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Noroviruses are considered an important cause of acute gastroenteritis (AGE) across all age groups. Here, we investigated the incidence of norovirus, genotypes circulation, and norovirus shedding in AGE stool samples from outpatients in Brazil. During a two-year period, 1546 AGE stool samples from ten Brazilian states were analyzed by RT-qPCR to detect and quantify GI and GII noroviruses. Positive samples were genotyped by dual sequencing using the ORF1/2 junction region. Overall, we detected norovirus in 32.1% of samples, with a massive predominance of GII viruses (89.1%). We also observed a significant difference between the median viral load of norovirus GI (3.4×105 GC/g of stool) and GII (1.9×107 GC/g). The most affected age group was children aged between 6 and 24 m old, and norovirus infection was detected throughout the year without marked seasonality. Phylogenetic analysis of partial RdRp and VP1 regions identified six and 11 genotype combinations of GI and GII, respectively. GII.4 Sydney[P16] was by far the predominant genotype (47.6%), followed by GII.2[P16], GII.4 Sydney[P31], and GII.6[P7]. We detected, for the first time in Brazil, the intergenogroup recombinant genotype GIX.1[GII.P15]. Our study contributes to the knowledge of norovirus genotypes circulation at the national level, reinforcing the importance of molecular surveillance programs for future vaccine designs.
Sylvia Kahwage Sarmento; Juliana Da Silva Ribeiro De Andrade; Marize Pereira Miagostovich; Tulio Machado Fumian. Virological and Epidemiological Features of Norovirus Infections in Brazil, 2017–2018. Viruses 2021, 13, 1724 .
AMA StyleSylvia Kahwage Sarmento, Juliana Da Silva Ribeiro De Andrade, Marize Pereira Miagostovich, Tulio Machado Fumian. Virological and Epidemiological Features of Norovirus Infections in Brazil, 2017–2018. Viruses. 2021; 13 (9):1724.
Chicago/Turabian StyleSylvia Kahwage Sarmento; Juliana Da Silva Ribeiro De Andrade; Marize Pereira Miagostovich; Tulio Machado Fumian. 2021. "Virological and Epidemiological Features of Norovirus Infections in Brazil, 2017–2018." Viruses 13, no. 9: 1724.
Rotavirus A (RVA) vaccines succeeded in lowering the burden of acute gastroenteritis (AGE) worldwide, especially preventing severe disease and mortality. In 2019, Brazil completed 13 years of RVA vaccine implementation (Rotarix™) within the National Immunization Program (NIP), and as reported elsewhere, the use of Rotarix™ in the country has reduced childhood mortality and morbidity due to AGE. Even though both marketed vaccines are widely distributed, the surveillance of RVA causing AGE and the monitoring of circulating genotypes are important tools to keep tracking the epidemiological scenario and vaccines impact. Thus, our study investigated RVA epidemiological features, viral load and G and P genotypes circulation in children and adults presenting AGE symptoms in eleven states from three out of five regions in Brazil. By using TaqMan®-based one-step RT-qPCR, we investigated a total of 1536 stool samples collected from symptomatic inpatients, emergency department visits and outpatients from January 2018 to December 2019. G and P genotypes of RVA-positive samples were genetically characterized by multiplex RT-PCR or by nearly complete fragment sequencing. We detected RVA in 12% of samples, 10.5% in 2018 and 13.7% in 2019. A marked winter/spring seasonality was observed, especially in Southern Brazil. The most affected age group was children aged >24–60 months, with a positivity rate of 18.8% (p < 0.05). Evaluating shedding, we found a statistically lower RVA viral load in stool samples collected from children aged up to six months compared to the other age groups (p < 0.05). The genotype G3P[8] was the most prevalent during the two years (83.7% in 2018 and 65.5% in 2019), and nucleotide sequencing of some strains demonstrated that they belonged to the emergent equine-like G3P[8] genotype. The dominance of an emergent genotype causing AGE reinforces the need for continuous epidemiological surveillance to assess the impact of mass RVA immunization as well as to monitor the emergence of novel genotypes.
Meylin Bautista Gutierrez; Alexandre Madi Fialho; Adriana Gonçalves Maranhão; Fábio Correia Malta; Juliana Da Silva Ribeiro De Andrade; Rosane Maria Santos De Assis; Sérgio Da Silva E Mouta; Marize Pereira Miagostovich; José Paulo Gagliardi Leite; Tulio Machado Fumian. Rotavirus A in Brazil: Molecular Epidemiology and Surveillance during 2018–2019. Pathogens 2020, 9, 515 .
AMA StyleMeylin Bautista Gutierrez, Alexandre Madi Fialho, Adriana Gonçalves Maranhão, Fábio Correia Malta, Juliana Da Silva Ribeiro De Andrade, Rosane Maria Santos De Assis, Sérgio Da Silva E Mouta, Marize Pereira Miagostovich, José Paulo Gagliardi Leite, Tulio Machado Fumian. Rotavirus A in Brazil: Molecular Epidemiology and Surveillance during 2018–2019. Pathogens. 2020; 9 (7):515.
Chicago/Turabian StyleMeylin Bautista Gutierrez; Alexandre Madi Fialho; Adriana Gonçalves Maranhão; Fábio Correia Malta; Juliana Da Silva Ribeiro De Andrade; Rosane Maria Santos De Assis; Sérgio Da Silva E Mouta; Marize Pereira Miagostovich; José Paulo Gagliardi Leite; Tulio Machado Fumian. 2020. "Rotavirus A in Brazil: Molecular Epidemiology and Surveillance during 2018–2019." Pathogens 9, no. 7: 515.
Brazil introduced the monovalent rotavirus vaccine (Rotarix®) in 2006. This study aimed to assess the epidemiology and genotype distribution of species-A rotavirus (RVA) in Brazil, comparing the pre- and post-vaccination periods. Laboratory-based RVA surveillance included 866 municipalities in 22 Brazilian states, over a 21-year period. A total of 16,185 children with diarrheal diseases (DD) aged up to 12 years between 1996 and 2005 (pre-vaccination period, n = 7030) and from 2006 to 2017 (post-vaccination period, n = 9155) were enrolled. RVA was detected using ELISA immune assay and/or polyacrylamide gel electrophoresis and genotyped using nested PCR and/or nucleotide sequencing. RVA-positivity and genotypes detection rates were compared in distinct periods and age groups and Rotarix vaccination status. RVA-positivity in pre- and post-vaccination periods was, respectively: 4–11 months bracket, 33.3% (668/2006) and 16.3% (415/2547) (p < 0.001); 12–24 months, 28.2% (607/2154) and 22.2% (680/3068) (p < 0.001); 25–48 months, 17.4% (215/1235) and 29.4% (505/1720) (p < 0.001). Genotypes distribution in the pre- and post-vaccination periods was, respectively: G1P [8]/G1P[Not Typed], 417/855 (48.8%) and 118/1835 (6.4%) (p < 0.001); G2P [4]/G2P[NT], 47/855 (5.5%) and 838/1835 (45.7%) (p < 0.001); G3P [8]/G3P[NT], 55/855 (6.4%) and 253/1835 (13.8%) (p < 0.001); G9P [8]/G9P[NT], 238/855 (27.8%) and 152/1835 (8.3%) (p < 0.001); G12P [8]/G129P[NT], 0/871 (0%) and 249/1835(13.6%) (p < 0.001). Concerning infants aged 4–11 months, RVA frequency in fully vaccinated and non-vaccinated individuals was 11.9% (125/1052) and 24.5% (58/237) (p < 0.001), respectively. In children aged 12–24 months, RVA detection rate was 18.1% (253/1395) and 29.6% (77/260) (p < 0.001), for the vaccinated and non-vaccinated individuals, respectively (p < 0.001). RVA infection was significantly less frequent in children aged ≤2 years with DD after implementing vaccination, mainly among vaccinated children. It was also observed a decrease of P [8] circulation and emergence of G2P[4] in 2005, and afterwards in the post-vaccine era, with spreading of G12P[8] in 2014–2015 and of G3P[8] in 2017. Continuous RVA surveillance must be carried out in this scenario.
Filipe A. Carvalho-Costa; Rosane M. S. De Assis; Alexandre M. Fialho; Irene T. Araújo; Marcelle F. Silva; Mariela M. Gómez; Juliana S. Andrade; Tatiana L. Rose; Tulio M. Fumian; Eduardo M. Volotão; Marize P. Miagostovich; José Paulo G. Leite. The evolving epidemiology of rotavirus A infection in Brazil a decade after the introduction of universal vaccination with Rotarix®. BMC Pediatrics 2019, 19, 1 -10.
AMA StyleFilipe A. Carvalho-Costa, Rosane M. S. De Assis, Alexandre M. Fialho, Irene T. Araújo, Marcelle F. Silva, Mariela M. Gómez, Juliana S. Andrade, Tatiana L. Rose, Tulio M. Fumian, Eduardo M. Volotão, Marize P. Miagostovich, José Paulo G. Leite. The evolving epidemiology of rotavirus A infection in Brazil a decade after the introduction of universal vaccination with Rotarix®. BMC Pediatrics. 2019; 19 (1):1-10.
Chicago/Turabian StyleFilipe A. Carvalho-Costa; Rosane M. S. De Assis; Alexandre M. Fialho; Irene T. Araújo; Marcelle F. Silva; Mariela M. Gómez; Juliana S. Andrade; Tatiana L. Rose; Tulio M. Fumian; Eduardo M. Volotão; Marize P. Miagostovich; José Paulo G. Leite. 2019. "The evolving epidemiology of rotavirus A infection in Brazil a decade after the introduction of universal vaccination with Rotarix®." BMC Pediatrics 19, no. 1: 1-10.
Foodborne transmission gastroenteritis (AGE) outbreak occurred during a celebration lunch in July, 2016, Brazil. All stool samples tested were positive for noroviruses (NoV) and phylogenetic analysis revealed that strains were genetically close to GII.17 Kawasaki_2014. These findings indicated circulation of NoV GII.17 Kawasaki_2014 in the Brazilian population, associated with AGE outbreak.
Juliana Da Silva Ribeiro De Andrade; Tulio Machado Fumian; José Paulo Gagliardi Leite; Matheus Ribeiro De Assis; Alexandre Madi Fialho; Sergio Mouta; Cristiane Mendes Pereira Santiago; Marize Pereira Miagostovich. Norovirus GII.17 Associated with a Foodborne Acute Gastroenteritis Outbreak in Brazil, 2016. Food and Environmental Virology 2017, 10, 212 -216.
AMA StyleJuliana Da Silva Ribeiro De Andrade, Tulio Machado Fumian, José Paulo Gagliardi Leite, Matheus Ribeiro De Assis, Alexandre Madi Fialho, Sergio Mouta, Cristiane Mendes Pereira Santiago, Marize Pereira Miagostovich. Norovirus GII.17 Associated with a Foodborne Acute Gastroenteritis Outbreak in Brazil, 2016. Food and Environmental Virology. 2017; 10 (2):212-216.
Chicago/Turabian StyleJuliana Da Silva Ribeiro De Andrade; Tulio Machado Fumian; José Paulo Gagliardi Leite; Matheus Ribeiro De Assis; Alexandre Madi Fialho; Sergio Mouta; Cristiane Mendes Pereira Santiago; Marize Pereira Miagostovich. 2017. "Norovirus GII.17 Associated with a Foodborne Acute Gastroenteritis Outbreak in Brazil, 2016." Food and Environmental Virology 10, no. 2: 212-216.
A newly GII.17 Kawazaki_2014 variant strain was detected recently in Brazil. Phylogenetic analysis reveals at least four independent introduction events of this lineage into this country that took place throughout 2014, coinciding with FIFA World Cup in Brazil, 2014, and Hong Kong has been identified as the most likely source of introduction. This variant emerged in Asia causing outbreaks and replacing prevalent GII.4. Emergence of GII.P17/GII.17 variant emphasizes the need for active laboratory surveillance for NoV including molecular epidemiology and studies on virus evolution.
Juliana S.R. Andrade; Tulio M. Fumian; José Paulo G. Leite; Matheus R. de Assis; Gonzalo Bello; Daiana Mir; Marize P. Miagostovich. Detection and molecular characterization of emergent GII.P17/GII.17 Norovirus in Brazil, 2015. Infection, Genetics and Evolution 2017, 51, 28 -32.
AMA StyleJuliana S.R. Andrade, Tulio M. Fumian, José Paulo G. Leite, Matheus R. de Assis, Gonzalo Bello, Daiana Mir, Marize P. Miagostovich. Detection and molecular characterization of emergent GII.P17/GII.17 Norovirus in Brazil, 2015. Infection, Genetics and Evolution. 2017; 51 ():28-32.
Chicago/Turabian StyleJuliana S.R. Andrade; Tulio M. Fumian; José Paulo G. Leite; Matheus R. de Assis; Gonzalo Bello; Daiana Mir; Marize P. Miagostovich. 2017. "Detection and molecular characterization of emergent GII.P17/GII.17 Norovirus in Brazil, 2015." Infection, Genetics and Evolution 51, no. : 28-32.
Group A rotavirus (RVA) genotype G12 is habitually associated with diarrhea disease (DD) in African children and recently its detection has increased worldwide. A total of 970 stool samples collected from individuals with DD in the Northeastern, Southeastern and Southern Brazilian regions, Eastern coast, were analyzed and 321 (33%) were positive for RVA and of these, 241 (75%) genotyped as G12P[8]. The rate of RVA positivity was higher among children aged 5 to 10 years old (60%). All RVA infections observed in adults aged > 21 years were G12P[8] (n = 27) showing that this genotype affected older age groups during the year of 2014 in Brazil. Phylogenetic analysis of VP7 and VP8* G12P[8] strains demonstrated an elevated similarity among Brazilian and G12-III prototypes strains circulating worldwide recently, suggesting that this lineage is associated with the global spread of the G12 genotype, considered as the 6th most prevalent human RVA genotype nowadays; while other G12 lineages remain sporadically detected and usually detected in association with other P genotypes. VP8* analysis revealed that Brazilian strains belong to P[8]-3 lineage, the single P[8] lineage presently detected in the country. No major nucleotide/amino acid disparities were observed among strains recovered from children and adults for VP7 and VP8* genes. These data are essential to support the surveillance studies, particularly in countries where the RVA vaccine was introduced in their National Immunization Program enabling identification of potential alterations in the epidemiological profile that can impact its efficacy in vaccination programs. This article is protected by copyright. All rights reserved
Marcelle Figueira Marques Da Silva; Tulio Machado Fumian; Rosane Maria Santos De Assis; Alexandre Madi Fialho; Filipe Anibal Carvalho-Costa; Juliana Da Silva Ribeiro De Andrade; José Paulo Gagliardi Leite. VP7 and VP8* genetic characterization of group A rotavirus genotype G12P[8]: Emergence and spreading in the Eastern Brazilian coast in 2014. Journal of Medical Virology 2016, 89, 64 -70.
AMA StyleMarcelle Figueira Marques Da Silva, Tulio Machado Fumian, Rosane Maria Santos De Assis, Alexandre Madi Fialho, Filipe Anibal Carvalho-Costa, Juliana Da Silva Ribeiro De Andrade, José Paulo Gagliardi Leite. VP7 and VP8* genetic characterization of group A rotavirus genotype G12P[8]: Emergence and spreading in the Eastern Brazilian coast in 2014. Journal of Medical Virology. 2016; 89 (1):64-70.
Chicago/Turabian StyleMarcelle Figueira Marques Da Silva; Tulio Machado Fumian; Rosane Maria Santos De Assis; Alexandre Madi Fialho; Filipe Anibal Carvalho-Costa; Juliana Da Silva Ribeiro De Andrade; José Paulo Gagliardi Leite. 2016. "VP7 and VP8* genetic characterization of group A rotavirus genotype G12P[8]: Emergence and spreading in the Eastern Brazilian coast in 2014." Journal of Medical Virology 89, no. 1: 64-70.