VIRUSES ASSOCIATED WITH

ACUTE GASTROENTERITIS IN
HUMANS

Dr. Moe Yee Soe

Assistant Lecturer
Department of Microbiology
UM1
Rotavirus
• Group A - most important cause of endemic
severe diarrheal illness in infants
and young childrean worldwide .
• Group B – outbreaks in adult & childrean in
China.
• Group C – sporadic cases & occasional
outbreaks in childrean.
Enteric adenovirus – second most important
agent in infants and
young childrean .
Norwalk virus & Norwalk – like viruses
- important cause of outbreaks in older
childrean & adults in families , communities
& institutions.
Caliciviruses – sporadic cases & occasional
outbreaks of diarrheal illness
in infants , young childrean &
elderly.
Astroviruses – sporadic cases & occasional
outbreaks of diarrheal illness in
infants , young childrean & elderly.
 ROTAVIRUSES
FAMILY–Reoviridae

IMPORTANT PROPERTIES

Genome – Double – stranded RNA , liner ,

segmented.(11)

Proteins – Nine structural proteins ; core

contains several enzymes.

Virion - Icosahedral , 60-80 nm in

diameter,double capsid shell .
• Genetic reassortment occurs readily

• No envelope

• Major cause of diarrheal illness in human

,infants , & young animals .

• Also common in adults .

CLASSIFICATION & ANTIGENIC PROPERTIES
Common antigens
• Type specific antigens - located on the outer
capsid
• At least - 9 serotypes
• Viruses associated with human GE .
• Group A Rotaviruses cause diarrheal outbreaks
primarily in adults .
• Group B Rotaviruses outbreaks of diarrheal
illness in adults & childrean in China .
• Group C – cause sporadic cases & occasional
• outbreaks in child . .
Animal susceptibility

• Wide host range

• Human rotavirus can cause diarrheal illness in
newborn colostrum deprived animals ( piglets,
calves)

• Newborns – subclinical infection

( presence of maternal antibody )

• Overt disease – weaning animals .

Propagation in cell culture
• fastidious agent to culture

• Group A human Rotaviruses – cultivated if

pretreated with Trypsin – cleaves outer capsid
protein & facilitate uncoating .
PATHOGENESIS & CLINICAL FINDINGS

• Infect cells in villi of small intestine .(gastric &

colonic mucosa spared )

• Multiply in cytoplasm of enterocytes .

• Damage their transport mechanisms.

• NSP4 - Viral enterotoxin & induce secretion by

triggering a signal transduction pathway .
• Damaged cells may slough into lumen of
intestine

• Release large quantities of viruses in the

stool.(up to 1010 particles / gm of faeces.)

• Viral excretion – 2-12 days or may be

prolounged in those with poor nutrition
• diarrhoea may be due to impaired sodium &
glucose absorption as damaged cells on villi are
replaced by non-absorbing immature crypt cells
Infants
• Incubation period – 1-4 days
• Typical symptoms - diarrhoea, fever,
abdominal pain, vomitting, dehydration.
• Milder cases – symptoms 3-8 days & recovered
completely.
• Asyptomatic infections with seroconvertion
occur. –
• in children with immunodeficiencies---- severe
and prolonged disease

.
Adult
• Contacts may be infected but rarely exhibit
symptoms ,& virus is infrequently detected in
their stool
• S.O.I – contact with pediatric cases.

• Epidemics of sever disease - in adults ,

especially in closed population as in geriatric
ward .
• Group B rotaviruses outbreaks in adults in
China.
LABORATORY DIAGNOSIS

• Virus in stool - Immune electron

microscopy,immunodiffusion, ELISA.
Dot hybridization using
rotaviruses- specific cDNA probes

• Serologic test - ELISA

EPIDEMIOLOGY & IMMUNITY
• Rotaviruses are single most important
worldwide cause of GE in young childrean.

• Under 5 years of age - annual diarrheal

episodes (3-5 billion) .

• Developed countries have high morbidity but

low mortality .

• 50 -60 % of cases of acute GE of hospitalized

childrean throughout the world .
Usually predominate during winter season.
• Symptomatic infection - 6 months to 2 years

• Asymptomatic infection - before 6 months

• Nosocomial infection - frequent

• Subclinical infection - (+) of Abs

• Secretory Ag or Interferon – important in protection

against rotavirus infection .

• Reinfection in the (+) of circulating Ab – reflect the (+)

of multiple serotypes .
TREATMENT AND CONTROL
• Effective replacement therapy

• Waste water treatment

• Sanitation

• Live oral attenuated vaccine – Rota Teq and

RotaRix vaccine(2,4,6 month of age)

• In very young infants – effective rotavirus

vaccine induce protective Abs - * serotypes
 OTHER AGENTS OF VIRAL
GASTROENTERITIS
• a group of small, round enteric viruses

• detected by electron microscopy

• cannot be cultured
 Norwalk Virus
• epedimic GE

• asociated with waterborne, foodborne, &

shellfish – associated GE

• community outbreak in any seasons

• four serotypes
• 27 nm , (+) sense, single- stranded RNA

• in stools from adult with acute GE, in a Norwalk,

Ohio

• worldwide distribution

• Abs acquired later in life , adult > 50% have Ab

• However, in developing countries – most

childrean have developed Abs (4 years of age)
 Calicivirus
• similar to picornaviruses but are slightly larger
(27-38 nm)
• contain a single major structural protein.
• exhibit a distinctive morphology in the electron
microscope.
• several serotypes.
• relatively common causes of GE in childrean,
especially in Southeast Asia, Japan, & UK.
 Astroviruses
• 30 nm in diameter , exhibit a distinctive
morphology in electron microscope.

• seen in stools from infants & young childrean &

from claves & lambs with diarrhoea .

• several serotypes

• minimally pathogenic
THE END