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G10 rotaviruses, which are usually found in cattle, have also been reported in neonatal infections in recent years. During the rotavirus surveillances of children less than 4years of age between 2003 and 2006 in Kolkata, eastern India, 60 out of 1153 samples could not be typed. All 60 samples gave usual electropherotype pattern in polyacrylamide gel. Thirty-one out of these 60 G and P untypable rotavirus strains were successfully characterized during the study. Among 31 samples, G9P[4] (n=8), G12P[8] (n=8), G1P[8] (n=6), G10P[4] (n=6), and G2P[4] (n=3) genotypes were identified. In this study we report genetic analysis of the six G10 strains, which revealed close relations with Turkish (E29TR) bovine strains, as well as with bovine-like-equine strain (Erv2) from India. SimPlot of the VP7 gene segment suggested possible recombination event between the bovine and the bovine-like-equine rotaviruses in these human rotavirus infections.

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OBJECTIVE: To compare the clinical efficacy of supplementation of zinc, zinc plus vitamin A, and zinc plus combination of micronutrients and vitamins (iron, copper, selenium, vitamin B(12), folate, and vitamin A) on acute diarrhea in children. STUDY DESIGN: This was a double-blind, randomized, placebo-controlled trial. Children aged 6 to 24 months with diarrhea and moderate dehydration were randomized to receive zinc plus placebo vitamin A (group 1), zinc plus other micronutrients plus vitamin A (group 2), zinc plus vitamin A (group 3), or placebo (group 4) as an adjunct to oral rehydration solution. Duration, volume of diarrhea, and consumption of oral rehydration solution were compared as outcome variables within the supplemented groups and with the placebo group. RESULTS: The 167 study subjects included 41 in group 1, 39 in group 2, 44 in group 3, and 43 in group 4. All 3 supplemented groups demonstrated a significant reduction in outcome variables (P < .0001) compared with the placebo group. Group 3 had the lowest reduction of outcome variables and group 2 had a speedy recovery, but differences among the supplemented groups were not statistically significant. CONCLUSIONS: Supplementation with a combination of micronutrients and vitamins was not superior to zinc alone, confirming the clinical benefit of zinc in children with diarrhea.

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BACKGROUND: Although recognized as a significant respiratory pathogen, there is a dearth of information on genetic diversity of human respiratory syncytial virus (HRSV) strains among children in India. OBJECTIVES: To study prevalence and genomic diversity of HRSV strains among children (<5 years of age) with acute respiratory tract infection (ARTI) at Dr. B.C. Roy Memorial Hospital for Children, Kolkata, Eastern India. STUDY DESIGN: During September 2005 to August 2008, nasal and/or throat swabs from children with ARTI were screened for presence of HRSVs by RT-PCR of nucleocapsid (N) and glycoprotein (G) genes. Classification of G gene of HRSV strains were achieved with different primer pairs designed for amplification of N'- and/or C'-terminal hypervariable regions (HVR1 and HVR2) of HRSV A and B strains. The HVR1 and HVR2 of G gene of 27 and 22 HRSV B strains were sequenced. RESULTS: One hundred seventy seven of 1720 clinical samples were positive for HRSVs. Group B strains were detected at higher rates (95% against 5%, n=80) than A in 2005-2006, whereas in consecutive years, the rate of detection of group A were higher (94.84% against 5.16%, n=97). The group B strains were genetically related to globally spreading BA genotype, exhibiting conserved nature of stop codon, six nucleotide deletions in HVR1 and formed single phylogenetic clusters for both HVR1 and HVR2. CONCLUSIONS: The detection of significant high rates of group B strains in 2005-2006 followed by increase in prevalence of A strains in subsequent years highlight the dynamic nature of prevalence of HRSV subtypes among children with ARTI in Eastern India.

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Deduced amino acid sequence and phylogenetic analyses of a group A rotavirus G9P[6] strain (designated as mcs/13-07), detected from a 3-year-old child in Eastern India, revealed a VP8* closely related to porcine P[6] strains (P[6] sublineage 1D), and the VP7 clustered with G9 lineage-III strains. To our knowledge, this is the first report of human P[6] strain clustering in sublineage Id. Thus, to further characterize the evolutionary diversity of strain mcs/13-07, all gene segments were analyzed. VP6 and NSP4 exhibited genetic relatedness to Wa-like human subgroup II strains, while VP1-3, NSP1-3 and NSP5 were closely related to porcine strains. Based on the new classification system of rotaviruses, mcs/13-07 revealed a G9-P[6]-I1-R1-C1-M1-A8-N1-T1-E1-H1 genotype with close similarity to human Wa-like and porcine Gottfried strains. Therefore, considering the porcine-like or porcine origin of multiple gene segments, it might be tempting to assume that strain mcs/13-07 represents a rare instance of whole-virus transmission from pig to human, after which the virus evolved with time. Alternatively, it is possible that strain mcs/13-07 resulted from multiple reassortment events involving human subgroup II and porcine P[6] strains. Nevertheless, detection of strain mcs/13-07 provides further evidence for complex interspecies transmission events, which are frequent in developing countries.

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To clarify the phylogenetic relatedness of rotaviruses causing gastroenteritis in children and adults, an epidemiologic investigation was conducted in Mymensingh, Bangladesh, during the period between July 2004 and June 2006. A total of 2,540 stool specimens from diarrheal patients from three hospitals were analyzed. Overall, rotavirus-positive rates in children and adults were 26.4 and 10.1%, respectively. Among the 155 rotavirus specimens examined genetically from both children and adults, the most frequent G genotype was G2 (detection rate: 54.0 and 47.6%, respectively), followed by G1 (21.2 and 26.2%, respectively), and G9 (15.9 and 9.5%, respectively). G12 was also detected in five specimens (3.2% in total; four children and one adult). Sequence identities of VP7 genes of G2 rotaviruses from children and adults were higher than 97.8%, while these Bangladeshi G2 viruses showed generally lower identities to G2 rotaviruses reported elsewhere in the world, except for some strains reported in African countries. Similarly, extremely high sequence identities between children and adults were observed for VP7 genes of G1, G9 and G12 rotaviruses, and also for the VP4 genes of P[4], P[6], and P[8] viruses. Rotaviruses from children and adults detected in this study were included in a single cluster in phylogenetic dendrograms of VP7 or VP4 genes of individual G/P types. Rotaviruses with two emerging types, G9 and G12, had VP7 genes that were phylogenetically close to those of individual G-types recently reported in Bangladesh and India and were included in the globally spreading lineages of these G-types. These findings suggested that genetically identical rotaviruses, including those with the emerging types G9 and G12, were circulating among children and adults in city and rural areas of Bangladesh.

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Novel rotavirus strains B219 and ADRV-N derived from adult diarrheal cases in Bangladesh and China, respectively, are considered to belong to a novel rotavirus group (species) distinct from groups A, B, and C, by genetic analysis of five viral genes encoding VP6, VP7, NSP1, NSP2, and NSP3. In this study, the nucleotide sequences of the remaining six B219 gene segments encoding VP1, VP2, VP3, VP4, NSP4, and NSP5 were determined. The nucleotide sequences of the group B human rotavirus VP1 and VP3 genes were also determined in order to compare the whole genome of B219 with those of group A, B, and C rotavirus genomes. The nucleotide and deduced amino acid sequences of all B219 gene segments showed considerable identity to the ADRV-N (strain J19) sequences (87.7-94.3% and 88.7-98.7%, respectively). In contrast, sequence identity to groups A-C rotavirus genes was less than 61%. However, functionally important domains and structural characteristics in VP1-VP4, NSP4, and NSP5, which are conserved in group A, B, or C rotaviruses, were also found in the deduced amino acid sequences of the B219 proteins. Hence, the basic structures of all B219 viral proteins are considered to be similar to those of the known rotavirus groups.

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Long RNA electropherotype rotavirus strains with subgroup I specificity predominated the infantile gastroenteritis outbreak in Manipur, India, in 1987-88. One such strain (RMC321) was found to possess porcine characteristics in 7 out of 8 genes sequenced. Partial characterization of its remaining VP1, VP2 and VP3 genes along with a porcine rotavirus strain (HP140) uncovered their close genetic relation to porcine strains. VP7 was the only gene segment of this strain with significant genetic identity to human strains. This indicates that a rotavirus reassortant strain with most of its genetic material derived from a porcine strain may cause symptomatic infection in a human host.

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Limited information is available about the prevalence and genotype distribution of hepatitis C virus (HCV) in the general population of India. A community-based epidemiologic study was carried out in a district in West Bengal, India. By a 1:3 sampling method, 3,579 individuals were preselected from 10,737 inhabitants of 9 villages of the district, of whom 2,973 (83.1%) agreed to participate. Twenty-six subjects (0.87%) were HCV antibody positive. The prevalence increased from 0.31% in subjects <10 years of age to 1.85% in those >or=60 years. No difference in prevalence between men and women was observed. Serum alanine aminotransferase (ALT) levels were elevated in 30.8% (8 of 26) of anti-HCV-positive subjects compared with 3.2% (94 of 2,947) anti-HCV-negative subjects (P <.001). HCV RNA was detectable in 80.8% (95% CI, 65.6%-95.91%) of the anti-HCV-positive subjects by reverse transcription-primed polymerase chain reaction (RT-PCR). The participants were HCV types 1b in 2 (9.5%), 3a in 8 (38.1%), 3b in 6 (28.6%), and unclassified in 5 (23.8%). Nucleotide sequencing and phylogenetic analysis assigned the unclassified type to genotype 3e. In conclusion, this study provides general population-based estimates of HCV prevalence, including genotypes, from a South Asian country. Although the prevalence of HCV infection in this population was lower than that reported from industrialized countries of the west, the total reservoir of infection is significant and calls for public health measures, including health education to limit the magnitude of the problem.

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