Diagnostiek en epidemiologie van rotavirusinfecties in Nederland

Abstract

In the Netherlands the infection occurs predominantly during the first four years of live and the seasonal activity is highest during early spring. The diagnosis is made more frequently in boys than in girls (56% vs 44%). Most virological laboratories in the Netherlands use latex agglutination (LA) tests for the diagnosis of rotavirus. A total of 205 human faecal specimens were examined for the presence of rotavirus by four different detection methods: latex agglutination (LA) test, a "home-made" enzyme immuno-assay (EIA), polyacrylamide gel electrophoresis (PAGE) and agarose gel electrophoresis (AGE). Identical results in all four tests were found in 188 (92%) of the stool specimens. Using the results of a newly defined golden standard: TRUE, we found the specificities of the LA, EIA, PAGE and AGE to be 97.9, 98.6, 100 and 100%, respectively. The sensitivities of these four methods were 98.4, 98.4, 88.7 and 88.7% respectively. Early diagnosis of rotavirus infection is essential for effective patient management and infection control. LA and AGE are both rapid screening tests for the diagnosis of rotavirus infection. AGE is also an inexpensive test with an added advantage that this method can detect non-group A rotaviruses. During our survey, we could not identify non-group A rotaviruses. The epidemiology of rotavirus gastroenteritis in the Netherlands was investigated by serotyping. We compared two different methods for serotyping 84 faecal rotavirusstrains from patients with gastroenteritis: serotyping by an enzyme immunoassay with serotype-specific monoclonal antibodies and gen amplification with type-specific oligonucleotide primers. With the PCR typing method we could type 96%, and with the EIA MAb 82% of the 84 faecal strains. 100% agreement of the result was observed with all the samples that were typed by both assays. Serotype 1 rotavirus was predominant in the Netherlands in 1990 with a prevalence of 77%. The prevalence of serotype 2,3 and 4 was 3,3 and 17% respectively.<br>