Quantitative detection of norovirus excretion in pediatric patients with cancer and prolonged gastroenteritis and shedding of norovirus
Identifieur interne : 000F34 ( Istex/Corpus ); précédent : 000F33; suivant : 000F35Quantitative detection of norovirus excretion in pediatric patients with cancer and prolonged gastroenteritis and shedding of norovirus
Auteurs : A. Ludwig ; O. Adams ; H. Laws ; H. Schroten ; T. TenenbaumSource :
- Journal of Medical Virology [ 0146-6615 ] ; 2008-08.
English descriptors
Abstract
Although chronic courses of norovirus infection have been described in immunocompromised patients, little is known about noroviral shedding and correlation with clinical symptoms in these patients. In this report, the quantitative courses of norovirus excretion in nine pediatric patients with hematologic and oncologic disorders and prolonged gastroenteritis were investigated. In a retrospective study multiple fecal samples from nine pediatric cancer patients were examined by a one‐step real‐time PCR. Clinical data of the patients were reviewed and virological data were correlated with clinical symptoms. All nine patients presented with prolonged illness and prolonged noroviral shedding. Vomiting and diarrhea were associated with high norovirus concentrations and norovirus excretion declined slowly in the patients. Retrospectively, initial PCR‐testing for norovirus was performed with a median of 7 days after onset of symptoms. This finding hints at the difficulty of obtaining early diagnosis of the infection in these children. The patients were shedding high norovirus concentration over a long period of time. Results of sequential quantitative PCR‐testing for norovirus correlated with clinical symptoms. Both clinical symptoms and quantitative PCR‐testings help to define the severity of norovirus infection and to estimate the risk for transmission. To prevent the spread of the disease, usage of virocidal disinfectants and isolation procedures should be maintained as long as patients are positive for noroviruses. Since vomiting is frequent in pediatric patients with oncological conditions, a screening program for rapid detection of norovirus infection in this group of patients should be considered. J. Med. Virol. 80:1461–1467, 2008. © 2008 Wiley‐Liss, Inc.
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DOI: 10.1002/jmv.21217
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<mods version="3.6"><titleInfo lang="en"><title>Quantitative detection of norovirus excretion in pediatric patients with cancer and prolonged gastroenteritis and shedding of norovirus</title>
</titleInfo>
<titleInfo type="abbreviated" lang="en"><title>Norovirus Infections in Pediatric Patients With Cancer</title>
</titleInfo>
<titleInfo type="alternative" contentType="CDATA" lang="en"><title>Quantitative detection of norovirus excretion in pediatric patients with cancer and prolonged gastroenteritis and shedding of norovirus</title>
</titleInfo>
<name type="personal"><namePart type="given">A.</namePart>
<namePart type="family">Ludwig</namePart>
<affiliation>Institute for Virology, Heinrich‐Heine‐University Duesseldorf, Duesseldorf, Germany</affiliation>
<description>Correspondence: Institute for Virology, Geb. 22.21, Universitaetsstr. 1, D‐40225 Duesseldorf, Germany.===</description>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">O.</namePart>
<namePart type="family">Adams</namePart>
<affiliation>Institute for Virology, Heinrich‐Heine‐University Duesseldorf, Duesseldorf, Germany</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">H.‐J.</namePart>
<namePart type="family">Laws</namePart>
<affiliation>Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich‐Heine‐University Duesseldorf, Duesseldorf, Germany</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">H.</namePart>
<namePart type="family">Schroten</namePart>
<affiliation>Pediatric Infectious Diseases, Department of Pediatrics, University Hospital Mannheim, Mannheim, Germany</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">T.</namePart>
<namePart type="family">Tenenbaum</namePart>
<affiliation>Pediatric Infectious Diseases, Department of Pediatrics, University Hospital Mannheim, Mannheim, Germany</affiliation>
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<originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher>
<place><placeTerm type="text">Hoboken</placeTerm>
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<dateIssued encoding="w3cdtf">2008-08</dateIssued>
<dateValid encoding="w3cdtf">2008-04-01</dateValid>
<copyrightDate encoding="w3cdtf">2008</copyrightDate>
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<languageTerm type="code" authority="iso639-2b">eng</languageTerm>
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<abstract lang="en">Although chronic courses of norovirus infection have been described in immunocompromised patients, little is known about noroviral shedding and correlation with clinical symptoms in these patients. In this report, the quantitative courses of norovirus excretion in nine pediatric patients with hematologic and oncologic disorders and prolonged gastroenteritis were investigated. In a retrospective study multiple fecal samples from nine pediatric cancer patients were examined by a one‐step real‐time PCR. Clinical data of the patients were reviewed and virological data were correlated with clinical symptoms. All nine patients presented with prolonged illness and prolonged noroviral shedding. Vomiting and diarrhea were associated with high norovirus concentrations and norovirus excretion declined slowly in the patients. Retrospectively, initial PCR‐testing for norovirus was performed with a median of 7 days after onset of symptoms. This finding hints at the difficulty of obtaining early diagnosis of the infection in these children. The patients were shedding high norovirus concentration over a long period of time. Results of sequential quantitative PCR‐testing for norovirus correlated with clinical symptoms. Both clinical symptoms and quantitative PCR‐testings help to define the severity of norovirus infection and to estimate the risk for transmission. To prevent the spread of the disease, usage of virocidal disinfectants and isolation procedures should be maintained as long as patients are positive for noroviruses. Since vomiting is frequent in pediatric patients with oncological conditions, a screening program for rapid detection of norovirus infection in this group of patients should be considered. J. Med. Virol. 80:1461–1467, 2008. © 2008 Wiley‐Liss, Inc.</abstract>
<subject lang="en"><genre>keywords</genre>
<topic>norovirus</topic>
<topic>immunocompromised patients</topic>
<topic>quantitative real‐time PCR</topic>
</subject>
<relatedItem type="host"><titleInfo><title>Journal of Medical Virology</title>
</titleInfo>
<titleInfo type="abbreviated"><title>J. Med. Virol.</title>
</titleInfo>
<genre type="journal">journal</genre>
<subject><genre>article-category</genre>
<topic>Research Article</topic>
</subject>
<identifier type="ISSN">0146-6615</identifier>
<identifier type="eISSN">1096-9071</identifier>
<identifier type="DOI">10.1002/(ISSN)1096-9071</identifier>
<identifier type="PublisherID">JMV</identifier>
<part><date>2008</date>
<detail type="volume"><caption>vol.</caption>
<number>80</number>
</detail>
<detail type="issue"><caption>no.</caption>
<number>8</number>
</detail>
<extent unit="pages"><start>1461</start>
<end>1467</end>
<total>7</total>
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<identifier type="istex">57C60BBF02576E3A52C338C410406DB4E59EE2EB</identifier>
<identifier type="DOI">10.1002/jmv.21217</identifier>
<identifier type="ArticleID">JMV21217</identifier>
<accessCondition type="use and reproduction" contentType="copyright">Copyright © 2008 Wiley‐Liss, Inc.</accessCondition>
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