Distinct Populations of Rotaviruses Circulating Among Neonates and Older Infants

We obtained three stool specimens from each of 371 neonates. Two specimens were obtained between days 1 and 3 after birth, while they were in the hospital, and one specimen was obtained between days 6 and 14 after birth, after they had been discharged from the hospital. Seventy neonates excreted human rotavirus (HRV) while they were in the hospital, and the incidence rate for the cohort was 0.094 episodes per infant day. The incidence rate of community-acquired neonatal infections was markedly reduced to 0.022 episodes per infant day, with eight additional episodes of infection being detected after the infants were discharged from the hospital. Nevertheless, this was higher than the incidence of community-acquired HRV infection of 0.0037 episodes per infant day previously estimated by serology for the same cohort during the subsequent 2 years of infancy. None of the 78 episodes of neonatal HRV infection was accompanied by diarrhea. There were at least 44 distinct electropherotypes of HRV circulating among older infants in the community during the study period, and they comprised at least four different serotypes. Despite the genetic and antigenic diversity of the prevalent HRV isolates, only five electropherotypes with either serotype 2 or 4 specificity were isolated from the neonates, while serotype 1 and 3 viruses were not detected. Two of these electropherotypes, including one which was isolated from 57 of the 78 infants with episodes of infection, were isolated exclusively from the neonates. The other three electropherotypes were also isolated from the older infants; one was a major electropherotype and two were minor electropherotypes which were prevalent among the older infants. These results suggest that distinct populations of HRV cocirculate among neonates and older infants.