title: Clinical neonatal rotavirus infection: association with necrotising enterocolitis.
abstract: BACKGROUND
  Rotavirus is the most important aetiological agent causing severe gastroenteritis in children <2 years of age in South Africa and worldwide. Most endemic neonatal nursery strains are thought to be asymptomatic. However, serious conditions have been reported to be associated with rotavirus infection, such as necrotising enterocolitis (NEC), diffuse intravascular coagulopathy, pneumonia, apnoea and seizures.
  
  
  METHODS
  We studied newborns needing screening for sepsis in our Neonatal Unit. Rotavirus screening was included in the septic screen. The clinical signs and symptoms were studied in the control group (no rotavirus identified) and the study group (rotavirus identified in the stools).
  
  
  RESULTS
  Of the 169 babies screened for sepsis, 44 (26%) were rotavirus positive. Of the remainder, 63 comprised the control group. Rotavirus-positive stools were identified from day 4 of life. The virus was excreted in the stools for a mean of 4 days per infection episode. Asymptomatic infection was only observed in one baby; the others had clinical signs and symptoms ranging from mild to severe and even death. Gastrointestinal symptoms were prominent manifestations of rotavirus infection. There was a high incidence of NEC (66% in the study group v. 30% in the control group). Of the rotavirus-infected babies, 9 died; 3 had no other pathogens identified, so that rotavirus infection could have been the cause of death.
  
  
  CONCLUSIONS
  Rotavirus infection in the neonate is rarely asymptomatic. It is a dangerous condition that may cause death. It is associated with, and probably a cause of, NEC.
authors: Department of Paediatrics and Child Health, University of Limpopo, Pretoria, South Africa. alfafrancois@yahoo.co.uk
authors: François P R
authors: FP
authors: de Villiers
authors: Marie
authors: M
authors: Driessen
mesh_terms: D015897:Comorbidity; D003968:Diarrhea, Infantile / Q000453:epidemiology / Q000821:virology; D020345:Enterocolitis, Necrotizing / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D005243:Feces / Q000821:virology*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D012307:Risk Factors; D012401:Rotavirus / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D013019:South Africa / Q000453:epidemiology