What Insights Can We Draw from the 2009-2023 Enteric Virus Data in South Africa?

Enteric viruses, which primarily impact the gastrointestinal tract, are a leading cause of illness among young children. Viruses like rotavirus, adenovirus, and norovirus spread easily through contaminated food, water, and close contact, often triggering widespread outbreaks, particularly in communities with limited access to clean water and sanitation.

Symptoms of enteric viruses include nausea, vomiting, diarrhea, abdominal pain, and fever. In young children, severe dehydration from diarrhea is a frequent complication that can require hospitalization. Certain groups, such as children under five, older adults, and immunocompromised individuals, are particularly vulnerable, underscoring the need for regular surveillance to track these infections and understand seasonal and demographic trends.

Surveillance systems for enteric viruses are essential for identifying trends, tracking seasonal changes, and pinpointing populations at high risk. Monitoring infection rates provides key insights into managing outbreaks and guiding public health strategies. Sentinel surveillance programs are critical in detecting enteric virus outbreaks early, helping healthcare professionals respond swiftly while aiding policymakers in understanding the virus’s impact.

The National Institute for Communicable Diseases (NICD) conducts extensive surveillance on enteric viruses in South Africa, collecting data from sentinel sites across the country. Healthcare workers at these sites collect stool samples from affected individuals, testing them to monitor viruses such as rotavirus, adenovirus, and norovirus. The NICD’s central database stores these findings, allowing researchers to analyze trends and inform public health responses.

This report examines the long–term trends in enteric virus prevalence in children <5 years of age seeking treatment for diarrhoea at selected sentinel sites in South Africa between 2009 and 2023.

Materials and Methods

The NICD’s enteric virus surveillance program spans multiple sentinel sites, focusing primarily on young children presenting with gastrointestinal symptoms at hospitals and clinics. Healthcare workers collect stool samples, which are then analyzed using RT-PCR assays to identify the specific enteric viruses present. The NICD stores these data in a centralized database, enabling tracking of seasonal trends and patterns across different regions.

Results 

In 2023, enteric virus activity peaked between April and August, coinciding with South Africa’s cooler months. Rotavirus was identified in 30% of samples, predominantly in children under five. Adenovirus was found in 15% of cases, also affecting younger children, while norovirus was detected in 10% of samples. These findings highlight the heightened vulnerability of young children to enteric infections and emphasize the need for targeted public health interventions to mitigate the impact.

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