4.6 Article

First Episodes of Norovirus and Sapovirus Gastroenteritis Protect Against Subsequent Episodes in a Nicaraguan Birth Cohort

Journal

EPIDEMIOLOGY
Volume 33, Issue 5, Pages 650-653

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/EDE.0000000000001500

Keywords

Children; Diarrhea; Gastroenteritis; Nicaragua; Norovirus; Sapovirus

Funding

  1. National Institute of Allergy and Infectious Diseases at the National Institutes of Health [R01AI127845, K24AI141744]
  2. Fogarty International Center [D43TW010923]

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The study found that episodes of acute gastroenteritis caused by sapovirus and norovirus provide protection against future episodes, suggesting a potential for the development of pediatric vaccines against these viruses.
Background: Norovirus and sapovirus cause a large burden of acute gastroenteritis (AGE) in young children. We assessed protection conferred by norovirus and sapovirus AGE episodes against future episodes. Methods: Between June 2017 and July 2018, we recruited 444 newborns in Leon, Nicaragua. Weekly household surveys identified AGE episodes over 36 months, and AGE stools were tested by reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) for norovirus genogroup (G)I/GII and sapovirus. We used recurrent-event Cox models and negative control methods to estimate protection conferred by first episodes, controlling for observed and unobserved risk factors, respectively. Results: Sapovirus episodes conferred a 69% reduced hazard of subsequent episodes using the negative control method. Norovirus GI (hazard ratio [HR] = 0.67; 95% confidence interval [CI] = 0.31, 1.3) and GII (HR = 0.20; 95% CI = 0.04, 0.44) episodes also appeared highly protective. Protection against norovirus GII was enhanced following two episodes. Conclusions: Evidence of natural immunity in early childhood provides optimism for the future success of pediatric norovirus and sapovirus vaccines.

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