A 4-year study on clinical characteristics of children hospitalized with rotavirus gastroenteritis

Abstract

Rotavirus (RV) is a frequent cause of severe gastroenteritis (GE) in children. With the licensure of new RV vaccines, data on the burden of disease are important regarding immunization strategies. We reviewed the medical records of children hospitalized with RV infection in our institution between July 2002 and March 2006. Relevant data were extracted in a standardized fashion from records of hospitalized children with a positive RV antigen test in a stool sample. Severity of disease was graded by the 20-point Vesikari score. Population data were obtained from the Federal Office of Statistics. Six hundred eighty-six RVGE were identified and records of 608 hospitalizations (in 607 children) were available. In 539 (89%) cases, RVGE was the primary reason for hospitalization and 69 (11%) were nosocomial infections; yearly peaks occurred between February and May. Cumulative incidence of RVGE was 26.7/1,000 children <3 years of age. Median age of 539 children (55.6% male) with primary RVGE was 1.4 years and median stay in the hospital for both community acquired and nosocomial RVGE was 4 days (interquartile range 3-5). Thirtypercent and 94% of RV hospitalizations were in children <1 and <3 years of age, respectively. Mean Vesikari score was 15 (range 6-20; 96% >11). Intravenous fluids were administered in 378 (70%) patients, 130 (24%) patients were rehydrated via nasogastral tube, and 31 (5.7%) received rehydration by mouth. RVGE causes a substantial burden in children with an estimated risk for hospitalization due to RVGE of one in 37 children <3 years of age.

Burden of rotavirus infections in Liguria, northern Italy: hospitalisations and potential savings by vaccination

“…In our study, the mean hospital stay among children with community-acquired RV was 4.18 days; this is similar to the European mean [17] [20] [21]. The age-class at greatest risk of hospitalisation for community-acquired RVGE was 0-23 months, while the distribution of nosocomial cases was similar in all age-classes.…”

Disease burden of rotavirus gastroenteritis in children up to 5 years of age in two Swiss cantons: paediatrician- and hospital-based surveillance

“…Laubereau et al [18] described an incidence rate of RV GE in the season 1997/1998 of 1.6%. In Germany, based on federal statistics from years 2001-2004, the incidence rate of RV GE in children below 4 years was 1.2% [8], and the incidence rate of RV GE was higher in children younger than 2 years than in the older age groups, as it was found in several studies [7,18,22,29]. Similarly, the percentage of <2 years children was also substantially higher in our study population than in the overall site population, suggesting that children <2 years are more prone to RV GE compared to older children.…”

Evaluation of a Gastroenteritis Severity Score for Use in Outpatient Settings

“…The score also has the greatest degree of endorsement from other researchers, as evidenced by its use. [14][15][16][17][18][19][20][21][22][23][24][25][26] The consensus opinion was that percent dehydration be removed from the current score. In several previous studies, this removal was performed or the measure was replaced by estimates of degree of dehydration, 20,23,27 because this variable cannot be easily determined or reported in outpatient settings.…”

“…We chose to use the Vesikari score as the basis for our revision because it has become the most commonly used score in clinical gastroenteritis research. [14][15][16][17][19][20][21][22][23][24][25][26] The cutoff points to define mild, moderate, and severe disease were defined arbitrarily. The use of 11 to define severe disease seems to be based on the finding that 11 was the mean score among children with rotavirus-related diarrhea in the original study.…”