Diagnostics and Virology

The diagnosis of rotavirus should be suspected in a child under the age of 3-5 years who has diarrhea preceded by vomiting at the time of the usual winter seasonal epidemic. At this time, the child will be shedding so much virus (i.e., >1012) that diagnosis is easy. The most commonly available test is an immunoassay for either an enzyme immunoassay (e.g., ELISA) or a latex assay which can be quicker but is slightly less sensitive. The assays will normally remain positive for the first few days of the disease. RT-PCR is useful for confirmation and characterization of strains but, this is only used in research laboratories. The virus is easily visible by electron microscopy with dark stain and by polyacrilamide gel electrophoresis which displays the 11 segments of RNA.

Rotavirus belongs to the family Reoviridae and is characterized by the presence of 11 segments of double stranded RNA that are encased by 3 shells, an inner core, an internal capsid and an outer coat. The outer coat is composed of 2 proteins that are seen by the child's immune system. These outer capsid proteins, called Viral Proteins 4 and 7 (VP4 and VP7) and also labeled the Protease-cleaved protein and the Glycoprotein respectively (P and G proteins) are the basis to characterize the diversity of this virus group and the targets to mount an immune response. Four or five strains of rotavirus ([P8], G1; [P8], G3; [P8], G4; [P8], G9, and [P4], G2) predominate worldwide and these have become the prime targets for the vaccines in development. At the same time, in developing countries, many new strains arise although they rarely become the predominant strains over time.

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