[Acute diarrhea and rotavirus infection in the child: assessment of data from emergency care and and the microbiology laboratory of the Armand-Trousseau (Paris) Hospital between 1988 and 2001].
METHODS
Between October 1, 1988 and March 31, 2001, a longitudinal survey was conducted at the French pediatric hospital Armand-Trousseau in Paris. Following data were simultaneously collected: consultations and hospitalizations for acute diarrhea at the emergency room, and identifications of rotavirus from diarrheic stools at the laboratory.


RESULTS
Acute diarrhea represented 9.3% to 11.1% of all consultations. The activity was continuous through the year with several epidemic peaks, the largest occurring during the winter months. The hospitalization rate was high and stable since 1989 (16.5% to 21%), reaching 22-26% at the winter peak. Overall, rotaviruses were identified in 22.4% of stool samples but the detection rate increased from 10% in 1989 to 31% in 1997. Rotaviruses were isolated mainly in winter, reaching the rate of 50-70% at the peak.


CONCLUSIONS
Despite numerous biases of methodology and the fact that data were extracted from two different sources, acute diarrhea appeared as a major epidemic phenomenon in Paris, and rotaviruses were the main pathogens identified in diarrheic infants in winter. The extent of the winter epidemic increased each year since ten years, in parallel with the increase of the global activity of the emergency room. Despite attempts to develop ambulatory care, admission rates remained high in patients with acute diarrhea and searching for care at the emergency room of our hospital, especially in winter.


CONCLUSIONS
These preliminary data were restricted to a single pediatric hospital in Paris. They need to be extended to a national level before considering a strategy for prevention using vaccination.
Grimprel
E
E
Service de pédiatrie, urgences, pathologie infectieuse et tropicale, hôpital Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France. em.grimprel@wanadoo.fr
Parez
N
N
Gault
E
E
Garbarg-Chenon
A
A
Bégué
P
P
D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000175:diagnosis / Q000453:epidemiology*; D004196:Disease Outbreaks; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005243:Feces / Q000382:microbiology; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D008137:Longitudinal Studies; D010297:Paris / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data*; D012401:Rotavirus / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D012621:Seasons