title: Human Parechovirus and Other Enteric Viruses in Childcare Attendees in the Era of Rotavirus Vaccines.
abstract: OBJECTIVE
  We studied the prevalence of enteric viruses, including rotavirus, enterovirus, norovirus, adenovirus, and human parechovirus (HPeV), in stool samples of childcare attendees. The prevalence of enteric viruses was described in children with and those without gastroenteritis.
  
  
  METHODS
  Children aged 1-19 months were recruited from 2 childcare centers in Tacoma, Washington, from October 2008 through June 2009. Stool samples were obtained at enrollment and during diarrheal illnesses for enteric virus testing. A symptom diary was completed by parents.
  
  
  RESULTS
  One hundred six children (mean age, 10 months) were followed for an average of 170 days. At enrollment, 78 asymptomatic children had stool samples available. Forty-eight illnesses with acute diarrhea (stool samples were available for 24 illnesses) occurred in 37 children. Rotavirus was not detected in samples from symptomatic or asymptomatic children. HPeV was present in 21% and adenovirus in 46% of symptomatic children. At least 1 virus was detected in 78% of samples from asymptomatic children, including HPeV in 27% and adenovirus in 55%. No differences were found in symptom prevalence between HPeV-positive and HPeV-negative diarrheal illnesses. Molecular analysis revealed a diversity of HPeV types.
  
  
  CONCLUSIONS
  Our study highlights the high level of HPeV circulation in childcare. The lack of rotavirus detected in this study supports the impact of rotavirus vaccine and emphasizes the need for a greater focus on the epidemiology of non-rotavirus etiologies of gastroenteritis.
authors.affiliation: Department of Pediatrics, Madigan Healthcare System, Tacoma.
authors.forename: LoRanée E
authors.initials: LE
authors.lastname: Braun
authors.affiliation: Department of Laboratory Medicine, University of Washington, Seattle.
authors.forename: Christian
authors.initials: C
authors.lastname: Renaud
authors.affiliation: Department of Pediatrics, Madigan Healthcare System, Tacoma.
authors.forename: Mary P
authors.initials: MP
authors.lastname: Fairchok
authors.affiliation: Department of Laboratory Medicine, University of Washington, Seattle.
authors.forename: Jane
authors.initials: J
authors.lastname: Kuypers
authors.affiliation: Pediatric Infectious Diseases, Seattle Children's Hospital Department of Pediatrics, University of Washington, Seattle, Washington.
authors.forename: Janet A
authors.initials: JA
authors.lastname: Englund
authors.affiliation: Department of Pharmacy Practice, Wayne State University, Detroit, Michigan.
authors.forename: Emily T
authors.initials: ET
authors.lastname: Martin