Joining methods and the trees were constructed using MEGA, version 4.0, software package. SCH strains are identified as SCH-month of isolation-the isolate number. The reference strains include for the comparison are: Lordsdale/1995/UK (X86557), Kobe034/2006/JP (AB291542), Farmington Hills/2002/USA (AY502203), Oxford/B5S13/2002/UK (AY588018), Sydney532D/04O/AU (DQ078801), Brynhaven/2003/UK (DQ676862), DenHaag54/2006/NL (EF126962), Yerseke38/2006/NL (EF126963), PA129R-/2004/IT (EU876865), PA15R-/2002/IT (EU876872), PA2/2005/IT (EU876877), PA173/2006/IT (FJ025876).

Table 1

Comparison of Demographic and Clinical Features of Children Hospitalized with Acute Gastroenteritis Due to Norovirus with Rotavirus in Cheonan from May 2008 through February 2009

AGE, acute gastroenteritis; No., number; SD, standard deviation; mon, month; yr, year

Table 2

Comparison of Symptoms of Children Hospitalized with Acute Gastroenteritis due to Norovirus with Rotavirus in Cheonan from May 2008 through February 2009

AGE, acute gastroenteritis; No., number

Table 3

Comparison of Laboratory Findings of Children Hospitalized with Acute Gastroenteritis due to Norovirus with Rotavirus in Cheonan from May 2008 through February 2009

AGE, acute gastroenteritis; No., number of patients; AST, Aspartate transaminase; ALT, Alanine transaminase; WBC, white blood cell

Table 4

Genotype Prevalance of Norovirus Strains isolated from Children hospitalized with Acute Gastroenteritis in Cheonan from May 2008 through February 2009

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