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Open Access Highly Accessed Research article

Rotavirus and Norovirus infections among acute gastroenteritis children in Morocco

Maria El Qazoui1*, Hicham Oumzil1, Larbi Baassi2, Nezha El Omari1, Khalid Sadki3, Saaid Amzazi3, Mohamed Benhafid1 and Rajae El Aouad4

Author Affiliations

1 Immunology–Virology Department, National Institute of Hygiene, Ministry of Health, 27 Avenue Ibn Batouta, Rabat, Morocco

2 Office of the Laboratories of the National Institute of Hygiene, Ministry of Health, 27 Avenue Ibn Batouta, Rabat, Morocco

3 Laboratory of Biochemistry and Immunology, Department of Biology, Faculty of Sciences, 4 Avenue Ibn Batouta, B.P. 1014 RP, Rabat, Morocco

4 UPR Immunology-School of Medicine and Pharmacy, Mohamed V University, Avenue Mohamed Belarbi El Alaoui Souissi, Rabat, Morocco

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BMC Infectious Diseases 2014, 14:300  doi:10.1186/1471-2334-14-300

Published: 3 June 2014

Abstract

Background

Acute gastroenteritis is a serious cause of child mortality and morbidity in resource-limited countries. A viral etiology is most common, and rotavirus and norovirus are reported to be the leading causative agents. There are still few epidemiological data on the simultaneous occurrence of these viruses in Morocco. The aim of this study was to provide useful epidemiological data on the gastroenteritis associated with rotavirus and norovirus among children aged less than 5 years.

Methods

From January to December 2011, 335 samples were tested for rotavirus and norovirus using enzyme-linked immunosorbent assay, reverse-transcription-polymerase chain reaction (RT-multiplex PCR) and real-time RT-PCR. Partial sequences of the norovirus were phylogenetically analyzed to determine the genotype.

Results

The overall rates of rotavirus and norovirus infections were 26.6% and 16.1%, respectively. Mixed viral infections were detected in 9 of 335 stool specimens (2.7%).

The most common genotype combination in the rotavirus strains was G1[P8] (51.7%), followed by G2[P4] (10.1%), G2[P8] (4.5%), G9[P8] (3.4%), G4[P8] (3.4%), and G1[P6] (2.3%). Among patients positive for norovirus, 42 (77.8%) tested positive for GII and 12 (22.2%) for GI. Thirty-three (78.6%) of the norovirus GII-positive cases were successfully characterized. Genotype GII.4 was the most prevalent (n = 27; 81.8%), followed by GII.3 (n = 2; 6.1%), GII.13 (n = 2; 6.1%), GII.16 (n = 1; 3%), and GII.17 (n = 1; 3%).

Conclusion

This study suggests that in Morocco, norovirus is the most frequent cause of acute gastroenteritis after rotavirus, but further enteric viruses need to be integrated in the surveillance system so that a conclusion could be drawn.

Keywords:
Norovirus; Rotavirus; Acute gastroenteritis; Morocco