Timing and genotype distribution of symptomatic and asymptomatic sapovirus infections and re-infections in a Nicaraguan birth cohort

Fredman González; Marta Diez-Valcarce; Yaoska Reyes; Nadja A Vielot; Christian Toval-Ruíz; Lester Gutiérrez; Omar Zepeda; Edwing Centeno Cuadra; Patricia Blandón; Hannah Browne; Natalie M Bowman; Samuel Vílchez; Jan Vinjé; Sylvia Becker-Dreps; Filemón Bucardo

doi:10.1016/j.cmi.2022.11.013

Timing and genotype distribution of symptomatic and asymptomatic sapovirus infections and re-infections in a Nicaraguan birth cohort

Clin Microbiol Infect. 2023 Apr;29(4):540.e9-540.e15. doi: 10.1016/j.cmi.2022.11.013. Epub 2022 Nov 21.

Authors

Affiliations

¹ Department of Microbiology, National Autonomous University of Nicaragua - León, León, Nicaragua.
² Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Rollins School of Public Health, Emory University, Atlanta, GA, USA.
³ Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁴ National Foundation for the Centers for Disease Control and Prevention Inc., Atlanta, GA, USA.
⁵ Rollins School of Public Health, Emory University, Atlanta, GA, USA.
⁶ Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁷ Department of Microbiology, National Autonomous University of Nicaragua - León, León, Nicaragua. Electronic address: fili_bucardo@hotmail.com.

Abstract

Objectives: To characterize the timing and genotype distribution of symptomatic and asymptomatic sapovirus infections and re-infections in a Nicaraguan birth cohort.

Methods: Infants (N = 444) were enrolled at 10-14 days of life and observed weekly until 2 years of age. Stool samples were collected for each acute gastroenteritis (AGE) episode, and routine stool samples were collected monthly. Stool samples were tested for sapovirus using RT-qPCR, and positive samples were genotyped.

Results: A total of 348 children completed 2 years of AGE weekly surveillance; 93 (26.7%) of them experienced sapovirus AGE. Most infections occurred after 5 months of age and mainly during the second year of life (62.4%, 58/93) and early in the rainy season. Sapovirus screening in all stools from a subset of 67 children who consistently provided samples showed sapovirus infections in 91 of 330 (27.6%) AGE episodes and in 39 of 1350 (2.9%) routine stools. In this subset, the median age at the first sapovirus AGE was 11.2 months (95% CI, 9.3-15.9 months); 38 of 67 (57%) children experienced re-infections, 19 symptomatic and 19 asymptomatic. On average, sapovirus re-infections were reported 7.2 months after symptomatic and 5.3 months after asymptomatic infections. Genogroup GI (64%, 69/108) was the most common detected. Sapovirus GI.1 was more frequently detected in AGE stool samples than in routine stool samples (47.2%, 43/91 vs. 25.6%, 10/39; p 0.005), and re-infection with the same genotype was uncommon.

Discussion: The first sapovirus infections occurred at approximately 11 months of age, whereas the median time to symptomatic re-infection was 7.2 months. Re-infections with the same sapovirus genotype were rare during 2 years of life suggesting genotype-specific protection after natural infection.

Keywords: Birth cohort; Genotype distribution; Natural protection; Re-infection; Sapovirus; Timing of infection.

MeSH terms

Asymptomatic Infections / epidemiology
Birth Cohort
Caliciviridae Infections* / diagnosis
Caliciviridae Infections* / epidemiology
Child
Feces
Genotype
Humans
Infant
Phylogeny
Reinfection
Sapovirus* / genetics

Abstract

MeSH terms

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