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Norovirus Infection and Acquired Immunity in 8 Countries: Results From the MAL-ED Study.

Norovirus Infection and Acquired Immunity in 8 Countries: Results From the MAL-ED Study.

Authors :
Rouhani S
Peñataro Yori P
Paredes Olortegui M
Siguas Salas M
Rengifo Trigoso D
Mondal D
Bodhidatta L
Platts-Mills J
Samie A
Kabir F
Lima A
Babji S
Mason CJ
Kalam A
Bessong P
Ahmed T
Mduma E
Bhutta ZA
Lima I
Ramdass R
Lang D
George A
Zaidi AK
Kang G
Houpt E
Kosek MN
Source :
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2016 May 15; Vol. 62 (10), pp. 1210-7. Date of Electronic Publication: 2016 Mar 24.
Publication Year :
2016

Abstract

Background: Norovirus is an important cause of childhood diarrhea. We present data from a longitudinal, multicountry study describing norovirus epidemiology during the first 2 years of life.<br />Methods: A birth cohort of 1457 children across 8 countries contributed 7077 diarrheal stools for norovirus testing. A subset of 199 children contributed additional asymptomatic samples (2307) and diarrheal stools (770), which were used to derive incidence rates and evaluate evidence for acquired immunity.<br />Results: Across sites, 89% of children experienced at least 1 norovirus infection before 24 months, and 22.7% of all diarrheal stools were norovirus positive. Severity of norovirus-positive diarrhea was comparable to other enteropathogens, with the exception of rotavirus. Incidence of genogroup II (GII) infection was higher than genogroup I and peaked at 6-11 months across sites. Undernutrition was a risk factor for symptomatic norovirus infection, with an increase in 1 standard deviation of length-for-age z score associated with a 17% reduction (odds ratio, 0.83 [95% confidence interval, .72-.97]; P = .011) in the odds of experiencing diarrhea when norovirus was present, after accounting for genogroup, rotavirus vaccine, and age. Evidence of acquired immunity was observed among GII infections only: Children with prior GII infection were found to have a 27% reduction in the hazard of subsequent infection (hazard ratio, 0.727; P = .010).<br />Conclusions: The high prevalence of norovirus across 8 sites in highly variable epidemiologic settings and demonstration of protective immunity for GII infections provide support for investment in vaccine development.<br /> (© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.)

Details

Language :
English
ISSN :
1537-6591
Volume :
62
Issue :
10
Database :
MEDLINE
Journal :
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Publication Type :
Academic Journal
Accession number :
27013692
Full Text :
https://doi.org/10.1093/cid/ciw072