Prevalence and Co-infection of Cosavirus in Pediatric Patients with Acute Gastroenteritis from North India

Viral gastroenteritis is one of the major causes of childhood mortality in India. About 30 to 50 % gastroenteritis caused by unknown etiological agents. This study was aimed to identify unknown RNA viral etiology and their clinical manifestation with pediatric acute gastroenteritis, conducted at tertiary care hospital of Uttar Pradesh, North India from July 2012 to December 2013. A total of 234 patients with their clinical profiling were enrolled in this study. Identification of viruses was performed by serological (ELISA for rotavirus) and molecular methods (PCR for astrovirus, norovirus and cosavirus). Quantitative and qualitative data analysis performed by Chi-square and student t-test. Total subjects positive for infection was 35%.Co-infection present in 21% cases. Rotavirus, astrovirus, norovirus and cosavirus were detected in 25%, 10%, 7% and 3% subjects respectively. Other than diarrhea, vomiting was a significant symptom (p=0.0002). Severity of diarrhea was more than vomiting with 5.5±2.7 vs. 3.3±2.6 episodes in 24 hrs. Mean duration of symptoms 3.7±9.1. Eighty percent virus positivity were below the age of 6 years (39.2 ±34.6, median=34 months) and 65% males were positive. This study defines the viral etiology and their clinical association with gastroenteritis. This is the first report of prevalence and co-infection of cosavirus in this region. The outcome of the study provides a baseline data which can be used to design and develop the preventive strategies against unknown etiologies like cosavirus.