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. 2014 May 21;9(5):e98201.
doi: 10.1371/journal.pone.0098201. eCollection 2014.

Predominance of norovirus and sapovirus in Nicaragua after implementation of universal rotavirus vaccination

Filemón Bucardo  1 , Yaoska Reyes  1 , Lennart Svensson  2 , Johan Nordgren  2
Affiliations

Predominance of norovirus and sapovirus in Nicaragua after implementation of universal rotavirus vaccination

Filemón Bucardo et al. PLoS One. .

Abstract

Background: Despite significant reduction of rotavirus (RV) infections following implementation of RotaTeq vaccination in Nicaragua, a large burden of patients with diarrhea persists.

Methods: We conducted a community- and hospital-based study of the burden of RV, norovirus (NV) and sapovirus (SV) infections as cause of sporadic acute gastroenteritis (GE) among 330 children ≤ 5 years of age between September 2009 and October 2010 in two major cities of Nicaragua with a RotaTeq coverage rate of 95%.

Results: We found that NV, SV and RV infections altogether accounted for 45% of cases of GE. Notably, NV was found in 24% (79/330) of the children, followed by SV (17%, 57/330) and RV (8%, 25/330). The detection rate in the hospital setting was 27%, 15% and 14% for NV, SV and RV respectively, whereas in the community setting the detection rate of RV was < 1%. Among each of the investigated viruses one particular genogroup or genotype was dominant; GII.4 (82%) for NV, GI (46%) for SV and G1P[8] (64%) in RV. These variants were also found in higher proportions in the hospital setting compared to the community setting. The GII.4.2006 Minerva strain circulating globally since 2006 was the most common among genotyped NV in this study, with the GII.4-2010 New Orleans emerging in 2010.

Conclusions: This study shows that NV has become the leading viral cause of gastroenteritis at hospital and community settings in Nicaragua after implementation of RV vaccination.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Temporal distribution of norovirus (NV), sapovirus (SV) and rotavirus (RV) infections in children with diarrhea ≤ 5 years of age, after national RotaTeq vaccination in Nicaragua, 2009–2010.
Left Y axis; the black, grey and white bars represent monthly frequencies of NV, RV and SV, respectively. Right Y axis; the line represent monthly frequencies of gastroenteritis cases enrolled. The X axis represents seasonality, with the early rainy season typically starting in May and lasting until July.
See this image and copyright information in PMC

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Grants and funding

This study was supported by grants from the Network for Research and Training in Tropical Diseases in Central America (NeTropica, Grant:05-N-2010) and Swedish Research Council (grants 10392 and 348-2011-7420). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.