HIGH PREVALENCE OF ROTAVIRUS INFECTION AMONG NEONATES BORN AT HOSPITALS IN DELHI, INDIA - PREDISPOSITION OF NEWBORNS FOR INFECTION WITH UNUSUAL ROTAVIRUS

Although rotavirus is the most common cause of diarrhea in children ol der than 3 months of age, neonatal infections, which are asymptomatic, have rarely been surveyed and have been identified in only a few disc rete nosocomial outbreaks. After such a nosocomial outbreak of rotavir us infection among newborns at a hospital in Delhi, we screened infant s born at five other nurseries in the immediate area to assess the pre valence of neonatal infections and to determine whether the unique neo natal rotavirus strain, 116E, previously identified in Delhi, was pres ent in other settings. Infection was documented in 43 to 78% of hospit alized infants between 4 and 6 days of life born at five of the six ho spitals. Infection with strains related to 116E were the most common, but other unusual strains and no strains common in the community were detected. In addition a shift in genotype was observed among specimens collected from two of these hospitals during a 2-year period. Our obs ervation that neonatal rotavirus infections are more common than recog nized previously would encourage the administration of rotavirus vacci nes during the newborn period and suggests that the low efficacy of va ccines observed during trials in developing countries may be caused by early natural exposure of infants before immunization. The extraordin ary predisposition of neonates for unusual rotavirus strains not commo nly found in the community should encourage others to screen neonates for this infection, characterize the strains more fully and attempt to understand at a molecular level the unique relationship between the i nfecting strain type and the age of the host.