title: Etiology of viral gastroenteritis in children <5 years of age in the United States, 2008-2009.
abstract: BACKGROUND
  Although rotavirus and norovirus cause nearly 40% of severe endemic acute gastroenteritis (AGE) in children <5 years of age in the United States, there are limited data on the etiologic role of other enteric viruses in this age group.
  
  
  METHODS
  We conducted active population-based surveillance in children presenting with AGE to hospitals, emergency departments, and primary care clinics in 3 US counties. Stool specimens from these children and from age-matched healthy controls collected between October 2008 and September 2009 were tested for enteric adenovirus, astrovirus, sapovirus, parechovirus, bocavirus, and aichivirus. Typing was performed by sequencing and phylogenetic analysis.
  
  
  RESULTS
  Adenovirus, astrovirus, sapovirus, parechovirus, bocavirus, and aichivirus were detected in the stool specimens of 11.8%, 4.9%, 5.4%, 4.8%, 1.4%, and 0.2% of patients with AGE and 1.8%, 3.0%, 4.2%, 4.4%, 2.4%, and 0% of healthy controls, respectively. Adenovirus (type 41), astrovirus (types 1, 2, 3, 4, and 8), sapovirus (genogroups I and II), parechovirus (types 1, 3, 4, and 5), and bocavirus (types 1, 2, and 3) were found cocirculating.
  
  
  CONCLUSIONS
  Adenovirus, astrovirus, and sapovirus infections were detected in 22.1% of the specimens from children <5 years of age who had medical visits for AGE and tested negative for rotavirus and norovirus. No causal role for parechovirus and bocavirus was found.
authors.affiliation: Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: Preeti
authors.initials: P
authors.lastname: Chhabra
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Payne
authors.forename: Peter G
authors.initials: PG
authors.lastname: Szilagyi
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Edwards
authors.forename: Mary Allen
authors.initials: MA
authors.lastname: Staat
authors.forename: S Hannah
authors.initials: SH
authors.lastname: Shirley
authors.forename: Mary
authors.initials: M
authors.lastname: Wikswo
authors.forename: W Allan
authors.initials: WA
authors.lastname: Nix
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Lu
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
authors.forename: Jan
authors.initials: J
authors.lastname: Vinjé
mesh_terms: D002675:Child, Preschool; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D058889:Molecular Typing; D010802:Phylogeny; D014481:United States / Q000453:epidemiology; D014777:Virus Diseases / Q000453:epidemiology* / Q000821:virology*; D014780:Viruses / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*
keywords: adenovirus; astrovirus; population-based surveillance; sapovirus; viral gastroenteritis