Epidemiology and clinical peculiarities of norovirus and rotavirus infection in hospitalized young children with acute diarrhea in Taiwan, 2009

J Microbiol Immunol Infect. 2010 Dec;43(6):506-14. doi: 10.1016/S1684-1182(10)60078-3.

Abstract

Background/purpose: Acute diarrhea is one of the most common morbidities in pediatrics worldwide. We conducted a study to investigate the incidence of norovirus in young children hospitalized with acute diarrhea in Taiwan and its clinical peculiarity compared with rotavirus gastroenteritis.

Methods: Between January and December, 2009, patients younger than 5 years and admitted to hospital with acute diarrhea were randomly selected; and their stool samples were collected and tested for presence of rotavirus and norovirus by enzyme immunoassay and reverse transcription-polymerase chain reaction, respectively. The clinical manifestations and laboratory findings of the enrolled patients were analyzed.

Results: A total of 989 cases were enrolled with a mean age of 21.6 ± 13.7 months and a male proportion of 56.0%. Rotavirus and norovirus was detected in 20.2% and 14.6% of all patients, respectively. Genogroup II was the predominant strain of norovirus (80.6%). Children aged 6-36 months accounted for the majority of patients positive for rotavirus and norovirus (73.0% and 81.3%, respectively). The incidences of norovirus and rotavirus infection were higher during winter and early spring. Most patients with rotavirus and norovirus diarrhea experienced vomiting (74.9%vs. 74.8%, respectively) and fever (94.7%vs. 71.3%, respectively).

Conclusion: Most young diarrheal patients presenting with vomiting were likely to have norovirus or rotavirus infection. Patients with norovirus diarrhea experienced an absence of, or low-grade fever and longer duration of vomiting compared with those positive for rotavirus infection. A family history of current gastroenteritis may suggest the possibility of norovirus infection.

MeSH terms

  • Acute Disease
  • Caliciviridae Infections / epidemiology*
  • Caliciviridae Infections / physiopathology
  • Caliciviridae Infections / virology
  • Child, Preschool
  • Diarrhea / epidemiology*
  • Diarrhea / physiopathology
  • Diarrhea / virology
  • Female
  • Gastroenteritis / epidemiology*
  • Gastroenteritis / physiopathology
  • Gastroenteritis / virology
  • Hospitalization
  • Humans
  • Immunoenzyme Techniques
  • Infant
  • Male
  • Norovirus / genetics
  • Norovirus / immunology
  • Norovirus / isolation & purification*
  • Reverse Transcriptase Polymerase Chain Reaction
  • Rotavirus / genetics
  • Rotavirus / immunology
  • Rotavirus / isolation & purification*
  • Rotavirus Infections / epidemiology*
  • Rotavirus Infections / physiopathology
  • Rotavirus Infections / virology
  • Taiwan / epidemiology