title: Prospective study of etiologic agents of acute gastroenteritis outbreaks in child care centers.
abstract: OBJECTIVE
  To investigate the etiology of outbreaks of acute gastroenteritis (AGE) in children attending childcare centers (CCCs) in North Carolina between October 2005 and March 2007.
  
  
  METHODS
  In this prospective study of outbreaks of AGE in CCCs, stool specimens from symptomatic children and environmental surface swabs were tested for adenovirus group F, astrovirus, norovirus (NoV), rotavirus group A, and sapovirus using real-time and conventional reverse transcription-polymerase chain reaction assays, and viruses were genotyped by sequencing.
  
  
  RESULTS
  A total of 29 AGE outbreaks were evaluated, of which 13 (45%) were caused by a single virus, including rotavirus group A (17%), NoV (10%), astrovirus (10%), and sapovirus (7%). Multiple viruses were detected in 3 outbreaks (10%). Environmental swabs from 13 of 22 outbreaks (59%) tested positive for at least 1 virus and confirmed the findings of the same virus in the fecal specimens for 10 of the outbreaks (45%).
  
  
  CONCLUSIONS
  This study confirms that viruses are major causes of AGE outbreak in CCCs. Our finding of widespread environmental contamination during such outbreaks suggests the need to study the effectiveness of current surface disinfectants against multiple gastroenteritis viruses in CCCs.
authors.affiliation: Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Whitney H
authors.initials: WH
authors.lastname: Lyman
authors.forename: Joan F
authors.initials: JF
authors.lastname: Walsh
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Kotch
authors.forename: David J
authors.initials: DJ
authors.lastname: Weber
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gunn
authors.forename: Jan
authors.initials: J
authors.lastname: Vinjé
mesh_terms: D000208:Acute Disease; D002656:Child Day Care Centers; D002675:Child, Preschool; D004196:Disease Outbreaks; D004777:Environment; D005243:Feces / Q000821:virology; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D007223:Infant; D009657:North Carolina / Q000453:epidemiology; D011446:Prospective Studies; D012327:RNA Virus Infections / Q000453:epidemiology*; D012367:RNA, Viral / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D012367:RNA, Viral