Epidemiology and molecular detection of human adenovirus and non-polio enterovirus in fecal samples of children with acute gastroenteritis: A five-year surveillance in northern Brazil

• Published in: PloS one 2024-08, Vol.19 (8), p.e0296568
• Main Authors: Alves, Jainara Cristina Dos Santos, Teixeira, Dielle Monteiro, Siqueira, Jones Anderson Monteiro, Deus, Danielle Rodrigues de, Oliveira, Darleise de Souza, Ferreira, James Lima, Lobo, Patricia Dos Santos, Soares, Luana da Silva, Tavares, Fernando Neto, Gabbay, Yvone Benchimol
• Format: Article
• Language: English
• Subjects: Acute Disease; Adenovirus Infections, Human - epidemiology; Adenovirus Infections, Human - virology; Adenoviruses; Adenoviruses, Human - classification; Adenoviruses, Human - genetics; Adenoviruses, Human - isolation & purification; Age; Analysis; Brazil; Brazil - epidemiology; Cell lines; Child; Child, Preschool; Children; Development and progression; Diarrhea; Enterovirus - genetics; Enterovirus - isolation & purification; Enterovirus Infections - diagnosis; Enterovirus Infections - epidemiology; Enterovirus Infections - virology; Enteroviruses; Epidemiology; Feces; Feces - virology; Female; Gastroenteritis; Gastroenteritis - epidemiology; Gastroenteritis - virology; Health aspects; Humans; Immunization; Infant; Laboratories; Male; Morbidity; Mortality; Nucleotides; Pediatrics; Phylogeny; Poliomyelitis; Rotavirus; Serotypes; Severe acute respiratory syndrome coronavirus 2; Surveillance; Viral diseases; Viruses; Vomiting
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0296568

Acute gastroenteritis (AGE) is a common pediatric infection that remains a significant cause of childhood morbidity and mortality worldwide, especially in low-income regions. Thus, the objective of this study was to detect human adenovirus (HAdV) and non-polio enterovirus (NPEV) in fecal samples from the Gastroenteritis Surveillance Network, and to identify circulating strains by nucleotide sequencing. A total of 801 fecal samples were tested using qPCR/RT-qPCR, and 657 (82.0%) were inoculated into HEp-2C and RD cell lines. The HAdV and NPEV positivity rates obtained using qPCR/RT-qPCR were 31.7% (254/801) and 10.5% (84/801), respectively, with 5.4% (43/801) co-detection. Cytopathic effect was observed in 9.6% (63/657) of patients, 2.7% (18/657) associated with HAdV, and 6.2% (41/657) associated with NPEV after testing by ICC-PCR. A comparison of the two methodologies demonstrated an agreement of 93.5% for EVNP and 64.4% for HAdV. These two viruses were detected throughout the study period, with HAdV positivity rates ranging from 41% in Amapá to 18% in Pará. The NEPV varied from 18% in Pará/Rondônia to 3% in Acre. The most affected age group was over 60 months for both HAdV and NPEV. Samples previously positive for rotavirus and norovirus, which did not show a major difference in the presence or absence of diarrhea, fever, and vomiting, were excluded from the clinical analyses of these two viruses. These viruses circulated over five years, with a few months of absence, mainly during the months corresponding to the waves of SARS-CoV-2 infection in Brazil. Five HAdV species were identified (A, B, C, D, and F), with a greater predominance of HAdV-F41 (56.5%) followed by HAdV-C (15.2%). Three NPEV species (A, B, and C) were detected, with serotypes E14 (19.3%) and CVA-24 (16.1%) being the most prevalent. The present study revealed a high diversity of NPEV and HAdV types circulating in children with AGE symptoms in the northern region of Brazil.