Viral gastroenteritis in children in Colorado 2006–2009

Abstract

Acute gastroenteritis accounts for a significant burden of medically attended illness in children under the age of five. For this study, four multiplex reverse transcription PCR assays were used to determine the incidence of adenovirus, astrovirus, coronavirus, norovirus GI and GII, rotavirus, and sapovirus in stool samples submitted for viral electron microscopy (EM) to the Children's Hospital Colorado. Of 1105 stool samples available, viral RNA/DNA was detected in 247 (26.2%) of 941 pediatric samples (median age = 2.97 years, 54% male) with 28 (3.0%) positive for more than one virus. Adenovirus, astrovirus, norovirus GI, norovirus GII, rotavirus, and sapovirus were detected in 95 (10.0%), 33 (3.5%), 8 (0.9%), 90 (9.6%), 49 (5.2%), and 2 (0.2%) of the pediatric samples, respectively. No coronaviruses were identified. Sequencing of norovirus positive samples indicated an outbreak of norovirus strain GII.4 in 2006 with evidence of numerous circulating strains. Multiple samples from the same immunocompromised patients demonstrated symptomatic shedding of norovirus for up to 32 weeks and astrovirus for 12 weeks. RT-PCR detected 99 of 111 (89%) adenovirus-positive samples versus 12 (11%) by EM, and 186 of 192 (97%) sapovirus/astrovirus/norovirus-positive samples versus 21 (11%) by EM. Noroviruses and adenoviruses are common causes of gastroenteritis in children. Immunocompromised patients can be infected with multiple viruses and shed viruses in their stools for prolonged periods. This data support the superiority of RT-PCR compared to EM for diagnosis of viral gastroenteritis.

Eco-Epidemiology and Control of Waterborne Gastroenteritis: A Review

“…Bacteria particularly involved with gastroenteritis are mainly Escherichia coli, Vibrio cholerae, Salmonella typhimurium, Shigelladysenteriae, Campylobacter jejuni while among viruses rotavirus and norovirus are the primary causes of gastroenteritis [7]. The epidemics of this disease have been reported from many countries including Germany [8], USA [9][10][11], Colorado [12], Switzerland [13], France [14], Netherland, Japan, Sweden, UK, Korea [15], Philippines [16], China [17,18], Pakistan [2,19], India [20], Bangladesh [21], Iran, [22], Saudi Arabia [23,24].…”

“…Children especially those less than five year of age and adults of over forty year of age, irrational users of antibiotics and immune-compromised hosts are most susceptible [12]. Thus children and elderly people are more prone to gastroenteritis attacks.…”

Clinical and Laboratory Characteristics of Pediatric Campylobacter spp. Acute Gastroenteritis

“…AGE is one of the most common human infectious diseases that affects more than 2.5 billion children annually (2,3). AGE occurs in both developing and developed countries and is the second leading cause of child mortality worldwide; approximately 1.5 million children under the age of five die annually due to the incidence of the disease (4,5).…”

“…AGE occurs in both developing and developed countries and is the second leading cause of child mortality worldwide; approximately 1.5 million children under the age of five die annually due to the incidence of the disease (4,5). Viruses, bacteria, and parasites are the three main groups of agents that produce AGE in children, with viruses accounting for over 80% in this population (2). The most common bacteria responsible for AGE in children are Escherichia coli, Shigella, Salmonella, and Campylobacter, and they can cause serious gastrointestinal and non-gastrointestinal complications despite their lower incidence than viral factors (6,7).…”

The Repertoire of Adenovirus in Human Disease: The Innocuous to the Deadly

“…Previous studies in children were mainly focused on community-acquired infection, but more recently, healthcare-associated adenoviral AGE is being more closely studied [44,[46][47][48]. Along with rotavirus and norovirus, adenovirus has emerged as one of the leading causes of viral AGE in both these settings, with immunocompromised patients possibly infected with multiple viruses and shedding viruses in their stools for prolonged periods [47,48]. Some studies even suggest adenovirus as the main cause of hospital acquired AGE [44].…”