title: Rotavirus-related hospitalizations are responsible for high seasonal peaks in all-cause pediatric hospitalizations.
abstract: BACKGROUND
  Seasonal rotavirus (RV) epidemics partly overlap with those of other common childhood infections, thereby generating enormous, but poorly quantified, pressure on hospital resources during winter and spring. We assessed RV contribution to seasonal excess in all-cause pediatric hospitalizations and RV hospitalization incidence rate in an observational study.
  
  
  METHODS
  The study was conducted among pediatric wards in 3 general hospitals and 1 pediatric tertiary care center. Numbers of RV hospitalizations were determined from 5-year data on confirmed RV hospitalizations and adjusted for RV underreporting, assessed through active surveillance for acute gastroenteritis during the 2011 RV season. Incidence rate and RV contribution to all-cause hospitalizations were determined on hospital administrative data and population statistics.
  
  
  RESULTS
  RV accounted for 6.2% (95% confidence interval: 5.3-7.1) of all-cause pediatric hospitalizations among general hospitals and 3.1% (95% confidence interval: 2.9-3.3) at the tertiary care center, adjusted for the proportion RV underreporting among gastroenteritis patients (33%) as observed during active surveillance. Among general hospitals, there was a 30% increase in all-cause hospitalizations during the active season of common childhood infections compared with summer months. RV contributed 31% to seasonal excess in all-cause pediatric hospitalizations, representing 12.9% of hospitalizations between January and May. RV hospitalizations incidence rate in the population was 510/100,000 child-years <5 years (95% confidence interval: 420-600).
  
  
  CONCLUSIONS
  RV is one of the main causes of seasonal peaks in pediatric hospitalizations, and as such contributes significantly to periodic high bed capacity pressures and associated adverse effects. RV vaccination benefits in this respect should be considered in decision-making processes.
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. P.Bruijning@umcutrecht.nl
authors: Patricia
authors: P
authors: Bruijning-Verhagen
authors: Valerie
authors: V
authors: Sankatsing
authors: Annemieke
authors: A
authors: Kunst
authors: Charlie
authors: C
authors: van den Born
authors: Esther
authors: E
authors: Bleeker
authors: Steven
authors: S
authors: Thijsen
authors: Ed P F
authors: EP
authors: Ijzerman
authors: Vincent H J
authors: VH
authors: van der Velden
authors: Marc J M
authors: MJ
authors: Bonten
mesh_terms: D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006769:Hospitals, General; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000473:pathology; D012621:Seasons