title: Outbreak of acute gastroenteritis in young children with death due to rotavirus genotype G9 in Rio Branco, Brazilian Amazon region, 2005.
abstract: BACKGROUND
  An epidemic of acute gastroenteritis occurred in Rio Branco City, Acre State, in Brazil's Amazon region in 2005. An investigation was conducted to confirm the etiology and identify possible risk factors for death.
  
  
  METHODS
  Rio Branco municipality surveillance data for the period May to October 2005 were reviewed. In a case-control study, children who died following acute gastroenteritis were compared to age-matched controls with acute gastroenteritis who survived. Rotavirus A (RV-A) was investigated in 799 stool samples and genotyped by reverse transcription polymerase chain reaction (RT-PCR).
  
  
  RESULTS
  The cumulative incidence of diarrhea in children aged <5 years was 21%. A fatal outcome was significantly associated with uncovered household water storage containers. RV-A was identified in 88% of samples and G9 was the prevalent genotype (71%).
  
  
  CONCLUSIONS
  Oral rehydration solution and boiling or chlorinating drinking water likely limited mortality. This epidemic was caused by RV-A genotype G9. After the outbreak, a rotavirus vaccine was introduced into the official childhood immunization schedule in Brazil.
authors.affiliation: Field Epidemiology Training Program (EPISUS), Secretariat of Health Surveillance (SVS), Ministry of Health, Setor Comercial Sul, Edificio Principal Quadra 04, Bloco A, 3° Andar, Brasília, DF, Brazil. alessandra.siqueira@saude.gov.br
authors.forename: Alessandra A
authors.initials: AA
authors.lastname: Siqueira
authors.forename: A C F S
authors.initials: AC
authors.lastname: Santelli
authors.forename: L R
authors.initials: LR
authors.lastname: Alencar
authors.forename: M P
authors.initials: MP
authors.lastname: Dantas
authors.forename: C P N
authors.initials: CP
authors.lastname: Dimech
authors.forename: G M I
authors.initials: GM
authors.lastname: Carmo
authors.forename: D A
authors.initials: DA
authors.lastname: Santos
authors.forename: R M S
authors.initials: RM
authors.lastname: Alves
authors.forename: M B F
authors.initials: MB
authors.lastname: Lucena
authors.forename: M
authors.initials: M
authors.lastname: Morais
authors.forename: R M S
authors.initials: RM
authors.lastname: Assis
authors.forename: A
authors.initials: A
authors.lastname: Fialho
authors.forename: J D P
authors.initials: JD
authors.lastname: Mascarenhas
authors.forename: M
authors.initials: M
authors.lastname: Costa
authors.forename: A C
authors.initials: AC
authors.lastname: Linhares
authors.forename: J P G
authors.initials: JP
authors.lastname: Leite
authors.forename: W N
authors.initials: WN
authors.lastname: Araujo
authors.forename: D L
authors.initials: DL
authors.lastname: Hatch
mesh_terms: D000208:Acute Disease; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D002675:Child, Preschool; D004196:Disease Outbreaks; D005759:Gastroenteritis / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D005838:Genotype; D006801:Humans; D007223:Infant; D012307:Risk Factors; D012401:Rotavirus / Q000235:genetics / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000401:mortality / Q000821:virology