Introduction Rotavirus (RV) is the leading cause of diarrhoea in children <5 years worldwide, especially in developing countries. RV viremia has been detected in some children with RV diarrhoea, especially during early RV infection and severe disease. There is however a paucity of data on the genotypes associated with viremia during acute RV diarrhoea. This study evaluated the burden of RV viremia among children with RV diarrhoea and circulating genotypes in blood and stools.

Methods Stool samples were prospectively collected from 332 children <5 years of age presenting with acute diarrhoea to Komfo Anokye Teaching Hospital, Ghana, from 9/2011 to 2/2012. Testing for RV in stools was performed using enzyme-linked immunosorbent assay. RV viremia was assessed on paired blood of children with RV by reverse transcriptase polymerase chain reaction (RT–PCR). RV capsid protein typing VP7 (G) and VP4 (P)) was determined by RT–PCR.

Results RV was detected in 129 (39%) children. Of 106 (82%) paired blood samples tested, RV viremia, was detected in 28 samples (26%). From stool samples, 7 G types and 3 P types were detected, with G1 (40%), G2 (20%), G12 (8%) and P[8] (56%) and P[6] (30%) most commonly detected. In contrast, fewer G and P types were associated with RV viremia; G2 (39%), G1 (32%), G9 (18%) and P[6] (29%), P[9] (7%) and P[8] (7%). The predominant RV combination strains in stool were G1P[8] (26%), G2P[8] (12%), and G1P[6] (9%) compared to G2P[6] (18%) in serum.

Conclusions This study confirms the hypothesis that viremia occurs among some children with rotavirus diarrhoea. There exists a wide diversity of genotype strain in stools and blood of children. Different genotype strains may be present in the blood and stool of one person possibly due to mutations and multi strains with different affinity of infecting sites.