Estudo epidemiológico da doença diarréica aguda associada aos adenovírus, em Juiz de Fora, Minas Gerais, no período 2007-2010

Abstract

Acute diarrheal disease (ADD) is still the major cause of child morbidity and mortality in developing countries. Among the non-bacterial diarrhea, enteric adenoviruses are one of the most important etiologic agents of disease. Human adenoviruses (HAdV) belongs to the Adenoviridae family and Mastadenovirus genus. The virus are classified into seven species (A-G) and 54 serotypes. Among them, serotypes 40 and 41, both of the species F, are the most commonly associated with ADD. Taking in consideration the importance of the DDA in developing countries, the large number of cases that don’t have the etiologic agent identified and the lack of knowledge about the participation of HAdV infection and the pathogenesis of ADD, we performed this study in Juiz de Fora, Minas Gerais. Between January of 2007 and December of 2010 395 diarrheal fecal specimens originating from individuals of various ages treated in ambulatory and hospitalized were analyzed. The presence of HAdV was detected by PCR, using specific primers, and molecular characterization of positive samples was performed by sequencing and phylogenetic analysis of partial sequences of the hexon gene. For statistical analyzes, we used SPSS version 13.0, adopting a value of p <0.05 as significant. The prevalence of infection by HAdV between 2007-2010 was 10.9% (43/395). The results showed no significant correlation between the origin of the sample (hospital X ambulatory) and the occurrence of infection (p = 0.152), and the same was observed in relation to gender of the infected person (P=0,393). Moreover, the majority of positive cases was detected in children under 24 months of age, showing a statistically significant correlation between the age of the infected individuals and the occurrence of infection (p=0,007). In most cases of infection HAdV (36/43), this was the only viral agent detected, however, cases of co-infection HAdV / Rotavirus (5/43) and HAdV /Norovirus (2/43) were identified. Phylogenetic analysis of partial sequences of the hexon gene from 35 positive samples revealed that all samples clustered with HAdV species F, serotypes 41, confirming the association of enteric HAdV in the cases of this study. This epidemiological survey revealed the presence and circulation of these viruses in the population of Juiz de Fora in the period studied, as well as its important role in the genesis of the DDA, our data identified a good number of cases of the disease, which normally remains unidentified.