Clinical and Epidemiologic Features of Severe Viral Gastroenteritis in Children: A 3-Year Surveillance, Multicentered Study in Taiwan With Partial Rotavirus Immunization.
The global epidemiological landscape of childhood acute gastroenteritis (AGE) is changing after the introduction of 2 effective rotavirus vaccines in 2006. A comprehensive evaluation for viral etiology of childhood AGE in Taiwan, where rotavirus vaccination was provided by the private sector since 2006, is lacking.From 2009 to 2011, children younger than 5 years of age with AGE who were hospitalized at 3 sentinel hospitals were enrolled in this surveillance study. Stool specimens were tested for rotavirus, norovirus, enteric adenovirus, and astrovirus. The epidemiologic and clinical information was collected by questionnaire-based interviews and chart reviews.Viral agents were detected in 1055 (37.5%) of 2810 subjects, with rotavirus (21.2%) being the leading cause of disease, followed by norovirus (14.9%), enteric adenovirus (3.74%), astrovirus (2.10%), and a mixture of at least 2 of 4 above-mentioned viruses (4.06%). The majority (56%) of the viral AGE occurred in children <2 years of age. Rotavirus and norovirus were detected more frequently in cool seasons (P < 0.0001 for both), whereas no seasonal variation was observed for adenovirus and astrovirus. Adult households with diarrhea and a Vesikari score >10 were independent factors respectively associated with an increased risk of norovirus (adjusted odds ratio [aOR] 9.034, P = 0.0003) and rotavirus (aOR, 3.284, P < 0.0001) infections. Rotavirus immunization and female gender were protective factors against rotavirus (aOR, 0.198, P < 0.0001) and astrovirus (aOR, 0.382, P = 0.0299) infections, respectively.Rotavirus and norovirus are the 2 most important viral agents of childhood AGE in Taiwan with partial rotavirus immunization. In addition, different enteric viruses are associated with distinct epidemiologic and clinical features.
From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Kweishan, Taoyuan, Taiwan, ROC (C-JC, Y-CH); Chang Gung University College of Medicine, Kweishan, Taoyuan, Taiwan, ROC (C-JC, Y-CH); Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Taipei, Taiwan, ROC (F-TW, H-SW, C-YW); Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC (W-CC, CAH); Department of Laboratory Medicine, Changhua Christian Hospital, Changhua, Taiwan, ROC (J-SL); and Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC (F-CH).
Chih-Jung
CJ
Chen
Fang-Tzy
FT
Wu
Yhu-Chering
YC
Huang
Wan-Chi
WC
Chang
Ho-Sheng
HS
Wu
Ching-Yi
CY
Wu
Jen-Shiou
JS
Lin
Fu-Chen
FC
Huang
Chao A
CA
Hsiung
D000208:Acute Disease; D002675:Child, Preschool; D005260:Female; D005759:Gastroenteritis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D065840:Protective Factors; D012307:Risk Factors; D012401:Rotavirus / Q000187:drug effects / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D022243:Rotavirus Vaccines / Q000627:therapeutic use*; D012621:Seasons; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology
D022243:Rotavirus Vaccines