Characteristics of persistent diarrhea in a community-based cohort of young US children.
OBJECTIVE
The objective of the study was to define the characteristics and microbiology of persistent diarrhea (PD) in US children.


METHODS
Six-month prospective cohort study of a convenience sample of 604 healthy 6- to 36-month-old children recruited by the Slone Center Office-based Research Network.


RESULTS
Of 611 diarrhea episodes, 50 (8.2%) lasted < or = 14 days. The incidence of PD was 0.18 episodes per person-year, and the median duration of episodes was 22.0 days (range, 14-64 days). PD episodes were more likely than acute episodes to result in a medical visit (28.0% vs 8.2%; P = 0.0001). The most commonly used treatments were oral rehydration solution (12.0% of episodes) and antibiotics (6.0%). No bacterial or parasitic pathogens were associated with PD; but norovirus, rotavirus and sapovirus were each significantly more prevalent in PD stools compared with baseline stools, with relative risks of 12.4, 6.9 and 6.2, respectively. Fifty-nine per cent of the PD specimens tested were negative for all studied pathogens.


CONCLUSIONS
PD occurs with a frequency of approximately 1 case per 5 person-years in US infants and young children. It seems to be a generally benign illness, with only 28% of cases presenting to medical care. Although viral pathogens seem to cause a minority of PD episodes in this population, most are not due to currently known infectious agents.
Vernacchio
Louis
L
Slone Epidemiology Center at Boston University, Boston, MA 02115, USA. lvernacchio@slone.bu.edu
Vezina
Richard M
RM
Mitchell
Allen A
AA
Lesko
Samuel M
SM
Plaut
Andrew G
AG
Acheson
David W K
DW
D000818:Animals; D002675:Child, Preschool; D003457:Cryptosporidiosis / Q000150:complications; D016785:Cryptosporidium parvum; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology / Q000469:parasitology / Q000503:physiopathology* / Q000821:virology; D005243:Feces / Q000382:microbiology / Q000469:parasitology / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D005873:Giardiasis / Q000150:complications; D016905:Gram-Negative Bacterial Infections / Q000150:complications; D016908:Gram-Positive Bacterial Infections / Q000150:complications; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009819:Office Visits; D011159:Population Surveillance; D011446:Prospective Studies; D012327:RNA Virus Infections / Q000150:complications; D012111:Residence Characteristics; D012307:Risk Factors; D012621:Seasons; D014481:United States / Q000453:epidemiology