title: Structured surveillance of infectious intestinal disease in pre-school children in the community: 'The Nappy Study'.
abstract: The incidence and causes of infectious intestinal disease (IID) in children aged <5 years presenting to general practitioners (GPs) were estimated. During a 12-month period, soiled nappies were collected from children presenting with symptoms suggestive of IID in a network of 65 GPs located across England. Molecular methods were used to detect a range of enteric pathogens including viruses, bacteria and parasites. Genotyping was performed on rotavirus and norovirus isolates. A total of 583 nappies were collected from 554 children; a pathogen was detected in 361 (62%) specimens. In the 43 practices 1584 new episodes of IID were recorded in a population averaging 19774; the specimen capture rate was 28%. IID incidence peaked during March and April. Norovirus (24.5%), rotavirus (19.0%) and sapovirus (12.7%) were most commonly detected, and mixed infections were detected in 11.7% of cases. Strain characterization revealed G1P[8] (65.8%), G4P[4] (8.1%) and G9P[8] (8.1%) as the most common rotavirus genotypes, similar to the UK national distribution. GII-3 (42.9%) and GII-4 (39.7%) were the most common norovirus genotypes; this was significantly different (P<0.005) to the national distribution.
authors.affiliation: Enteric Virus Unit, Health Protection Agency Centre for Infections, London, UK. Miren.Iturriza@hpa.org.uk
authors.forename: M
authors.initials: M
authors.lastname: Iturriza-Gómara
authors.forename: A J
authors.initials: AJ
authors.lastname: Elliot
authors.forename: C
authors.initials: C
authors.lastname: Dockery
authors.forename: D M
authors.initials: DM
authors.lastname: Fleming
authors.forename: J J
authors.initials: JJ
authors.lastname: Gray
mesh_terms: D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology / Q000469:parasitology; D003967:Diarrhea / Q000382:microbiology / Q000469:parasitology; D004739:England / Q000453:epidemiology; D005243:Feces / Q000382:microbiology / Q000469:parasitology; D006801:Humans; D007410:Intestinal Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000469:parasitology; D011159:Population Surveillance; D013997:Time Factors; D014777:Virus Diseases / Q000453:epidemiology / Q000821:virology; D014852:Wales / Q000453:epidemiology