Structured surveillance of infantile gastroenteritis in East Anglia, UK: incidence of infection with common viral gastroenteric pathogens

Abstract

The aim of this study was to investigate the burden of disease associated with gastroenteric viruses (rotavirus, norovirus, sapovirus, astrovirus and enteric adenovirus) using structured surveillance of children aged <6 years in the community. Faecal samples were collected between 2000 and 2003 from 685 children with symptoms of gastroenteritis. The children comprised three groups; 223 in the structured surveillance cohort, 203 in a community cohort and 259 in a cohort of hospitalized children. All samples were tested for the presence of viral pathogens using molecular methods. Questionnaires were sent to the parents/carers of the children recruited to the structured surveillance cohort in order to collect data that would allow an estimation of the severity of illness by means of the Vesikari score, and of the cost associated with gastrointestinal disease in this age group. A viral aetiological agent was detected in 53.5% of samples tested. Rotavirus was the most common pathogen found in all three cohorts followed by norovirus and enteric adenoviruses. Multiple viruses were found in 8% of the samples, and commonly involved rotavirus and any other virus. G1P[8] was the most commonly detected rotavirus strain and there was no significant difference in the distribution of rotavirus genotypes among the three cohorts. Analysis of the questionnaires indicated that rotavirus infections were likely to be more severe than any other virus infection, and children from whom a viral pathogen was identified were more likely to require rehydration therapy.

Diagnosing rotavirus A associated IID: Using ELISA to identify a cut-off for real time RT-PCR

“…Subsequently, all archived specimens were retested for rotavirus A using RT-PCR 8 . In this study, a real time RT-PCR assay (method previously described 14 ) was used to determine the viral load in specimens that were previously positive for rotavirus A by ELISA or RT-PCR.…”

Infantile gastroenteritis in the community:a cost-of-illness study

“…Full details of the methods and results of the virological surveillance are reported separately [10]. Full details of the methods and results of the virological surveillance are reported separately [10].…”

“…For a more detailed analysis of the virological data see Iturriza Go´mara et al [10]. Twenty children tested positive for more than one virus, the most common combination being rotavirus and norovirus ; while for 67 children who consulted the GP with symptoms of vomiting and/or diarrhoea no aetiological agent was detected.…”

Diagnosing norovirus-associated infectious intestinal disease using viral load

“…Mixed gastrointestinal infections are frequently detected, especially in infants and young children and when polymerase chain reaction (PCR) assays are used for diagnosis [1,2]. It is important to determine which pathogen is the cause of illness, in order to direct clinical management for individual patients and to advance epidemiological understanding of IID.…”