Detection of Novel Rotavirus Strain by Vaccine Postlicensure Surveillance

Geoffrey A. Weinberg

, Elizabeth N. Teel, Slavica Mijatovic-Rustempasic, Daniel C. Payne, Sunando Roy, Kimberly Foytich, Umesh D. Parashar, Jon R. Gentsch, and Michael D. Bowen

Author affiliations: University of Rochester School of Medicine and Dentistry, Rochester, New York, USA (G.A. Weinberg); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (E.N. Teel, S. Mijatovic-Rustempasic, D.C. Payne, S. Roy, K. Foytich, U.D. Parashar, J.R. Gentsch, M.D. Bowen)

Abstract

Surveillance for rotavirus-associated diarrhea after implementation of rotavirus vaccination can assess vaccine effectiveness and identify disease-associated genotypes. During active vaccine postlicensure surveillance in the United States, we found a novel rotavirus genotype, G14P[24], in a stool sample from a child who had diarrhea. Unusual rotavirus strains may become more prevalent after vaccine implementation.

Active vaccine postlicensure surveillance for rotavirus-associated diarrhea is informative for determination of vaccine effectiveness and for characterization of disease-associated rotavirus genotypes (1–5). Most rotaviruses circulating in the United States belong to a limited number of strains, routinely characterized by serologic or genetic identification of the outer capsid protein antigens viral protein (VP) 7, which defines G types, and VP4, which defines P types (6,7). Of circulating strains in the United States, 85% contain a G or P antigen that is included in both US-licensed rotavirus vaccines (2,8). However, > 70 G and P antigen combinations have been reported, and uncommon strains may suddenly appear in a new geographic area (1,2,5,9). Ongoing active surveillance is conducted through the Centers for Disease Control and Prevention’s New Vaccine Surveillance Network, a prospective, population-based surveillance program for acute gastroenteritis among children < 5 years old, the details of which have been published (3–5). This surveillance has detected the emergence of G12P[8] and G9P[8] rotavirus genotypes, as well as 3 reported instances of US children infected with G8P[4] rotavirus (3–5,10). During the 2009 winter season (December 2008–June 2009) in Rochester, New York, 54 (30%) of 183 enrolled children with acute gastroenteritis had rotavirus infection. Fifty (94%) of 51 rotavirus strains were typical US strains, with G or P antigens contained in the licensed rotavirus vaccines; 3 were G8P[4] (10). One strain, however, appeared to be an unusual reassortant not previously reported in human infection. We describe this novel rotavirus genotype, G14P[24], found along with enteric adenovirus in a stool sample from a child with diarrhea.