《儿科学》课程教学课件（PPT讲稿）26 Rotavirus Infection in Children

Rotavirus Infectionin Children

Rotavirus Infection in Children 1

Overview of Rotavirus infectionThe most common cause of severe diarrhea among infantsand young childrenAccounts for up to 50%ofhospitalizations for severediarrheaOne of several viruses that cause infections often calledstomach flu, despite having no relation to influenza.It is a double-stranded RNAvirus in the family ReoviridaeAlmost every child in the world has been infected withrotavirus at least once by the age of five. Adults are rarelyaffectedAbout 600,000 children under five years of age die fromrotavirus infection each year in whole world.Almost two million more become severely ill

2 Overview of Rotavirus infection • The most common cause of severe diarrhea among infants and young children. • Accounts for up to 50% ofhospitalizations for severe diarrhea. • One of several viruses that cause infections often called stomach flu, despite having no relation to influenza. • It is a double-stranded RNA virus in the family Reoviridae. • Almost every child in the world has been infected with rotavirus at least once by the age of five. Adults are rarely affected. • About 600,000 children under five years of age die from rotavirus infection each year in wholeworld. • Almost two million more become severely ill

History of RotavirusFirst identified as cause ofdiarrhea in 1973 by RuthBishop.Thomas Flewettsuggested the namerotavirus after observingthat.WheelRata(Latin)(E ng lish)

History of Rotavirus • • First identified as cause of diarrhea in 1973 by Ruth Bishop. Thomas Flewett suggested the name rotavirus after observing that. Rata (Latin) 3 Wheel = (E nglish)

RotavirusOne of Flewett'soriginalelectronComputer-aidedreconstructionofarotavirusmicrographsbasedonseveralelectronmicrographs4

Rotavirus One of Flewett’soriginalelectron micrographs 4 Computer-aided reconstruction of a rotavirus based on several electronmicrographs

ElectronmicrographsDiameter75nmRotavirusAstrovirusCalicivirus-NVAdenovirusOCalicivirus-SvTorovirusPicobirnavirusEnterovirus22Harrison' s Principle of Internal Medicinge, 17th Ed

Electron micrographs Harrison’sPrinciple of InternalMedicin5 e,17th E d Diameter ≈75 n m

Rotavirus StructuredsRNADouble-shelledicosahedronProteinsegmentcontaining 11 segments of1VP1Polymerasedouble-stranded RNA2VP2InnershellVP3Capping enzyme3VP4Neutralization8-5NSP1Interferonantagonist6VP6Middleshell>NSP3Systemic spread8NSP2ViroplasmVP19VP7Neutralization&VP310NSP4EnterotoxinVP411NSP5VP2ViroplasmNSP66VP7VP6

Rotavirus Structure • Double-shelled icosahedron containing 11 segments of double-stranded RNA 6

Rotavirus ClassificationGroups: A, B, C,D,E, F, G.According to inner protein VP6: Most human illness is caused by group A, afew by groupsBand C. Group Bis reported in China and India onlySerotypes: G1-23, P1-31Defined by two outer-capsid protein VP7 (Gprotein) andVP4 (P protein): Only 10 Gtypes and 11 Ptypes found in human isolates

7 Rotavirus Classification Groups: A, B, C, D, E, F, G • According to inner proteinVP6 • Most human illness is caused by group A, a few by groups B and C. Group B is reported in China and India only. Serotypes: G1-23, P1-31 • Defined by two outer-capsid protein VP7 (G protein) and VP4 (P protein) • Only 10 G types and 11 P types found in human isolates

RotavirusDiseaseBurdenGlobally,estimated to cause 125million casesofdiarrhea.Ofthese, 18 million cases are considered at leastmoderately severe, with approximately 600,000 deathsper year.In china, estimated to cause more than 10 million casesofdiarrhea per year.:In U.S., estimated 3 million cases of diarrhea, 50,000hospitalizations, and 20-40 deaths annually in U.S

8 Rotavirus Disease Burden • Globally, estimated to cause 125 million cases of diarrhea. Of these, 18 million cases are considered at least moderately severe, with approximately 600,000 deaths per year. • In china, estimated to cause more than 10 million cases of diarrhea per year. • In U.S., estimated 3 million cases of diarrhea, 50,000 hospitalizations, and 20-40 deaths annually in U.S

Pathogens for acute gastroenteritis inchildrenFrequencyof enteropathogensinEuropeanchildren(O-5y)PathogenFrequency,%Rotavirus10-35Norovirus2-204-13Campylobacter2-10Adenovirus5-8Salmonella14.5EPECYersinia0.4-30.9-3Giardia0-3Cryptosporidium0-2EAggECShigella0.31.4STEC0-3ETEC0-0.50-4Entamoeba45-60No agent detectedEPEC=enteropathogenic Escherichia coli; EAggEC=enteroagenteroaggregative E coli; STEC-Shiga toxin-producing E coli,ETEC=enterotoxigenic strainsof Ecoli

Pathogens for acute gastroenteritis in children Frequency of enteropathogens in E u r o p e an children (0–5 y) 9

ViralGastroenteritis in childrenFamilyVirusPrimary Age Group at Risk Clnial Severty Detection AssaysGenomeReoviridaeDouble-strand segmented RNAChildren<5 years+EM,EIA(commercal),PAGERT-PCRGroup ArotavirusNorovrusCaliviridaeEM,EIA, RT-PCRPositive-sense single-strand RNA Allages++CaliviridaeEM,EIA,RT-PCRSapovirusPositive-sense single-strand RNA Children<5 yearsAstrovrusAstrovidaePositivesensesinglestrandRNhildrenyearsEM, EIA, RT-PCR+++chidren<5 earsAdenovirus (types 40 and 41)Adenovinidae Double-strand DNAEM, EIA (commercial,CRHarrison'sPrinciple of Internal Medicine,17th Ed10

Viral Gastroenteritis in children Harrison’sPrinciple of InternalMedicine, 17th E d 1 0