Molecular epidemiology of human bocavirus infection in hospitalized children with acute gastroenteritis in South Africa, 2009-2015

Molecular characterization of human bocavirus in municipal wastewaters using amplicon target sequencing

Human bocavirus (HBoV) is an emerging health concern worldwide, associated with range of clinical manifestations, including gastroenteritis and respiratory infections. Therefore, it is crucial to comprehend and minimize their prevalence in different systems. In this study, we conducted regular sampling throughout the year in two different sizes and work processes of wastewater treatment plants (WWTPs) in Tianjin, China. Our objective was to investigate the occurrence, prevalence, and endurance of HBoV in wastewater, while also evaluating the efficacy of amplicon target sequencing in directly detecting HBoV in wastewater. At two WWTPs, HBoV2 (45.51 %-45.67 %) and HBoV3 (38.30 %-40.25 %) were the most common genotypes identified, and the mean concentration range of HBoV was 2.54-7.40 log10 equivalent copies/l as determined by multiplex real-time quantitative PCR assay. A positive rate of HBoV was found in 96.6 % (29/30) samples of A-WWTP, and 96.6 % (26/27) samples of B-WWTP. The phylogenetic analysis indicated that the nucleotide similarity between the HBoV DNA sequences to the reference HBoV sequences published globally ranged from 90.14 %-100 %. A significant variation in the read abundance of HBoV2 and HBoV3 in two wastewater treatment plants (p < 0.05) was detected, specifically in the Winter and Summer seasons. The findings revealed a strong correlation between the genotypes detected in wastewater and the clinical data across various regions in China. In addition, it is worth mentioning that HBoV4 was exclusively detected in wastewater and not found in the clinical samples from patients. This study highlights the high prevalence of human bocavirus in municipal wastewater. This finding illustrates that amplicon target sequencing can amplify a wide variety of viruses, enabling the identification of newly discovered viruses.

Prevalence, molecular characterization, and clinical features of human bocavirus in children under 5 years of age with acute gastroenteritis admitted to a specialized children's hospital in Iran: A cross-sectional study

Background and Aims

Although some reports have confirmed the role of human bocavirus (HBoV) in respiratory infections, the importance of this virus in causing acute gastroenteritis has not yet been proven. This study aimed to determine the molecular prevalence of HBoV in children under 5 years old with gastroenteritis and to compare the clinical symptoms of HBoV-positive and -negative gastroenteritis cases.

Methods

A total of 100 stool samples were collected from children with gastroenteritis hospitalized in a pediatric hospital in Tehran, Iran. Demographic and clinical data were collected from patients' medical records. Viral genomic DNA was extracted from stool samples and amplified using the PCR assay. Finally, sequencing was used to determine the genotype of HBoV.

Results

The HBoV genome was detected in 14 samples (14%). The highest prevalence of HBoV was observed in the age range of 24-60 months (n = 5; 35.7%); However, no statistically significant relationship was observed between the prevalence of HBoV and age groups (p = 0.09). Nine (64.3%) and 5 (35.7%) HBoV-positive cases were boys and girls, respectively (p = 0.45). Fever, vomiting, and heartache were seen in 5 (35.7%), 3 (21.4%), and 1 (7.1%) HBoV-positive patients, respectively. Overall, no significant difference was observed in any of the investigated clinical manifestations between patients positive or negative for HBoV. Five HBoV-positive samples were subjected to sequencing and all five sequenced samples were genotype 3.

Conclusion

HBoV infections can be considered a risk factor for causing at least a portion of acute gastroenteritis cases in children under 5 years of age.

Epidemiologic and clinical characteristics of human bocavirus infection in children hospitalized for acute respiratory tract infection in Qingdao, China

Persistent infection and prolonged shedding of human bocavirus 1 (HBoV1) in children have been reported, and the role of HBoV1 as a sole causative pathogen in acute respiratory infection (ARI) is yet to be established. While the reported prevalence of HBoV infection varies due to different detection methods and sampling criteria, determining the viral and bacterial etiology of HBoV infection using multiplex real-time PCR is yet to be reported. Herein, we aimed to further explore the pathogenicity of HBoV in patients with ARI by screening the viral and bacterial infections in children with ARI in Qingdao and comparing the epidemiological, clinical characteristics, and etiological results. Human bocavirus was identified in 28.1% of the samples, and further sequencing analysis of the detected HBoV confirmed 96.4% as HBoV1. The rate of HBoV as a single viral infection was 75%, and the rate of coinfection with bacteria was 66.1%, suggesting the need for continued monitoring of HBoV in children with ARIs. Clinical characterization suggested that HBoV infection may affect the function of organs, such as the liver, kidney, and heart, and the blood acid–base balance. Additionally, it is essential to promote awareness about the importance of disinfection and sterilization of the hospital environment and standardizing operations. The interactions between HBoV and other pathogens remain to be investigated in further detail in the future.

Molecular characterization of human bocavirus in recycled water and sewage sludge in Thailand

The study aimed to assess the presence and molecular characterization of human bocavirus (HBoV) in recycled water and sewage sludge samples in Thailand. One hundred and two recycled water and eighty-six sewage sludge samples collected from a wastewater treatment plant were tested for the presence of HBoV using nested PCR with broad-range primer pairs targeting the capsid proteins VP1 and VP2. HBoV DNA was detected in recycled water of 9/102 (8.8%) samples and sewage sludge of 27/86 (31.4%) samples. Based on DNA sequencing and phylogenetic analysis, the HBoV DNA sequences had 98.8-100.0% nucleotide identity to the sequences from HBoV reported globally. Thirty-five HBoV-positive samples were identified to genotypes as the predominant HBoV2; 26 followed by HBoV3; 8 and the rare HBoV4; 1 sample. Concerning recycled water, HBoV2 was detected in 3 (2.9%) and HBoV3 was detected in 5 (4.9%) of all samples. The sewage sludge samples were characterized as HBoV2 in 23 (26.7%), HBoV3 in 3 (3.5%) and HBoV4 in 1 (1.2%) of all samples. The frequency of HBoV detected in recycled water and sewage sludge samples significantly differed in sample type (p-value = 0.007). The findings of three HBoV genotypes in recycled water and sewage sludge emphasized the circulation of the virus in the environment and the potential source of transmission to the community.

Polymerase Chain Reaction Study of Human Bocavirus in Children with Acute Gastroenteritis

Aim:

The present study aimed to detect Human bocavirus (HBoV) in stool samples from young children below 5 years complaining of acute gastroenteritis (GE) in addition to detection of rotavirus, norovirus, and astrovirus.

Methods:

The study included 90 children below 5 years with acute GE with excluded bacterial pathogens. The determination of the presence of HBoV was performed by nested polymerase chain reaction (PCR) beside determination of astrovirus and norovirus by multiplex PCR and rotavirus antigen by enzyme-linked immunosorbent assay (ELISA).

Results:

The most prevalent virus among the studied viruses was rotavirus (33.3%) detected by ELISA for antigen in the stool. The other three viruses detected by molecular methods were bocavirus (14.4%), astrovirus (13.3%), and norovirus (10%). Mixed viral infection with two or more viruses was detected in 16 children (17.8%). The most common was bocavirus and rotavirus in 6 patients (37.5%). In the study of demographic and clinical presentations of the children with HBoV, the affected children were mainly females, i.e., 10 (76.9%), from rural residence i.e., 11 (84.6%) with the mild classification of GE in 7 children (53.8%) and moderate GE in 6 children (46.2%) and none of them had severe GE. Fever was the most common presenting sign in those children (53.8%) followed by vomiting (46.2%).

Conclusion:

The study highlights the existence of HBoV in children with acute GE under the age of five. The infection associated with this virus was either mild or moderate in severity. The combined viral infection was common especially associated with rotavirus. There is a need for further additional study to identify the type of the circulated strain of bocavirus and the confections with other pathogens.

Etiology of diarrheal disease among children under 5 years in Egypt: a high incidence of human bocavirus

BACKGROUND

Human bocavirus (HBoV) is globally distributed and associated with respiratory and enteric infections. Limited data are available about the incidence of HBoV in Egyptian children. We aimed to investigate the association of HBoV genotypes in children with diarrheal disease and also to determine the possibility of HBoV co-infections with other human enteric pathogens.

METHODS

A total of 102 stool samples were collected from children under five years old with diarrhea. Samples were analyzed for the presence of HBoV by real-time PCR. HBoV positive samples were tested for adenovirus (AdV), rotavirus (RoV), parasitic helminths, and enteric protozoa.

RESULTS

HBoV was detected in 58% of examined cases. HBoV-3 was the most prevalent genotype observed (44%; 45 of 102), followed by HBoV-2/4 (33%; 34 of 102) and HBoV-1 (30%; 31 of 102). Although the incidence of HBoV was higher in males (66.6%; 34 of 51) than females (49%; 25 of 51), the analysis showed no significant difference for HBoV between genders. The average HBoV concentrations were 5.3 × 10⁴ GC/g in males and 1.03 × 10⁵ GC/g in females. Among the HBoV-positive samples, the single infection of HBoV was 52.5% (31/59), while the co-infections with multiple viruses were found in 1.7% (1/59) for HBoV and AdV, 33.9% (20/59) for HBoV and RoV, and 11.9% (7/59) for HBoV, and RoV and AdV. No co-infection with parasitic helminths or enteric protozoa was found.

CONCLUSIONS

The single infection of HBoV in some children suffering from acute gastroenteritis indicated that HBoV could be the main etiologic agent of the disease. The study highlights the high incidence of HBoVs genotypes with remarkable multiple co-infections in the pre-school children in Egypt.

Human bocavirus genotypes 1, 2, and 3 circulating in pediatric patients with acute gastroenteritis in Chiang Mai, Thailand, 2012-2018

BACKGROUND

Global distribution of human bocavirus (HBoV) has been known to associate with viral gastroenteritis in pediatric population. This study was conducted in Chiang Mai, Thailand from 2012 to 2018 to investigate epidemiology and genotype distribution of HBoV in pediatric patients less than 5 years old hospitalized with diarrhea.

METHODS

A total of 2727 fecal specimens were investigated for the presence of HBoV using nested-PCR targeting partial VP1 capsid region. The detected HBoV strains were further characterized by nucleotide sequencing and phylogenetic analysis.

RESULTS

Detection rate of HBoV infection in pediatric patients with acute diarrhea was 5.2%. Three genotypes of HBoV were detected with the most predominance of HBoV1 (50.4%), followed by HBoV2 (42.5%), and HBoV3 (7.1%). The majority of HBoV positive cases were children of 1 to <2 years old (31.9%) with high detection rate of HBoV1 and HBoV2. HBoV infection occurred all year-round. Phylogenetic analysis revealed that majority of HBoV1 displayed the genetic relationship with HBoV1 strains reported previously from Asia whereas only a few were related to the strains from Europe, South America, and Middle East. The HBoV2 and HBoV3 were also mainly closely related to the strains reported from Asia and a few from South America and North Africa.

CONCLUSIONS

This study highlights distribution of HBoV genotypes circulating in pediatric patients with acute gastroenteritis in Chiang Mai, Thailand. Overall, three genotypes of HBoV were detected with equally high prevalence of HBoV1 and HBoV2 whereas HBoV3 was detected with much lower prevalence.

Unveiling Viruses Associated with Gastroenteritis Using a Metagenomics Approach

Acute infectious gastroenteritis is an important illness worldwide, especially on children, with viruses accounting for approximately 70% of the acute cases. A high number of these cases have an unknown etiological agent and the rise of next generation sequencing technologies has opened new opportunities for viral pathogen detection and discovery. Viral metagenomics in routine clinical settings has the potential to identify unexpected or novel variants of viral pathogens that cause gastroenteritis. In this study, 124 samples from acute gastroenteritis patients from 2012–2014 previously tested negative for common gastroenteritis pathogens were pooled by age and analyzed by next generation sequencing (NGS) to elucidate unidentified viral infections. The most abundant sequences detected potentially associated to acute gastroenteritis were from Astroviridae and Caliciviridae families, with the detection of norovirus GIV and sapoviruses. Lower number of contigs associated to rotaviruses were detected. As expected, other viruses that may be associated to gastroenteritis but also produce persistent infections in the gut were identified including several Picornaviridae members (EV, parechoviruses, cardioviruses) and adenoviruses. According to the sequencing data, astroviruses, sapoviruses and NoV GIV should be added to the list of viral pathogens screened in routine clinical analysis.

Molecular and epidemiological trends of human bocavirus and adenovirus in children with acute gastroenteritis in Bangladesh during 2015 to 2019

Virus associated diarrhea remains one of the leading causes of children morbidity and mortality in Bangladesh. Human bocavirus (HBoV) has been reported as a potential pathogen of children's diarrhea worldwide. However, due to its frequent association with other gastroenteric pathogens, its role as diarrhea causative agent remains to be defined. This study focuses to detect the incidence of HBoV and adenovirus (AdV) and to determine the molecular and epidemiological characteristics of HBoV and AdV. Between January 2015 to January 2019, 290 fecal specimens were collected from diarrheal children in Bangladesh. All fecal specimens were tested for HBoV and AdV by conventional polymerase chain reaction and sequencing methods. HBoV was detected in 7.24% (21 of 290) of the stool samples, as a sole virus in 71.42% (15 of 21) of the positive samples. AdV was detected in 4.82% (14 of 290) of the samples. The most common clinical symptoms of HBoV infected patients were diarrhea (100%) and vomiting (57%). All of the isolates of HBoV were from HBoV1 and AdV were from AdV41, AdV5, AdV7, and AdV8. To the best of our knowledge, this is the first epidemiological and molecular analysis report of HBoV from clinical specimens in Bangladesh. In the future, more studies are needed to clarify the role of HBoV as diarrheal pathogens.

Human Bocavirus in Brazil: Molecular Epidemiology, Viral Load and Co-Infections

Human bocavirus (HBoV) is an emerging virus and has been detected worldwide, especially in pediatric patients with respiratory and gastrointestinal infection. In this study, we describe HBoV prevalence, genotypes circulation and DNA shedding, in stool samples from children up to two years of age in Brazil. During 2016 and 2017, 886 acute gastroenteritis (AGE) stool samples from ten Brazilian states were analyzed by TaqMan^®-based qPCR, to detect and quantify HBoV. Positive samples were genotyped by sequencing the VP1/2 overlap region, followed by phylogenetic analysis and co-infections were accessed by screening other gastroenteric viruses. HBoV was detected in 12.4% (n = 110) of samples, with viral load ranging from 1.6 × 10² to 1.2 × 10⁹ genome copies per gram of stool. From these, co-infections were found in 79.1%, and a statistically lower HBoV viral load was found compared to viral loads of rotavirus, norovirus and adenovirus in double infected patients (p < 0.05). No significant differences were found between HBoV viral load in single or co-infections, age groups or genotypes. Phylogenetic analysis identified the circulation of HBoV-1 in 38%, HBoV-2 in 40% and HBoV-3 in 22%. Continuous HBoV monitoring is needed to clarify its role in diarrhea disease, especially in the absence of classic gastroenteric viruses.

Predominance of Human Bocavirus Genotype 1 and 3 in Outpatient Children with Diarrhea from Rural Communities in South Africa, 2017-2018

Human bocavirus (HBoV) is an emerging virus globally associated with diarrhea in young children. This study aims to investigate the prevalence of HBoV genotypes in children (≤5 years) from rural communities in South Africa (SA) suffering from acute gastroenteritis (AGE). A total of 141 fecal samples of children ≤5 years with acute gastroenteritis (AGE) were collected from rural primary health care facilities in the Vhembe district of SA between June 2017 and July 2018. Clinical symptoms and demographic data were also recorded. A total of 102 (72%) were outpatients, and 39 (28%) were hospitalized patients. Human bocavirus (HBoV) genotypes were determined using real-time multiplex PCR. DNA extracts of positive samples were confirmed by conventional PCR targeting the NS1 gene. Co-infection with other enteric viruses were determined in HBoV-positive samples using real-time PCR. HBoV was detected in eight (5.7%) children with AGE, of which three (37.5%) were HBoV1, three (37.5%) were HBoV3, and two (25%) were HBoV2. The majority of positive cases were identified in outpatients (62%) between the ages of 1 and 24 months. Co-infection in HBoV-positive samples with other enteric viruses included rotavirus (37.5%), adenovirus (37.5%), norovirus (25%), and astrovirus (12.5%). HBoV infections could be seen as a potential emerging diarrheal pathogen in South Africa. However, more studies are needed to understand the role of HBoV infections in children with AGE.