Showing papers by "Jim Gray published in 2003"
TL;DR: Data demonstrate that the diagnostic gap can be reduced considerably through the use of molecular amplification and detection techniques, however, additional work is required to reduce this deficit further by optimising sampling algorithms and by identifying other agents associated with viral gastroenteritis.
Abstract: A total of 305 faecal specimens collected from children under the age of 5 who presented with symptoms of acute gastroenteritis either as inpatients at Addenbrooke's Hospital (N = 100) or to General Practitioners in East Anglia (N = 205) during 1999–2001 were tested for the presence of rotavirus, norovirus, sapovirus, enteric adenoviruses (Group F, serotypes 40 and 41), and astrovirus. An aetiologic agent was found in 184 specimens (60.3%). The most commonly found single viral pathogen was rotavirus (27.9%), followed by norovirus (13.4%), enteric adenoviruses (7.9%), astrovirus (2.3%), and sapovirus (1%). Mixed infections were observed in 27 specimens (8.9%), and no aetiologic agent was found in over a third of the specimens tested. These data demonstrate that the diagnostic gap can be reduced considerably through the use of molecular amplification and detection techniques. However, additional work is required to reduce this deficit further by optimising sampling algorithms and by identifying other agents associated with viral gastroenteritis. J. Med. Virol. 70: 258–262, 2003. © 2003 Wiley-Liss, Inc.
132 citations
TL;DR: The ELISA is a suitable alternative to the preliminary screening by EM for investigating outbreaks of gastroenteritis and should be examined by RT-PCR in order to detect strains non-reactive in the assay and virus strains from representative ELISA positive outbreaks should be characterised fully to allow the genetic diversity of NLVs co-circulating in the population to be described.
107 citations
TL;DR: A mid-summer peak in reported cases of Norovirus was observed in 2002, unlike all six previous years when there was a marked summer decline.
Abstract: Background
Noroviruses are the most common cause of gastroenteritis outbreaks in industrialised countries Gastroenteritis caused by Norovirus infection has been described as a highly seasonal syndrome, often referred to as "winter vomiting disease"
99 citations
TL;DR: There is a large burden of rotavirus diarrhoea in an area of northern Ghana, but the effectiveness of future vaccines could be diluted by the high polymorphism of the virus, and the difficulty of reaching remote populations.
Abstract: We measured the type-specific incidence of paediatric rotavirus diarrhoea in an area of northern Ghana. Over 1 year, diarrhoea 1717 episodes were identified, of which 677 (39%) were positive for rotavirus. Risk factors for rotavirus infection included old age, wasting, high Vesikari score and the episode occurring in the dry season. Rotavirus-positive episodes tended to be more acute, causing vomiting and greater dehydration, and were more likely to require hospitalization. The incidence was 0.089 episodes per person-year for all diarrhoea, and 0.035 for rotavirus diarrhoea. The observed incidence decreased markedly with distance from the nearest health centre, suggesting a large unobserved burden. G2P[6], G3P[4] and G9P[8] made up more than half the genotypes detected, but the remainder were diverse. There is a large burden of rotavirus diarrhoea, but the effectiveness of future vaccines could be diluted by the high polymorphism of the virus, and the difficulty of reaching remote populations.
83 citations
TL;DR: The NSP4-VP6 association may be structurally determined during rotavirus replication (morphogenesis), suggesting that these two proteins may be host restriction determinants.
Abstract: NSP4-encoding genes of 78 human rotavirus strains of common or reassortant genotypes were characterized by reverse transcription-PCR followed by sequencing and phylogenetic analysis. It was found that all the human strains characterized clustered into only two of the five known NSP4 genotypes. Linkage between NSP4 genotypes and VP6 subgroups was 100%, NSP4 genotype A being linked to VP6 of subgroup I (SGI) and NSP4 of genotype B being linked to VP6 of SGII. The diversity among the NSP4- and VP6-encoding genes was significantly less than that among the VP7 and VP4 genes in cocirculating human rotavirus strains. Whereas G and P types appear to be shared among different animal species and humans, the NSP4- and VP6-encoding genes appear to segregate according to their host of origin, suggesting that these two proteins may be host restriction determinants. The NSP4-VP6 association may be structurally determined during rotavirus replication (morphogenesis).
79 citations
TL;DR: This chapter describes the variability of group A RVs with regard to SGs and G and P types and reviews the mechanisms of genomic change underlying the evolution of these viruses.
Abstract: Publisher Summary Rotaviruses (RVs) are the main cause of acute gastroenteritis in infants and young children worldwide and in the young of many animals They are classified into at least five groups (A to E), and there are possibly two more groups (F and G) according to epitopes on the viral protein 6 (VP6) protein Within group A, four subgroups (SGs) have been differentiated according to the epitopes on the VP6 middle layer protein The two outer layer proteins, VP7 and VP4, form the basis of the present dual classification system of group A RVs into G and P types At least 14 different G-serotypes, G1 to G14, have been identified among human and animal RVs, based on differences in the neutralization epitopes of the VP7 protein Of these, at least 10 are associated with infection in humans Twenty different P types have been differentiated by sequence analysis of their VP4 genes, of which at least 10 have been found in human isolates This chapter describes the variability of group A RVs with regard to SGs and G and P types It reviews the mechanisms of genomic change underlying the evolution of these viruses
54 citations
TL;DR: Testing for the prevalence of IgG antibodies specifically directed against group C rotavirus VP6 may suggest transmission from animals to humans, however further work is required to identify the reservoir of group Crotavirus for human infection.
Abstract: A total of 3199 serum samples collected in 1993--1994 from two population cohorts from England and Wales were tested for the prevalence of IgG antibodies specifically directed against group C rotavirus VP6. Seroprevalence was 39% (95% confidence intervals: 37.0-40.4%). Seroprevalence was highest (46.0%) in the oldest age group (61-70 years of age). Infection with group C rotaviruses occurred at an earlier age and with higher incidence in rural than in urban populations. These results may suggest transmission from animals to humans, however further work is required to identify the reservoir of group C rotavirus for human infection.
41 citations
Journal Article•
TL;DR: The molecular diversity of norovirus strains associated with 26 outbreaks of NV gastroenteritis has been determined and two mixed genogroup I and II outbreaks were detected, which suggested contaminated food or water as the source of the infection.
Abstract: The molecular diversity of norovirus (NV) strains associated with 26 outbreaks of NV gastroenteritis has been determined The outbreaks occurred on 14 cruise ships from seven cruise lines, during the period from 1998 to 2002 The ships cruised in seas worldwide, including the Mediterranean, the Baltic and the Caribbean Genogroup I NVs were more common in the cruise ship setting than in hospitals, with 38% of the cruise ship outbreaks associated with genotype I NVs, as compared to < 10% in hospital and other semi-closed institutions in the UK Outbreaks on cruise ships were more common in the period April to September, than in the winter Two mixed genogroup I and II outbreaks were detected, which suggested contaminated food or water as the source of the infection
19 citations