Clinical presentations of rotavirus infection among hospitalized children.
BACKGROUND
Although rotaviruses (RVs) are the most common cause of severe gastroenteritis in children, there is a lack of information detailing the spectrum of clinical manifestations of RV disease resulting in hospitalization.


OBJECTIVE
To characterize the clinical spectrum of RV-associated hospitalizations, including short stay visits in children.


METHODS
Active RV disease surveillance was conducted at three children's hospitals Sundays through Thursdays in children 15 days through 4 years of age admitted with diarrhea (D), vomiting (V) and/or unexplained fever (F) between November, 1997, and June, 1998. Stool specimens were collected and tested for RV by enzyme immunoassay.


RESULTS
Of the 862 children enrolled, 763 (88%) had a stool specimen tested for RV. Overall 31% of children excreted RV. RV excretion was highest when all 3 symptoms (D, V and F) occurred in the same child (56%), lower when 2 symptoms occurred together (38% DV; 19% DF; 13% VF) and lowest when each symptom occurred alone (3% D; 11% V; 6% F). Nine percent of the children without diarrhea excreted RV. Children admitted without diarrhea were more likely to have rotavirus if they developed diarrhea during their hospitalization.


CONCLUSIONS
RV detection was greatest when diarrhea, vomiting and fever occurred together and lowest when each symptom occurred alone. The spectrum of symptoms of rotavirus disease in children at the time of admission to the hospital or short stay unit may be broader than previously recognized.
Staat
Mary Allen
MA
Division of Infectious Disease, Children's Hospital Medical Center, Cincinnati, OH 45229, USA. staam0@chmcc.org
Azimi
Parvin H
PH
Berke
Tamas
T
Roberts
Nancy
N
Bernstein
David I
DI
Ward
Richard L
RL
Pickering
Larry K
LK
Matson
David O
DO
D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000821:virology; D005334:Fever / Q000453:epidemiology / Q000821:virology; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009820:Ohio / Q000453:epidemiology; D011159:Population Surveillance; D011446:Prospective Studies; D012401:Rotavirus / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000175:diagnosis* / Q000453:epidemiology*; D012621:Seasons; D014768:Virginia / Q000453:epidemiology; D014839:Vomiting / Q000453:epidemiology / Q000821:virology