title: Burden of rotavirus disease among children visiting pediatric emergency departments in Cincinnati, Ohio, and Oakland, California, in 1999-2000.
abstract: OBJECTIVE
  We assessed the incidence of rotavirus disease requiring an emergency department visit among children <5 years of age.
  
  
  METHODS
  We conducted active surveillance for acute gastroenteritis in pediatric emergency departments in Cincinnati, Ohio, and Oakland, California, from March 1999 to May 2000, among children 2 weeks to 59 months of age with acute diarrhea and/or vomiting. We obtained clinical and demographic information from participants and tested their stool specimens for rotavirus.
  
  
  RESULTS
  Approximately 9% of all emergency department visits at the study sites were attributable to acute gastroenteritis. A total of 1433 children were eligible at the 2 sites; 85% were enrolled and 68% provided a stool specimen. Overall, rotavirus was detected in specimens from 27% of children (30% in Cincinnati and 24% in Oakland). Rotavirus detection was higher in bulk stools, compared with rectal swabs, at both Cincinnati (37% vs 23%) and Oakland (46% vs 18%). Patients with rotavirus had more-severe disease than did those with nonrotavirus gastroenteritis. We estimated that the mean annual incidence of emergency department visits attributable to rotavirus was 12 cases per 1000 children in Cincinnati and 15 cases per 1000 children in Oakland. Through extrapolation, we estimated that rotavirus infection causes approximately 260,910 emergency department visits per year among US children.
  
  
  CONCLUSIONS
  Active surveillance demonstrated that the burden of laboratory-confirmed rotavirus disease treated in emergency department settings among US children is substantial and greater than estimated previously.
authors.affiliation: Division of Viral Diseases, Epidemic Intelligence Service Program, Office of Workforce and Career Development, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. eyee@cdc.gov
authors.forename: Eileen L
authors.initials: EL
authors.lastname: Yee
authors.forename: Mary Allen
authors.initials: MA
authors.lastname: Staat
authors.forename: Parvin
authors.initials: P
authors.lastname: Azimi
authors.forename: David I
authors.initials: DI
authors.lastname: Bernstein
authors.forename: Richard L
authors.initials: RL
authors.lastname: Ward
authors.forename: Charles
authors.initials: C
authors.lastname: Schubert
authors.forename: David O
authors.initials: DO
authors.lastname: Matson
authors.forename: Reina M
authors.initials: RM
authors.lastname: Turcios-Ruiz
authors.forename: Umesh
authors.initials: U
authors.lastname: Parashar
authors.forename: Marc-Alain
authors.initials: MA
authors.lastname: Widdowson
authors.forename: Roger I
authors.initials: RI
authors.lastname: Glass
mesh_terms: D002140:California / Q000453:epidemiology; D017281:Cost of Illness; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009820:Ohio / Q000453:epidemiology; D011159:Population Surveillance; D012400:Rotavirus Infections / Q000453:epidemiology*; D012621:Seasons; D012720:Severity of Illness Index