Prevalence of human rotavirus serotypes in some European countries 1981-1988

Characterization of rotavirus causing acute diarrhoea in children in Kathmandu, Nepal, showing the dominance of serotype G12

Diarrhoeal diseases are a major problem in developing countries. Though precise data on childhood mortality associated with diarrhoeal diseases in Nepal are not available, it has been estimated that approximately 25 % of child deaths are associated with diarrhoeal disease, particularly acute diarrhoea. The purpose of this study was to assess the incidence of rotavirus causing acute diarrhoea in children less than 5 years of age. A total of 525 children with acute diarrhoea in a children's hospital of Kathmandu, Nepal, were enrolled between April and September 2011. The incidence of acute diarrhoea due to rotavirus was 25.9 % (136/525) as determined by ELISA. The percentage of rotavirus-infected males was higher (64.5 %) than females (35.5 %). The frequency of rotavirus cases was higher in children less than 2 years of age, among which the majority of cases (80.2 %) were in children between 6 and 24 months old (P<0.01). Genotypic characterization by RT-PCR revealed that the serotype G12 represented 55.9 % of cases in this study associated with P-types of either P[6], P[4] or P[8]. Further to this, a total of eight G/P combinations were identified, G12P[6] being the most common strain type of rotavirus in Nepal, with a prevalence rate of 46.4 %. The aim of this study was to find out the major genotypes of rotavirus causing acute diarrhoea in children.

G2P[4] the most prevalent rotavirus genotype in 2007 winter season in an European non-vaccinated population

BACKGROUND

Recently, a high prevalence of G2P[4] rotavirus (RV) infection was reported from Brazil, and linked with the universal RV vaccination programme that used the G1P[8] live oral RV vaccine.

OBJECTIVE

To determine the genotypes of RV co-circulating in a non-vaccinated population, in northern Portugal in the winter season of 2007.

STUDY DESIGN

Prospective multicenter study of the genotypes circulating in the northwest region of Portugal during January to March 2007. Children with acute gastroenteritis, who attended the Pediatric Emergency Services of five Hospitals, were included in the study. The parents of the children completed a clinical and epidemiological data questionnaire and stool samples were collected. Stool samples positive in a RV enzyme immunoassay (EIA) were genotyped by reverse transcriptase-polymerase chain reaction.

RESULTS

Stool samples were collected from 424 children. Two hundred and thirty-four (55.2%) stool samples were RV-positive. G2P[4] was the predominant RV type (68.6%), followed by G9P[8] (14.0%).

CONCLUSIONS

Because our population was naïve for RV vaccine, the G2P[4] predominance cannot be explained by vaccination. Rather, this high prevalence of G2P[4] may be within the normal fluctuation of RV genotypes. RV strain surveillance programmes are important for informing RV vaccination programmes.

Emergence of unusual human rotavirus strains in Salento, Italy, during 2006-2007

BACKGROUND

In recent years, rotavirus genotyping by RT-PCR has provided valuable information about the diversity of rotaviruses (RV) circulating throughout the world.The purpose of the present study was to monitor the prevalence of the different G and P genotypes of rotaviruses circulating in Salento and detect any uncommon or novel types.

METHODS

During the period from January 2006 to December 2007, a total of 243 rotavirus positive stool samples were collected from children with diarrhoea admitted to four Hospitals in the province of Lecce (Copertino, Galatina, Gallipoli and Tricase).All the specimens were tested for RV by real time PCR and genotyped for VP7 (G-type) and VP4 (P-type) gene by reverse transcription (RT) and multiplex PCR using different type specific primers.

RESULTS

In course of this study we identified 4 common G&P combinations viz. G2P[8], G1P[8], G2P[4] and G9P[8] amongst 59.8% of the typeable rotavirus positives.Rotavirus G2P[8] was recognized as the most widespread genotype during the sentinel-based survey in Salento.The detection of other novel and unusual strains, such as G2P[10], G4P[10], G8P[4], G9P[11] and G10P[8] is noteworthy.Furthermore, a significant number of mixed infections were observed during the survey period but G3P[8] rotaviruses were not detected.

CONCLUSION

This study highlights the genetic diversity among rotaviruses isolated from children in Salento and the emergence of some novel strains. Therefore, it is highly essential to continuously monitor for these strains so as to assess the impact of vaccines on RV strains circulating in Salento and understand the effect of strain variation on efficacy of presently available vaccines.

Epidemiology of rotavirus infection in Thailand

Rotavirus is a major cause of acute severe diarrhea in children worldwide and an important cause of death among young children in developing countries. Group A rotaviruses are antigenically complex and multiple serotypes infect humans. Reassortant rotavirus vaccines are now available which offer protection against severe illness caused by rotavirus serotypes G1-4. Before vaccines are introduced into target populations, it is necessary to establish the baseline data of the epidemiology of rotavirus infection in those countries. The purpose of the present study is to provide information related to the epidemiology of rotavirus infection in Thailand. All rotavirus studies performed in Thailand were found through Medline and Thai Index Medicus searches. A total of 26 of the most relevant studies published in international and national journals are reviewed. Most studies reported that the prevalence of rotavirus infection in Thailand was 27-34%, although a few studies have reported a prevalence above this range. The peak seasonal distribution of rotavirus infection among children hospitalized with diarrhea in Thailand was seen in the dry cool seasons: October to February. The prevalence of rotavirus infection was most frequently found in children aged 6-11 months up to 2 years. G1 was the most prevalent serotype in Thailand, followed by G2, G4 and G3, respectively. At least three G serotypes, mostly G1, G2 and G4, are seen to coexist in Thailand each epidemic year and in some studies all four G-serotypes were reported in the same epidemics. In a 1996-1997 study, G9 was the third prevailing serotype after G1 and G2, respectively. These results indicate that rotavirus epidemics occur in Thailand every year and children are the most affected population. In Thailand, although G1-G4 have been reported, G1 is the most prevalent serotype in each epidemic and G9 is becoming increasingly common.

Distribution of rotavirus VP4 genotypes and VP7 serotypes among nonhospitalized and hospitalized patients with gastroenteritis and patients with nosocomially acquired gastroenteritis in Austria

To assess the potential benefits of a reassortant tetravalent rotavirus vaccine, we investigated stool specimens from children in three different groups by reverse transcription-PCR (RT-PCR) for rotavirus G and P types: (i) children not hospitalized with community-acquired rotavirus-acute gastroenteritis (RV-AGE), (ii) children hospitalized for RV-AGE, and (iii) children with nosocomially acquired RV-AGE. From a total of 553 samples investigated, 335 were positive by enzyme-linked immunosorbent assay, of which 294 (88%) were positive by RT-PCR. Among the RT-PCR-positive samples, the predominant types were G1P[8] (84%), followed by G4P[8] (9%) and G3P[8] (2%). No differences between the three groups were observed, suggesting that community vaccination will diminish the most cost-relevant cases of hospitalizations and nosocomial infections.

VP7 and VP4 genotyping of human group A rotavirus in Buenos Aires, Argentina

Specific and sensitive tests for the detection and typing of group A rotavirus strains are needed for a more comprehensive knowledge of the epidemiology of rotaviral infection. In this study 500 stool specimens taken from 1996 to 1998 from children with acute diarrhea in Buenos Aires were examined. Group A rotavirus was unequivocally demonstrated in 62% of the samples tested by enzyme-linked immunosorbent assay (ELISA) for detection of VP6 antigen, polyacrylamide gel electrophoresis of double-stranded RNA, and reverse transcription-PCR (RT-PCR) for amplification of the VP7:G (1, 062 bp) and VP4:P (876 bp) genes. Only five positive specimens were found by RT-PCR but not by ELISA. G and P typing was carried out by nested amplification of variable sequences of the VP7 and the VP4 genes with six G- and five P-type-specific primers (multiplex PCR). Results obtained by this method showed the prevalence of the following G and P types: G1, 39%; G2, 43%; G4, 4%; P[8], 16%; P[4], 71%. Unexpectedly, the G-P type combination most frequently found was G2P[4] (43%) rather than G1P[8] (12%), which is the most commonly found worldwide. Unusual strains of the type G1P[4] accounted for 14% of the total, while mixed infections with more than one type were found in 10% of the samples. Detection of fecal rotavirus-specific immunoglobulin M (IgM) and IgA antibodies in consecutive samples of two patients taken at daily intervals demonstrated that high levels of IgM and IgA antibodies were detected on day 1 after the onset of disease and that the samples remained positive for about 10 days, after which virus shedding was no longer observed. Multiplex PCR offers a sensitive and specific alternative to determine the prevalence of group A rotavirus G and P types and to identify the emergence of uncommon strains, whereas detection of fecal IgM and IgA antibodies represents a useful supplement to virus detection for the diagnosis of current or recently acquired infections.

Comparative studies of human rotavirus serotype G8 strains recovered in South Africa and the United Kingdom

Epidemiological studies on the VP7 serotype prevalence of human rotaviruses in South Africa and the United Kingdom identified several strains which could not be serotyped as G1-G4 by monoclonal antibodies. Further analysis of these strains with a G8-specific monoclonal antibody and with probes for human rotaviruses confirmed them as G8 rotaviruses. These G8 strains exhibited a high degree of sequence identity when compared with each other and with other rotavirus G8 strains. Five South African strains were further characterized as VP6 subgroup I, but with a long RNA electropherotype, which is similar to the G8 strains previously isolated in Finland. In the UK strains, one was VP6 subgroup II with a long RNA electropherotype (similar to the Italian G8 strain). The other two were subgroup I with a short RNA electropherotype. None of these strains exhibited the super-short RNA electropherotype described in the prototype G8 strains recovered from Indonesia (69M).

Distribution of human rotavirus G types circulating in Paris, France, during the 1997-1998 epidemic: high prevalence of type G4

Group A human rotavirus G genotypes were determined by means of reverse transcription-PCR in 170 stool specimens from children with acute diarrhea admitted to a Paris children's hospital during a 1-year survey (1997 to 1998). The isolates all belonged to types G1 to G4, with type G4 predominating (60%).

Evidence of high-frequency genomic reassortment of group A rotavirus strains in Bangladesh: emergence of type G9 in 1995

We characterized 1,534 rotavirus (RV) strains collected in Bangladesh from 1992 to 1997 to assess temporal changes in G type and to study the most common G and P types using reverse transcription-PCR, oligonucleotide probe hybridization, and monoclonal antibody-based enzyme immunoassay. Results from this study combined with our previous findings from 1987 to 1991 (F. Bingnan et al., J. Clin. Microbiol. 29:862-868, 1991, and L. E. Unicomb et al., Arch. Virol. 132:201-208, 1993) (n = 2,515 fecal specimens) demonstrated that the distribution of the four major G types varied from year to year, types G1 to G4 constituted 51% of all strains tested (n = 1,364), and type G4 was the most prevalent type (22%), followed by type G2 (17%). Of 351 strains tested for both G and P types, three globally common types, type P[8], G1, type P[4], G2, and type P[8], G4, comprised 45% (n = 159) of the strains, although eight other strains were circulating during the study period. Mixed G and/or P types were found in 23% (n = 79) of the samples tested. Type G9 RVs that were genotype P[6] and P[8] with both long and short electrophoretic patterns emerged in 1995. The finding of five different genotypes among G9 strains, of which three were frequently detected, suggests that they may have an unusual propensity for reassortment that exceeds that found among the common G types. We also detected antigenic changes in serotypes G2 and G4 over time, as indicated by the loss of reactivity with standard typing monoclonal antibodies. Our data suggest that a vaccine must provide protection against type G9 RVs as well as against the four major G types because G9 strains constituted 16% (n = 56) of the typeable RV strains and have predominated since 1996.

The current status of the rotavirus vaccine

The US just licensed of an oral tetravalent rhesus reassortant vaccine for routine immunization of infants against rotavirus. The virus was first identified 25 years ago and is now recognized to be the most common single cause of severe diarrhea throughout the world. Most children suffer at least one infection and reinfection is common. Studies of natural immunity show that breastfeeding may merely delay onset of primary infection and that maternal immunity has little effect-especially in developing countries where onset in early infancy is common. Immunity, furthermore, appears to be serotype-specific. Early attempts to develop a vaccine focused on animal forms of rotavirus. More recent efforts have created human-animal reassortants that have been far more successful.

Rotavirus infection among children with diarrhoea in Italy

Despite the absence of a nationwide surveillance system for rotavirus infection, relevant information concerning the epidemiology of this pathogen in Italy can be obtained from hospital-based studies carried out since the early 1980s on patients with acute diarrhoea. A review of more than 50 papers and congress proceedings published in both international and national literature indicates that rotavirus is the most important cause of diarrhoea in Italy among young children requiring hospitalization, with a prevalence ranging from approximately 20% to 40% in different studies. Infection is predominant among children aged 6-24 months, although cases are also common in younger children and in children 2-3 y of age. Despite differences among studies in geographical area, years and age group under investigation, an increase in rotavirus cases is consistently reported in the winter months, with a peak in February through April. Although a few studies have been conducted in non-hospitalized patients, rotavirus infection is significantly less frequent among outpatients with enteritis than among inpatients. Most circulating rotavirus strains typed from 1981 to 1992 belong to serotype 1 and, to a lesser extent, 4. However, untypable rotavirus strains have been found in these years, with prevalences up to 27%, suggesting a possible spread of non-serotype 1 through 4 strains.

Seasonality and diversity of Group A rotaviruses in Europe

Group A rotaviruses are a major cause of severe gastroenteritis in children under 4 y of age worldwide. Group A rotaviruses have been identified in many animal and bird species, they are antigenically complex, and multiple serotypes infect humans. Re-assortant rotavirus vaccines are now available which confer protection against severe illness due to rotavirus serotypes G1-4. Before vaccines are introduced it is necessary to establish the diversity of rotavirus in the target population to ensure efficacy and to establish a baseline for future surveillance strategies. The purpose of this review is to describe our current knowledge of the diversity of rotaviruses across Europe. Since multinational studies with standardized methodology have not been performed, this review is based on the available published studies. In Europe, more than 90% of Group A rotavirus strains that have been typed are of serotypes G1-4, with an average 8% of non-G1-4 strains in published studies. The percentage of non-typeable strains may fluctuate from one year to another, and has been as high as 18% in one study in Great Britain, indicating the need for a more systematic study. Group A rotavirus infection typically occurs as a winter peak in the European countries studied. Comparison of seasonality data from national laboratory surveillance systems showed seasonal differences, with the annual rotavirus peak occurring first in Spain, usually in December, followed by France in February, and ending in Northern Europe in England and Wales in February or March, and the Netherlands and Finland in March.

Rotavirus gastroenteritis in Finland: burden of disease and epidemiological features

The burden of disease attributable to childhood rotavirus infection in Finland was assessed from data on hospital admissions for acute gastroenteritis and from reported virological diagnoses of rotavirus from 1985 to 1995. The mean number of hospitalizations (3584 annually in children under 5 y of age) corresponded to approximately 5.6% of the birth cohort. Rotavirus was estimated to be responsible for 54% of cases; accordingly, 3% of all children in Finland are hospitalized for rotavirus diarrhoea. The monthly distribution of hospitalizations for acute diarrhoea showed a similar pattern as monthly diagnoses of rotavirus, with a long epidemic period starting as early as November or December and lasting until June or even July. The prevalent rotavirus G-type throughout the study period was G1, which was detected in over 60% of the cases; however, in the season 1988-89 G4 was the prominent type. Improved case management has led to a shorter duration of hospital stay (3.3 d in 1985 vs. 2.3 d in 1995), but otherwise these was no significant trend for rotavirus gastroenteritis over the years. These findings underscore the need to control rotavirus gastroenteritis with a specific intervention, notably rotavirus vaccination.

Detection and characterization of novel rotavirus strains in the United States

We recently established a rotavirus strain surveillance system in the United States to monitor the prevalent G serotypes before and after the anticipated implementation of a vaccination program against rotavirus and to identify the emergence of uncommon strains. In this study, we examined 348 rotavirus strains obtained in 1996 to 1997 from children with diarrhea in 10 U.S. cities. Strains were characterized for P and G types, subgroups, and electropherotypes by using a combination of monoclonal antibody immunoassay, reverse transcription-PCR, and hybridization. The four strains most commonly found worldwide comprised 83% of the isolates (P[8]G1, 66.4%; P[4]G2, 8.3%; P[8]G3, 6.9%; P[8]G4, 1.4%), but 9.2% were unusual strains (P[6]G9, 5.5%; P[8]G9, 1.7%; P[6]G1, 1.4%; and P[4]G1 and P[8]G2, 0. 3% each). Strains not typeable for P or G type accounted for 5.5% of the total, while 2.3% of the strains had more than one G type (mixed infections). All P[6]G9 strains tested had short electropherotypes and subgroup I specificity and were detected in 4 of 10 cities, while P[8]G9 strains had long electropherotypes and subgroup II VP6 antigens. Both sequence analysis of the VP7 open reading frame (about 94 to 95% amino acid identity with the VP7 gene of G9 prototype strain WI61) and binding to a G9-specific monoclonal antibody strongly suggest that U.S. G9 strains belong to serotype G9. The high detection rates of unusual rotaviruses with G9 (7.2%) or P[6] (6.9%) specificity in multiple U.S. cities suggest the emergence of new strains or inadequate diagnosis in the past. The epidemiologic importance of these strains remains to be determined.

Prevalence of G and P serotypes among equine rotaviruses in the faeces of diarrhoeic foals

Variant types of VP4 and VP7 gene segments of faecal rotaviruses from diarrhoeic foals were identified by restriction endonuclease digestion of reverse transcription/polymerase chain reaction (RT/PCR) products. The variants observed were correlated with serotypes by determination of the sequence of representative RT/PCR products (entire coding sequence for VP7 and the VP8 region of VP4) and comparison to published sequences of equine G and P serotype genes. Both G and P serotypes could be predicted for 95/116 (82%) strains, P serotype only for a further 8 (7%) strains and G serotype only for 1 (1%) strain. All characterised strains belonged to the same P serotype, P12, although minor sequence variations were observed. Of those strains able to be assigned to G serotypes, 84/96 (87.5%) belonged to serotype G3A, and 12/96 (12.5%) belonged to serotype G14. Comparison of G serotyping by ELISA to the RT/PCR method showed that serotyping equine rotaviruses by currently available ELISA methods was prone to error. This study establishes the restricted serotypic diversity of equine rotaviruses, and the significance of serotype G14.

Rotavirus serotypes and electropherotypes in Finland from 1986 to 1990

Four epidemic seasons of rotaviruses were studied in Helsinki during 1986-1990. This is the first Scandinavian study, where both electropherotypes and serotypes are determined. Out of 5316 fecal specimens 769 (14.5%) rotavirus positive samples were detected by electron microscopy. Of these, 645 isolates (83.9%) gave a clear RNA pattern in gel electrophoresis and they clustered into 87 electropherotypes. An illustrative number of isolates representing each electropherotype (= E-type) was serotyped using VP7 protein-specific monoclonal antibodies for serotypes G1-G4 and without exceptions, within one E-type only a single serotype specificity was found. After establishment of the serotype of each E-type, the distribution of serotypes was scored as 61.2%, 2.0%, 0.5% and 29.8% for G1-G4, respectively; 6.5% remained untypable. Two seasons had one predominant E-type (Season 1, 1986-87, and Season 3, 1988-89, 84.2% and 80.6% of rotavirus positive samples, respectively). Both were followed by a season with no predominant E-type, but several minor E-types. Altogether, 5 short E-types (13/645 samples) with serotype G2 specificity were found, most of them occurring in Season 2. Only 2 E-types (3 samples) belonged to serotype G3. Group C rotavirus was found in 8 specimens. In this study a shift in serotypes, from G1 to G4, was observed in Finland in 1988/89; a similar shift was reported in many European countries at that time.

Electropherotypes and serotypes of human rotavirus in Estonia in 1989-1992

The electropherotypes and serotypes of human rotaviruses circulating in Tallinn (Estonia) in 1989-1992 have been studied. Rotaviruses were found in 372 (25.8%) of 1,442 faecal specimens of pediatric patients with acute diarrhea. Polyacrylamide gel electrophoresis of RNA from 318 isolates has revealed 41 electropherotypes. Frequent genomic alterations, including a shift of predominant electropherotypes, were observed during the study period. The serotype of 158 (50.3%) of 314 tested rotavirus isolates was identified using ELISA with VP7-specific monoclonal antibodies against 4 established human rotavirus serotypes. Serotype G1 was found to be largely predominant and accounted for 70.9% of the typeable specimens, serotypes G4, G2, and G3 accounted for 12%, 9.5%, 7.6%, respectively. A major shift to serotype G4 took place in 1990-1991. Serotype G1 was represented by the largest number of electropherotypes. All G1, G3 and G4 isolates were of "long" and all G2 isolates were of "short" electropherotypes. According to our results the isolates of an identical electropherotype belong to the same serotype.

Rotavirus vaccines and vaccination potential

The development of a successful rotavirus vaccine is a complex problem. Our review of rotavirus vaccine development shows that many challenges remain, and priorities for future studies need to be established. For example, the evaluation of administration of a vaccine with OPV or breast milk might receive less emphasis until a vaccine is made that shows clear efficacy against all virus serotypes. Samples remaining from previous trials should be analyzed to determine epitope-specific serum and coproantibody responses to clarify why only some trials were successful. Detailed evaluation of the antigenic properties of the viruses circulating and causing illness in vaccinated children also should be performed for comparisons with the vaccine strains. In future trials, sample collection should include monitoring for asymptomatic infections and cellular immune responses should be analyzed. The diversity of rotavirus serotype distribution must be monitored before, during, and after a trial in the study population and placebo recipients must be matched carefully to vaccine recipients. Epidemiologic and molecular studies should be expanded to document, or disprove, the possibility of animal to human rotavirus transmission, because, if this occurs, vaccine protection may be more difficult in those areas of the world where cohabitation with animals occurs. We also need to have an accurate assessment of the rate of protection that follows natural infections. Is it realistic to try to achieve 90% protective efficacy with a vaccine if natural infections with these enteric pathogens only provide 60% or 70% protection? Subunit vaccines should be considered to be part of vaccine strategies, especially if maternal antibody interferes with the take of live vaccines. The constraints on development of new vaccines are not likely to come from molecular biology. The challenge remains whether the biology and immunology of rotavirus infections can be understood and exploited to permit effective vaccination. Recent advances in developing small animal models for evaluation of vaccine efficacy should facilitate future vaccine development and understanding of the protective immune response(s) (Ward et al. 1990b; Conner et al. 1993).

Evidence for two serotype G3 subtypes among equine rotaviruses

Ten cultivable equine rotavirus isolates, two of North American, six of British, and two of Irish origin, were compared with standard rotavirus strains and with each other by cross neutralization, neutralization with a panel of monoclonal antibodies (MAbs), hybridization to a simian rotavirus (SA-11) VP7 gene probe, and reaction with rotavirus subgrouping and serotyping MAbs in enzyme-linked immunosorbent assays. Six isolates, two of which had previously been serotyped as G3 by other workers, were found to be serotype G3; one was confirmed to be G5, and three were not related to serotypes G1 to G10. The serotype G3 strains were divisible into two subtypes, G3A and G3B, on the basis of cross neutralization. This division was also apparent in reactions with neutralizing VP7-specific MAbs and in the liquid hybridization assay. Two of the isolates were not bound by either subgroup MAb, six were bound by both subgroup I and II MAbs, and two were bound by only the subgroup I MAb. The assays used in this characterization provide a range of epidemiological information for use in future field investigations.

Rotavirus serotype G3 predominates in horses

Foal fecal group A rotavirus strains were characterized by electropherotype, serotype, and subgroup and shown to be distinctly different from rotaviruses of other mammals. Of 86 strains that were electropherotyped, 98% had similar profiles, with gene segments 3 and 4 close together and segments 7, 8, and 9 widely spaced. Of 70 strains that had sufficient detectable VP7 antigen to be serotyped by enzyme-linked immunosorbent assays (ELISAs), 63% were serotype G3 (39% were subtype G3A and 24% were subtype G3B), 4% were serotype G13, and 33% were untypeable. Serotypes G1, G2, G4, G5, G6, G9, G10, and G14 were not detected, although G5 and G14 strains have been identified among cultivable equine strains. Of 50 strains that had sufficient detectable VP6 antigen to be subgrouped by ELISAs, only 12% were able to be assigned to either subgroup I or II, with the remaining 88% belonging to neither subgroup.

Isolation and characterization of two distinct human rotavirus strains with G6 specificity

Two new human rotavirus (HRV) strains, PA151 and PA169, with subgroup I specificity and a long RNA pattern, yet with a serotype G (VP7) specificity different from those of any of the six well-established HRV serotypes (G1 to G4, G8, and G9), were isolated 3 months apart from two children with acute gastroenteritis in Sicily, southern Italy, in the winter season of 1987 and 1988. The HRV isolates were adapted to growth in cell cultures and were then characterized by neutralization and RNA-RNA (Northern blot) hybridization. Cross-neutralization studies with type-specific immune sera to RV serotypes 1 to 10 showed the antigenic relatedness of the two strains with serotype 6 bovine strains UK and NCDV. Monoclonal antibodies to VP7 of UK were able to recognize UK and NCDV strains as well as both HRV isolates. Cross-hybridization studies showed a genetic relatedness of PA151 and PA169 to bovine strains for all genes except gene 4. Gene 4 of PA151 appeared to be genetically related to that of AU228 (a human strain of subgroup I and with serotype G3 specificity that belongs to a feline genogroup), whereas gene 4 of PA169 appeared to be unique, yet it was related to gene 4 of two recently reported subgroup I HRV strains, one (PA710) with serotype G3 specificity and the other (HAL1271) with serotype G8 specificity. The new HRV strains must be taken into consideration when deciding strategies for the development of an effective RV vaccine.

Epidemiological survey of human rotavirus serotypes and electropherotypes in young children admitted to two children's hospitals in northeast London from 1984 to 1990

A retrospective and prospective survey was carried out to determine the relative frequency of rotavirus serotypes infecting children with diarrhea or vomiting or both who were admitted to the Hospitals for Sick Children in London during a 6-year period from 1984 to 1990. The results were compared with data for the same period from a study in Birmingham, United Kingdom. The serotype of rotaviruses infecting 1,019 children was ascertained by enzyme immunoassay with VP7-specific monoclonal antibodies. In London, serotype G1 accounted for 60% of the cases, serotype G4 accounted for 24%, serotype G2 accounted for 11%, G3 accounted for 3%, and coinfections accounted for 2%. Considerable differences in the relative prevalence of serotypes were seen when data from London and Birmingham were compared. A major shift from serotype G1 to G4 was observed in London in the 1989 to 1990 season, and a lesser shift was seen in Birmingham. Examination of the electrophoretic profiles of 611 rotaviruses from London showed that there were at least 108 different profiles. Continuous variation occurred throughout the 6-year period, and the same electropherotype never recurred once it had disappeared from the population. None of the electrophoretic profiles were characteristic of group B or group C rotaviruses. There was no evidence that any strain of rotavirus had become endemic in either of the children's hospitals in London.

Culture adaptation and characterization of group A rotaviruses causing diarrheal illnesses in Bangladesh from 1985 to 1986

Group A rotaviruses collected between 1985 and 1986 during comprehensive surveillance of treated diarrheal episodes occurring in a rural Bangladesh population were culture adapted and characterized by electropherotype, serotype, and subgroup. Of 454 episodes of rotavirus-associated diarrhea, rotaviruses were culture adapted from 381 (84%), and 335 contained 11 electrophoretically identical segments in unpassaged and cultured preparations. These 335 comprised 69 different electropherotypes with between 1 (32 isolates) and 79 representatives. The persistence of specific rotavirus strains within the study population, as defined by the detection of viruses with particular electropherotypes, was generally limited to a period of only a few months. All 335 isolates were serotyped by neutralization with hyperimmune antisera to prototype rotavirus strains representative of serotypes 1 to 4, i.e., Wa, DS-1, P, and ST-3. It was found that 80, 48, 119, and 88 isolates belonged to serotypes 1 to 4, respectively. The concentrations of hyperimmune antisera required to neutralize these isolates, however, were at least threefold greater than those needed to neutralize the homologous strains. Therefore, the isolates appeared to have altered neutralization epitopes from their prototype strains. Furthermore, the serotype 4 isolates were consistently shown to be much more closely related to the serotype 4B VA70 strain than the serotype 4A ST-3 strain. All but two isolates identified as serotypes 1, 3, or 4 had long electropherotypes and were subgroup II, and all but one serotype 2 isolate were subgroup I and had short electropherotypes. The three disparate strains appeared to be genetic reassortants. Evidence is presented that dual infections required for reassortant formation were not uncommon. Thus, formation of multiple reassortants may have been a cause for the observed rapid shift in viral strains within the study population.

Reactivities of serotyping monoclonal antibodies with culture-adapted human rotaviruses

Rotaviruses collected in Bangladesh during 1985 to 1986 were culture adapted and used in a comparative serotyping study with three groups of monoclonal antibodies, all of which reacted with the major neutralization protein (VP7) of serotype 1, 2, 3, or 4. The goals were to determine which monoclonal antibodies most accurately predicted the serotype and why large variations in serotyping efficiencies have occurred with these monoclonal antibodies in previous studies. The 143 rotavirus isolates used in this study belonged to 69 different electropherotypes; and 44, 23, 21, and 55 isolates were identified as serotype 1 through 4, respectively, by neutralization with serotype-specific hyperimmune antisera. Serotyping specificity by enzyme-linked immunosorbent assay with monoclonal antibodies was 100% consistent with results found by neutralization with polyclonal antisera, but large differences were observed in the sensitivities of the different monoclonal antibodies. Monoclonal antibodies 5E8 (serotype 1), 1C10 (serotype 2), 159 (serotype 3), RV3:1 (serotype 3), ST-3:1 (serotype 4), and ST-2G7 (serotype 4) reacted with all the isolates of the corresponding serotype for which there were sufficient infectious particles. Monoclonal antibody 2F1 (serotype 2) was much less sensitive and reacted with only five serotype 2 isolates, but these were among those with the highest titers. Monoclonal antibodies RV4:2 (serotype 1), KU6BG (serotype 1), RV5:3 (serotype 2), and S2-2G10 (serotype 2), on the other hand, failed to react with between one and three isolates of the corresponding serotypes which had high titers, apparently because of epitope changes in these isolates. Effects of epitope variation were, however, most apparent with monoclonal antibodies 2C9 (serotype 1) and YO-1E2 (serotype 3), which reacted with one and no isolates of the corresponding serotypes, respectively. Cross-neutralization of escape mutants indicated that the serotype 1 monoclonal antibodies 5E8, 2C9, and RV4:2 reacted with different but probably overlapping epitopes, as did serotype 2 monoclonal antibodies 2F1, 1C10, and RV5:3, finding that were consistent with the enzyme-linked immunosorbent assay data. Because of epitope variations between rotavirus strains, serotyping with several monoclonal antibodies directed at different epitopes may increase the sensitivity of the method.

Electropherotypes, subgroups and serotypes of human rotavirus strains causing gastroenteritis in infants and young children in Palermo, Italy, from 1985 to 1989

During 1985-89, an epidemiological survey was conducted in Palermo, Sicily (Southern Italy) on group A human rotavirus (HRV) strains which cause gastroenteritis in infants and young children. Two hundred and thirty eight HRV strains were characterized for subgroup and serotype using monoclonal-antibody-based ELISA systems, and for electropherotype using polyacrylamide gel electrophoresis. Subgroup II strains were largely predominant, constituting 218/238 of the positive stool samples (91.6%). Among the serotypes, 192/238 strains (80.7%) were serotype 1 and 16 strains (6.7%) were serotype 4; serotype 2 circulated intermittently and serotype 3 was nearly absent (only one subgroup I strain was detected). Two electropherotypes, bbba and cbba, accounted for the largest proportion of the 345 HRV strains examined, 74 (21.4%) and 222 (64.3%) strains, respectively. Unexpected combinations of subgroup, serotype and electropherotype were detected in 5 subgroup I strains, of which 4 possessed a "long" RNA pattern (1 serotype 3 and 3 serotype 4 strains) and one a "short" RNA pattern (a serotype 4 strain). In addition, 4 group C HRV strains (atypical HRV or pararotaviruses) were detected on the basis of electropherotype. These findings emphasize the need for continuous surveillance of HRV infections in different geographic areas of the world in order to detect the appearance of new strains early and to adopt adequate strategies for vaccine preparation and administration.

Isolation in Europe of 69 M-like (serotype 8) human rotavirus strains with either subgroup I or II specificity and a long RNA electropherotype

During an epidemiological study on the prevalence of human rotavirus (HRV) serotypes 1-4 in Europe, we found that some strains could not be typed. However, when a monoclonal antibody directed to serotype 8 HRV was included in the typing assay, we detected seven 69 M-like (serotype 8) strains, six from Finland and one from Italy. The previously reported serotype 8 HRV strains, 69 M, B 37, and B 38 isolated in Indonesia, were of subgroup I specificity and presented a peculiar "super short" RNA electropherotype. In contrast, all the seven European strains possessed a long RNA pattern, and one of them had subgroup II specificity. Three of these strains were adapted to growth in cell cultures and were further characterized by neutralization and by Northern blot hybridization. They appeared to be closely related to serotype 8 HRV strain 69 M by neutralization, but showed partial homology with several human and animal strains by hybridization. The epidemiological importance of these serotype 8 strains circulating in Europe should be investigated, in view of their possible inclusion in a rotavirus vaccine.