Rotavirus VP4 Genotypes and Phylogenetic Analysis Among Strains Recovered From Children, Admitted With Acute Gastroenteritis in Bahrami Children’s Hospital, Tehran, Iran

Background: Rotavirus infection is one of the most common causes of severe dehydrating diarrhea in children with a significant health burden on them, in Middle Eastern countries, including Iran.

Objectives: We aimed to investigate P serotype of group A rotavirus variability among children hospitalized with acute gastroenteritis (AGE), track the changes in the genotypes of circulating viruses, and elucidate the efficacy of introducing the commonly accepted rotavirus vaccines to the national vaccination program.

Patients and Methods: All children 14 years or younger, admitted in the Infectious Disease Ward of Bahrami Children’s Hospital due to acute nonbloody gastroenteritis between January 2009 and January 2010, were included in this study. Stool samples were collected and specific rotavirus genotype primers were defined by Virology Lab of the Pasteur Institute. The specimens were assessed for rotavirus using RNA-PAGE and semi-nested multiplex molecular virology techniques.

Results: Twenty nine rotavirus strains were retrieved from 150 samples collected from hospitalized children with gastroenteritis (14 males and 15 females; mean age 20.9 ± 18.19 months) were included in the study. The most frequent P serotype was P8 (86.2%), followed by P6 (6.9%) and P4 (6.9%). In addition, the majority of strains (89.65%) exhibited a long electrophore-type pattern on the PAGE system. Rotavirus was mostly isolated from children aged less than 2 years (86.2%), and during winter (44.7%). No significant relationships were observed between the rotavirus infection and; age, sex, season, or initial signs and symptoms such as fever, estimated dehydration on admission, nausea, and vomiting.

Conclusions: Results of the current study supported the potential efficacy of introducing RotaTeq and Rotarix vaccines to the Iranian children vaccination program. We also propose prospective studies on confirmed rotavirus diarrheal illness in various parts of Iran, to determine the distribution of various genotypes across the country.