Rotavirus and not age determines gastroenteritis severity in children: a hospital-based study.
BACKGROUND
The severity of childhood gastroenteritis is generally believed to be age-related rather than aetiology-related. Rotavirus-induced gastroenteritis is more severe than gastroenteritis caused by other enteric pathogens and is also age-related. We thus addressed the question of whether the increased severity of rotavirus-induced gastroenteritis is related to age or to features intrinsic to the agent.


METHODS
In this multicentre, hospital-based, prospective survey, we evaluated the severity of diarrhoea in rotavirus-positive and rotavirus-negative children up to 4 years of age. Severity was assessed with a score in four groups of age-matched children.


RESULTS
Rotavirus was detected in 381 of 911 children. Disease severity was evaluated in 589 cases for which clinical data were complete. The rotavirus-positive and rotavirus-negative groups differed with regards to diarrhoea duration, hospital stay, degree of dehydration and the number of episodes of vomiting. Gastroenteritis was more severe in rotavirus-positive than in rotavirus-negative children. In contrast, none of the main severity parameters differed in the four age groups, irrespective of the presence of rotavirus.


CONCLUSIONS
These data provide the evidence that aetiology and not age determines diarrhoeal severity. The demonstration that diarrhoea was more severe in rotavirus-positive children supports the need for a rotavirus vaccine and for studies that address the duration of vaccine protection.
Albano
Fabio
F
Dipartimento di Pediatria, Università di Napoli Federico II, via S. Pansini 5, 80131 Naples, Italy.
Bruzzese
Eugenia
E
Bella
Antonino
A
Cascio
Antonio
A
Titone
Lucina
L
Arista
Serenella
S
Izzi
Giancarlo
G
Virdis
Raffaele
R
Pecco
Paola
P
Principi
Nicola
N
Fontana
Massimo
M
Guarino
Alfredo
A
D017677:Age Distribution; D002675:Child, Preschool; D005260:Female; D005759:Gastroenteritis / Q000145:classification / Q000821:virology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D007902:Length of Stay; D008297:Male; D012401:Rotavirus / Q000145:classification / Q000302:isolation & purification / Q000472:pathogenicity*; D012400:Rotavirus Infections / Q000145:classification*; D012720:Severity of Illness Index