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Jon R Gentsch

Publications and source records attributed to Jon R Gentsch.

23 records · Page 2Linked to original sources

Outbreaks of adult gastroenteritis traced to a single genotype of rotavirus.

Between November 1998 and December 2000, the Centers for Disease Control and Prevention screened samples from 263 outbreaks of gastroenteritis in the United States and identified 3 that were associated with rotavirus among adults. Rotaviruses from each outbreak were further characterized by reverse-transcription polymerase chain reaction. Surprisingly, all specimens were of serotype G2, a strain that is, as determined by high-stringency hybridization analysis, genetically distinct in all 11 gene segments from the other common rotavirus strains in circulation. The unusual coincidence of identification of only G2 strains in these 3 outbreaks of rotavirus gastroenteritis among adults is similar to results from other studies, in which G2 strains were found in association with more-severe disease in children than other rotavirus serotypes and in association with outbreaks of diarrhea among adults in Japan. Although rotavirus infections in adults are relatively uncommon, which indicates that good overall protective immunity exists, the predominance of G2 strains in outbreaks that have occurred in adults suggests that natural immunity to more common strains does not always provide adequate heterotypic immunity to G2 strains. For the rotavirus vaccines under development, special attention may need to be paid to protection against G2 strains.

Adult↗

The role of serum antibodies in the protection against rotavirus disease: an overview.

A critical observation in understanding immunity to rotavirus is that children infected with wild virus or vaccinated with oral live vaccines develop a humoral immune response and are protected against severe disease upon reinfection. Nevertheless, much controversy exists as to whether these serum antibodies are directly involved in protection or merely reflect recent infection, leaving the protective role to mucosal or cell-mediated immunity or to other as-yet-undefined mechanisms. We have reviewed data from a variety of studies in humans, including challenge experiments in adult volunteers, longitudinal studies of rotavirus infection in young children, and clinical trials of animal and animal-human reassortant rotavirus vaccines in infants. These data suggest that serum antibodies, if present at critical levels, are either protective themselves or are an important and powerful correlate of protection against rotavirus disease, even though other host effectors may play an important role as well.

Animals↗

Diversity of rotavirus strains among children with acute diarrhea in China: 1998-2000 surveillance study.

As part of a national rotavirus surveillance activity, we collected fecal specimens from 3,177 children with acute diarrhea in 10 regions of China between April 1998 and April 2000 and screened them for rotavirus. Rotavirus was detected in 41% (n = 1,305) of specimens, and in these, G1 was the predominant serotype (72.6%), followed by G3 (14.2%), G2 (12.1%), G4 (2.5%), G9 (0.9%), and G untypeable (0.7%). Among 327 G-typed strains tested for P genotype, 14 different P-G combinations were identified, with the globally common strains P[8]G1, P[4]G2, P[8]G3, and P[8]G4 representing 75.6% of all typed rotavirus strains. Among the uncommon strains, 11 were P[6]G9, and others included P[6]G1, P[6]G3, and five novel P-G combinations (P[9]G1, P[4]G1, P[4]G3, P[4]G4, and P[8]G2). Our results indicate that while the common rotavirus strains remain predominant, the diversity of strains is much greater than was previously recognized.

Acute Disease↗

Rotavirus typing methods and algorithms.

Vaccination is the current strategy for control and prevention of severe rotavirus infections, a major cause of acute, dehydrating diarrhoea in young children worldwide. Public health interventions aimed at improving water, food and sanitation are unlikely adequately to control the disease. The development of vaccines against severe rotavirus diarrhoea is based upon homotypic or heterotypic protection provided against either a single common G serotype (monovalent vaccines) or against multiple serotypes (multivalent vaccines). Rotavirus strain surveillance has a high priority in disease control programmes worldwide. The continued identification of the most common G and P serotypes for inclusion in vaccines is an important priority. And subsequent to the introduction of a vaccine candidate, not only monitoring of circulating strains is recommended, but also surveillance of potential reassortment of animal rotavirus genes from the vaccine into human rotavirus strains is critical. Conventional methods used in the characterisation of rotavirus strains, such as enzyme immunoassay serotyping and reverse-transcription PCR-based genotyping often fail to identify uncommon and newly appearing strains. The application of newer molecular approaches, including sequencing and oligonucleotide microarray hybridisation, may be required to characterise such strains. The present paper presents a brief overview of the variety of standard methods available, followed by suggestions for a systematic approach for routine rotavirus strain surveillance as well as for characterisation of incompletely typed rotavirus strains. Improved detection and characterisation of incompletely typed strains will help to develop a comprehensive strain surveillance that may be required for tailoring effective rotavirus vaccines.

Algorithms↗