Existence of multiple outbreaks of viral gastroenteritis among infants in a day care center in Japan.

A total of 921 fecal specimens collected from 44 infants in a day care center (DCC) in Tokyo, Japan during June 1999 to July 2000 were tested for the presence of rotavirus, norovirus, sapovirus, astrovirus and adenovirus by reverse-transcription-multiplex polymerase chain reaction (RT-multiplex PCR) and sequence analysis. Of 88 fecal specimens from infants with acute gastroenteritis, 51.1% (45) were found to be positive for diarrheal viruses. Astrovirus was the most prevalent (15.9%, 14 of 88), followed by norovirus GII (14.8%, 13 of 88), adenovirus (12.5%, 11 of 88), and sapovirus (2.3%, 2 of 88). Viral mixed infection accounted for 5.7% (5 of 88). Interestingly, 230 of 833 (27.6%) fecal specimens collected from asymptomatic infants were also infected with diarrheal viruses. Of these, astrovirus, norovirus GII, adenovirus and sapovirus were identified in 53, 46, 96 and 22 fecal specimens (23%, 20%, 41.7%, and 9.6%, respectively). Moreover, 13 of 833 (1.6%) normal specimens showed mixed viral infections. Surprisingly, no rotavirus (known as the most common causative agent of acute gastroenteritis in DCCs) was detected in those subjects. Another interesting feature was the demonstration of five separate outbreaks of acute gastroenteritis identified in a single DCC. Outbreak A was associated with both astrovirus serotype 1 and norovirus GII/3 (known as Toronto virus cluster); Outbreak B with adenovirus 12; Outbreak C with norovirus GII/4 (Lordsdale virus cluster); Outbreak D with sapovirus GIV and Outbreak E with astrovirus serotype 1. To our knowledge, this is the first proof of multiple outbreaks of viral gastroenteritis in Japanese infants in a single DCC. Our results confirm the presence as well as the importance of these viruses and warn of the threat they pose.

Development of a simple and rapid latex test for rotavirus in stool samples.

In the fields of infectious diseases, a variety of immunoassay methods has been reported. More simple, rapid and cost-effective manual tests for infectious diseases are needed. For the purpose of simple diagnosis of rotavirus infection, a rapid test against human rotavirus was developed. As for the preparation of the reagent, clinically isolated human rotavirus was cultured using MA-104 cells. Then, the cultured virus was purified by an ultracentrifugation method. The purified virus was inactivated with formaldehyde for use as antigen for immunization of rabbits. The antibody was purified and applied to sensitize the surface of latex particles to react with rotavirus in diarrheal stools. The latex agglutination test showed that the sensitivity was 98.2% and the specificity was 94.8%, in comparison with electron microscopy as the gold standard. Furthermore, to measure the virus concentration in stool samples, an automated latex photometric immunoassay system (LPIA) was used, which has been developed for quantitative measurement of agglutination. The range of the reactive viruses detected by the LPIA system was 3 x 10(7)-10(9) virions/mL. The rotavirus-positive and rotavirus-negative subjects were clearly discriminated. The results were in good accordance with electron microscope results. Those results showed that the latex agglutination test is a good tool for the simple and rapid detection of rotavirus in stool samples.

Molecular epidemiology of astroviruses in Japan from 1995 to 1998 by reverse transcription-polymerase chain reaction with serotype-specific primers (1 to 8).

In addition to the serotype-specific primers described previously (1 to 7), a new serotype 8-specific primer has been designed, allowing detection of all astrovirus serotypes. A total of 1,382 diarrheal stool samples in 5 regions in Japan were examined by reverse transcription-polymerase chain reaction (RT-PCR). The incidence of astrovirus infection in all 5 regions was 5.9% (82 of 1,382 samples) and infection occurred mainly from November to April. Serotypes 1, 3, and 4 were detected in 66, 14, and 2 of the 82 positive samples, respectively. None of the other serotypes was detected. The highest detection rate was from 0 to 1 year old, 39.0%, and the next highest was from 1 to 2 years old, 34.1%. The primers provide a useful approach for study of the epidemiology of astroviruses.

Genetic variation in the VP4 and NSP4 genes of human rotavirus serotype 3 (G3 type) isolated in China and Japan.

Sequence analyses of the VP4 and NSP4 genes were performed on twenty human isolates of serotype G3 rotavirus obtained from China and Japan. One isolate from China, CHW17, possessed P[4] genotype VP4 and KUN group NSP4 genes which are associated with G2. One isolate (02/92) from Japan, which was shown to have a wider spacing between RNA segments 10 and 11 by RNA polyacrylamide gel electrophoretic analysis like AU-1, possessed P[9] genotype VP4 and AU-1 group NSP4 genes. The other isolates had P[8] genotype VP4 and Wa group NSP4 genes. While the nucleotide sequence conservation among the G3 VP7 genes was more than 79% (Wen et al, Arch. Virol., 1997, 142: 1481-1489), the conservation of VP4 and NSP4 genes in the same genotypes or groups was more than 85%.