Acute gastroenteritis in children attending day-care centres with special reference to rotavirus infections. II. Clinical manifestations.
In a prospective study of a cohort of 214 children (aged 6 months-7 years) attending day-care centres, a total of 197 episodes of acute gastroenteritis (GE) occurred in 109 children (i.e. 51% of the participants) during a 12-month observation period. Rotavirus, pathogenic bacteria and Giardia lamblia caused GE in 24%, 6% and 2% of the cases, respectively. The aetiology of the remaining 68% was not discovered. Generally, the symptoms of GE were light and only two episodes led to hospitalization. Thirty-two rotavirus infections were asymptomatic. Two rotavirus GE reinfections occurred. They showed less severe symptoms than the primary infections. The older children (greater than 1.5 years) with rotavirus GE had lighter symptoms than the younger ones (less than or equal to 1.5 years). Compared with children with non-rotavirus GE, those with rotavirus GE showed the following clinical features: (1) Age between 6 months and 2 years. (2) Occurrence of rotavirus GE almost exclusively during the rotavirus season, i.e. January to April (winter). (3) High frequency of vomiting, the onset of which often preceded that of diarrhoea. However, these signs did not form a safe basis for the clinical diagnosis of rotavirus GE. One or more upper respiratory manifestations (URM) were observed in 39% of the children with rotavirus GE and in 36% of those with non-rotavirus GE. The occurrence of URM was age-related being highest in children less than 2 years. Consequently, the existence of a rotavirus syndrome is questioned. It is argued that URM in children with rotavirus GE may be due to a co-infection of the upper respiratory tract by a different micro-organism.
Hjelt
K
K
Department of Paediatrics, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Nielson
O H
OH
Paerregaard
A
A
Grauballe
P C
PC
Krasilnikoff
P A
PA
D000208:Acute Disease; D000367:Age Factors; D002656:Child Day Care Centers; D002675:Child, Preschool; D005759:Gastroenteritis / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D007223:Infant; D011446:Prospective Studies; D012400:Rotavirus Infections / Q000175:diagnosis*; D012621:Seasons