Clin. Lab. 1+2/2012
117
Clin. Lab. 2012;58:117-123
©Copyright
ORIGINAL ARTICLE
A Wide Variety of Diarrhea Viruses Circulating in
Pediatric Patients in Thailand
NATTHAWAN CHAIMONGKOL
1
, PATTARA KHAMRIN
1
, BOONPA SUANTAI
1
,
WILAIPORN SAIKHREANG
1
, AKSARA THONGPRACHUM
2
,
RUNGNAPA MALASAO
1
, NUTHAPONG UKARAPOL
3
,
TIPACHAN KONGSRICHAROERN
4
, HIROSHI USHIJIMA
2
,
NIWAT MANEEKARN
1
1
Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
2
Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine,
the University of Tokyo, Tokyo, Japan
3
Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
4
Pediatric Hematology Unit, Nakornping Hospital, Chiang Mai, Thailand
SUMMARY
Background: Viral gastroenteritis has been recognized as one of the most common illnesses that affects infants and
young children all over the world. A wide variety of viruses associated with the disease are continually being re-
ported. To investigate the epidemiological situation of diarrhea virus infection in Chiang Mai, Thailand, surveil-
lance was conducted during January to December 2007.
Methods: A total of 160 fecal specimens collected from pediatric patients admitted to the hospital with acute gas-
troenteritis were tested for the presence of group A, B, and C rotaviruses, norovirus, sapovirus, astrovirus, adeno-
virus, Aichi virus, enterovirus, bocavirus, and human parechovirus by RT-multiplex PCR.
Results: Of 160 fecal specimens tested, 85 (53.1%) were positive for diarrhea viruses. Of these, group A rotavirus
was the predominant with a prevalence of 27.5%, followed by norovirus GII (11.9%), sapovirus (3.1%), entero-
virus (2.5%), human parechovirus (1.9%), and norovirus GI, astrovirus, adenovirus (each 0.6%). Mixed-infec-
tions of 2 or 3 viruses were observed in 7 (4.4%) patients. However, none of groups B and C rotaviruses and Aichi
virus were detected in this study. Monthly distribution analysis revealed that all those diarrhea viruses were de-
tected continually throughout the year at a low level of infection except for group A rotavirus and norovirus infec-
tions which appeared to peak in a cool season in January-March and December, respectively.
Conclusions: This surveillance revealed a wide variety of diarrhea viruses currently circulating in pediatric pa-
tients with acute gastroenteritis in Chiang Mai, Thailand.
(Clin. Lab. 2012;58:117-123)
KEY WORDS
Epidemiology, gastroenteritis viruses, diarrhea
INTRODUCTION
Acute gastroenteritis continues to be a major public
health problem worldwide. Children under 5 years old
are particularly affected with more than 700 million
cases every year [1]. Furthermore, annual mortality as-
sociated with gastroenteritis has been estimated around
5 to 8 million cases [2]. Several groups of viruses have
been reported, including rotavirus (RV), norovirus
(NoV), sapovirus (SaV), astrovirus (AstV), and adeno-
virus (AdV) [3,4], as pathogens that are responsible for
numerous outbreaks of nonbacterial gastroenteritis in
several settings such as hospitals, day care centers, nurs-
ing homes, and schools [4,5].
Among different types of gastroenteritis viruses, RV is
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Manuscript accepted May 30, 2011