Aetiology and epidemiology of acute gastro-enteritis in Swedish children.
In a prospective 1-year study, 144 children attending or admitted to hospital and 272 children outside hospital with acute gastro-enteritis and 200 controls were investigated by a broad panel of diagnostic methods for enteropathogenic agents in the faeces and for related antibody responses. Enteropathogens were identified in 77% of the inpatients, 63% of the outpatients and 8% of the controls. Rotavirus and Yersinia enterocolitica were detected significantly more often among inpatients. Altogether, viral, bacterial and parasitic agents were found in 58%, 14% and 1% of diarrhoeal patients, respectively. The isolation of more than one pathogenic agent was uncommon (6.5%). Rotavirus (45%) and enteric adenoviruses 40 and 41 (7.9%) predominated among the viruses, while Campylobacter jejuni (4.8%) was most common among the bacteria. Clostridium difficile and/or its cytotoxin, which were found in 14% of the children with gastroenteritis and in 15% of the controls, were significantly associated with antibiotic therapy but not with gastro-intestinal illness. Diarrhoeal infections of unknown aetiology exhibited a seasonal peak in the autumn. The duration of excretion of enteropathogens was investigated. Rotavirus particles were detectable by solid-phase immune electron microscopy for 14-25 days after the diarrhoea had ceased. Transmission of rotavirus and bacterial pathogens within families was studied also.
D000208:Acute Disease; D000258:Adenovirus Infections, Human / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000382:microbiology* / Q000469:parasitology; D005243:Feces / Q000382:microbiology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology*; D008297:Male; D011446:Prospective Studies; D012400:Rotavirus Infections / Q000453:epidemiology; D012621:Seasons; D012737:Sex Factors; D013548:Sweden; D014777:Virus Diseases / Q000453:epidemiology* / Q000382:microbiology