Evaluation of Detected Rotavirus Antigen Positivity in the Council of Forensic Medicine Postmortem Microbiology Laboratory from 2007-2011

Abstract

Introduction: Infectious gastroenteritis is progressing with a high morbidity and mortality in developing countries especially among children below the age of five. The viruses cause 50-75% of all infectious gastroenteritis cases. The rotaviruses, are the most common and significant cause of gastroenteritis among newborns and infants worldwide. Rotavirus infections are responsible for the death of one million children every year. Postmortem data regarding this subject are limited in our country. The aim of our study was to determine the seasonal and age distributions associated with postmortem rotavirus positivity delected in the stool samples of autopsy cases that were microbiologically sampled due to suspected infection. Materials and Methods: Two hundred and seventy two stool samples, which were sent between August 2007 and December 2011, were examined retrospectively in terms of rotavirus antigen positivity in the Department of Forensic Medicine Postmortem Microbiology Laboratory. According to the autopsy reports, lung infection and complications were the most common causes of death, and the death was primarily due to the individual’s pre-existing disease, followed its emerging complications and finally due to gastroenteritis. Two kits that detect rotavirus antigen using enzyme immunoassay technique were used to examine stool samples: Ridascreen Rotavirus kit (R-Biopharm AG, Darmstadt, Germany) for the samples between August 2007 and December 2010 and Enzyme-Linked Fluorescent Assay (ELFA; Vidas; Biomerieux, France) for the samples between December 2010 and December 2011. The distributions of rotavirus frequency according to seasons, age and sex were evaluated statistically. Results: Rotavirus antigen was detected in 47 (17.3%) of 272 samples that were examined. Rotavirus antigen positivity was observed more in the 0-2 age group (p 0.05). It was found that the percentage of rotavirus positivity was decreased in summer (17%) and autumn (12.8%) compared to the other seasons, and the highest positivity rates were seen during winter (34.1%) and spring (36.1%). Conclusion: Rotavirus gastroenteritis, which is quite common in our country, is an important health issue that causes morbidity and mortality. As the clinical signs are non-spesific for the virus, analysis of viral antigen in stool samples is important for the diagnosis in order to predict the course of the disease and particulary to determine a treatment protocol. The role of rotavirus in fatal conditions is not clear, and additional research methods are required to evaluate deaths associated with diarrhea. The studies related to pathological examinations of people who died due to rotavirus infections are limited to a few autopsy data. We believe that a better understanding of the outcome may alter the approach to these infections and to treatment