Surveillance results from pediatric cases and outbreaks of viral gastroenteritis in Japan are presented. In winter, both small round structured virus (SRSV, or Norwalk-like viruses) and rotavirus were detected from infants with gastroenteritis; however, in recent years, the prevailing time of SRSV infection has preceded that of rotavirus infection. Most nonbacterial gastroenteritis outbreaks were related to SRSV infection, and >60% of the outbreaks were caused by contaminated food. In small-sized outbreaks, raw oysters were the primary source of transmission. In large-sized outbreaks, school lunches and catered meals that were served at schools, banquet halls, and hospitals were most often implicated in the transmission of foodborne gastroenteritis.
It is clarified from the NESID that neurologic complications such as acute encephalitis/encephalopathy, apart from Reye's syndrome, have occurred associated with influenza virus infection, especially among young children. Further investigation should be necessary to find the pathogenesis of this serious complication of influenza virus infection and whether this is unique in Japan, due to unclarified factor/factors, or whether it has not been recognized in other countries.
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