Clinical and epidemiologic features of severe viral gastroenteritis in children: A 3-year surveillance, multicentered study in Taiwan with partial rotavirus immunization

Chih Jung Chen, Fang Tzy Wu, Yhu Chering Huang, Wan Chi Chang, Ho Sheng Wu, Ching Yi Wu, Jen Shiou Lin, Fu Chen Huang, Chao A. Hsiung*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

37 Scopus citations

Abstract

The global epidemiological landscape of childhood acute gastroenteritis (AGE) is changing after the introduction of 2 effective rotavirus vaccines in 2006. A comprehensive evaluation for viral etiology of childhood AGE in Taiwan, where rotavirus vaccination was provided by the private sector since 2006, is lacking. From 2009 to 2011, children younger than 5 years of age with AGE who were hospitalized at 3 sentinel hospitals were enrolled in this surveillance study. Stool specimens were tested for rotavirus, norovirus, enteric adenovirus, and astrovirus. The epidemiologic and clinical information was collected by questionnaire-based interviews and chart reviews. Viral agents were detected in 1055 (37.5%) of 2810 subjects, with rotavirus (21.2%) being the leading cause of disease, followed by norovirus (14.9%), enteric adenovirus (3.74%), astrovirus (2.10%), and a mixture of at least 2 of 4 above-mentioned viruses (4.06%). The majority (56%) of the viral AGE occurred in children <2 years of age. Rotavirus and norovirus were detected more frequently in cool seasons (P<0.0001 for both), whereas no seasonal variation was observed for adenovirus and astrovirus. Adult households with diarrhea and a Vesikari score >10 were independent factors respectively associated with an increased risk of norovirus (adjusted odds ratio [aOR] 9.034, P=0.0003) and rotavirus (aOR, 3.284, P<0.0001) infections. Rotavirus immunization and female gender were protective factors against rotavirus (aOR, 0.198, P<0.0001) and astrovirus (aOR, 0.382, P=0.0299) infections, respectively. Rotavirus and norovirus are the 2 most important viral agents of childhood AGE in Taiwan with partial rotavirus immunization. In addition, different enteric viruses are associated with distinct epidemiologic and clinical features.

Original languageEnglish
Pages (from-to)e1372
JournalMedicine (United States)
Volume94
Issue number33
DOIs
StatePublished - 01 08 2015

Bibliographical note

Publisher Copyright:
© 2015 Wolters Kluwer Health, Inc.

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