title: Epidemiology and clinical peculiarities of norovirus and rotavirus infection in hospitalized young children with acute diarrhea in Taiwan, 2009.
abstract: OBJECTIVE
  Acute diarrhea is one of the most common morbidities in pediatrics worldwide. We conducted a study to investigate the incidence of norovirus in young children hospitalized with acute diarrhea in Taiwan and its clinical peculiarity compared with rotavirus gastroenteritis.
  
  
  METHODS
  Between January and December, 2009, patients younger than 5 years and admitted to hospital with acute diarrhea were randomly selected; and their stool samples were collected and tested for presence of rotavirus and norovirus by enzyme immunoassay and reverse transcription-polymerase chain reaction, respectively. The clinical manifestations and laboratory findings of the enrolled patients were analyzed.
  
  
  RESULTS
  A total of 989 cases were enrolled with a mean age of 21.6 ± 13.7 months and a male proportion of 56.0%. Rotavirus and norovirus was detected in 20.2% and 14.6% of all patients, respectively. Genogroup II was the predominant strain of norovirus (80.6%). Children aged 6-36 months accounted for the majority of patients positive for rotavirus and norovirus (73.0% and 81.3%, respectively). The incidences of norovirus and rotavirus infection were higher during winter and early spring. Most patients with rotavirus and norovirus diarrhea experienced vomiting (74.9%vs. 74.8%, respectively) and fever (94.7%vs. 71.3%, respectively).
  
  
  CONCLUSIONS
  Most young diarrheal patients presenting with vomiting were likely to have norovirus or rotavirus infection. Patients with norovirus diarrhea experienced an absence of, or low-grade fever and longer duration of vomiting compared with those positive for rotavirus infection. A family history of current gastroenteritis may suggest the possibility of norovirus infection.
authors.affiliation: Division of Pediatric Infectious Disease, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Shu-Yan
authors.initials: SY
authors.lastname: Yang
authors.forename: Kao-Pin
authors.initials: KP
authors.lastname: Hwang
authors.forename: Fang-Tzy
authors.initials: FT
authors.lastname: Wu
authors.forename: Ho-Sheng
authors.initials: HS
authors.lastname: Wu
authors.forename: Chao Agnes
authors.initials: CA
authors.lastname: Hsiung
authors.forename: Wan-Chi
authors.initials: WC
authors.lastname: Chang
authors.forename: Jen-Shiou
authors.initials: JS
authors.lastname: Lin
authors.forename: Shun-Cheng
authors.initials: SC
authors.lastname: Yang
authors.forename: Sun-Lin
authors.initials: SL
authors.lastname: Huang
authors.forename: Yhu-Chering
authors.initials: YC
authors.lastname: Huang
mesh_terms: D000208:Acute Disease; D017250:Caliciviridae Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D006760:Hospitalization; D006801:Humans; D007124:Immunoenzyme Techniques; D007223:Infant; D008297:Male; D029322:Norovirus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012401:Rotavirus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D013624:Taiwan / Q000453:epidemiology