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Noroviruses in children seen in a hospital for acute gastroenteritis in Finland.

Räsänen S, Lappalainen S, Salminen M, Huhti L, Vesikari T - Eur. J. Pediatr. (2011)

Bottom Line: NoVs were found in 196 (26%) cases.RVs were found respectively in 128 (38%) and 260 (62%) cases in these two seasons.The median clinical severity of NoV AGE was 14 compared to 16 for RV AGE on a 20-point scale.

View Article: PubMed Central - PubMed

Affiliation: University of Tampere Medical School, FM3, Biokatu 10, 33520 Tampere, Finland. sirpa.rasanen@uta.fi

ABSTRACT

Unlabelled: Noroviruses (NoVs) are second only to rotaviruses (RVs) as causative agents of acute gastroenteritis (AGE) in children. The proportional role of NoVs is likely to increase after control of RV by vaccination. We investigated NoVs in children seen in Tampere University Hospital either treated as outpatients or hospitalized because of AGE before universal RV vaccination was implemented in Finland. This prospective study was conducted from September 2006 to August 2008. A total of 1,128 children <15 years of age with symptoms of AGE were enrolled either in the hospital clinic or in a ward, and stool samples for NoV studies were obtained from 759 children. NoVs were found in 196 (26%) cases. In the first year, NoVs were found in 116 (34%) out of 341, and in the second year, in 80 (19%) out of 418 cases. RVs were found respectively in 128 (38%) and 260 (62%) cases in these two seasons. Both RV and NoV were present in 24 cases. NoV genotype GII.4 predominated with a 96% share of the NoV cases in the first season and an 80% share in the second season. Other NoV genotypes seen infrequently were GII.7, GIIb, GI.6, GII.1, GII.2, and GIIc. The median clinical severity of NoV AGE was 14 compared to 16 for RV AGE on a 20-point scale.

Conclusion: NoVs were nearly as common as RVs as causative agents of severe AGE in children seen in hospital. After implementing universal RV vaccination, the importance of NoVs will still increase further.

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Severity of clinical symptoms of acute gastroenteritis caused either by norovirus (n = 79) or rotavirus (n = 196) (September 2006–August 2008). Severity is assessed with a 20-point scale in which ≥11 points is considered as severe
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Fig3: Severity of clinical symptoms of acute gastroenteritis caused either by norovirus (n = 79) or rotavirus (n = 196) (September 2006–August 2008). Severity is assessed with a 20-point scale in which ≥11 points is considered as severe

Mentions: Clinical severity score could be calculated in 79 out of 171 (46%) of NoV-positive and RV-negative, and 196 out of 356 (55%) RV-positive and NoV-negative AGE cases. The severity scores of AGE cases caused by NoV ranged from 8 to 19, and cases caused by RV from 10 to 20 (Fig. 3). Median severity of AGE cases with a NoV as single causative agent was 14, and with a RV as a single causative agent, median was 16. The difference between the severities of AGE caused by NoV and RV was statistically significant (P < 0.01).Fig. 3


Noroviruses in children seen in a hospital for acute gastroenteritis in Finland.

Räsänen S, Lappalainen S, Salminen M, Huhti L, Vesikari T - Eur. J. Pediatr. (2011)

Severity of clinical symptoms of acute gastroenteritis caused either by norovirus (n = 79) or rotavirus (n = 196) (September 2006–August 2008). Severity is assessed with a 20-point scale in which ≥11 points is considered as severe
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3197931&req=5

Fig3: Severity of clinical symptoms of acute gastroenteritis caused either by norovirus (n = 79) or rotavirus (n = 196) (September 2006–August 2008). Severity is assessed with a 20-point scale in which ≥11 points is considered as severe
Mentions: Clinical severity score could be calculated in 79 out of 171 (46%) of NoV-positive and RV-negative, and 196 out of 356 (55%) RV-positive and NoV-negative AGE cases. The severity scores of AGE cases caused by NoV ranged from 8 to 19, and cases caused by RV from 10 to 20 (Fig. 3). Median severity of AGE cases with a NoV as single causative agent was 14, and with a RV as a single causative agent, median was 16. The difference between the severities of AGE caused by NoV and RV was statistically significant (P < 0.01).Fig. 3

Bottom Line: NoVs were found in 196 (26%) cases.RVs were found respectively in 128 (38%) and 260 (62%) cases in these two seasons.The median clinical severity of NoV AGE was 14 compared to 16 for RV AGE on a 20-point scale.

View Article: PubMed Central - PubMed

Affiliation: University of Tampere Medical School, FM3, Biokatu 10, 33520 Tampere, Finland. sirpa.rasanen@uta.fi

ABSTRACT

Unlabelled: Noroviruses (NoVs) are second only to rotaviruses (RVs) as causative agents of acute gastroenteritis (AGE) in children. The proportional role of NoVs is likely to increase after control of RV by vaccination. We investigated NoVs in children seen in Tampere University Hospital either treated as outpatients or hospitalized because of AGE before universal RV vaccination was implemented in Finland. This prospective study was conducted from September 2006 to August 2008. A total of 1,128 children <15 years of age with symptoms of AGE were enrolled either in the hospital clinic or in a ward, and stool samples for NoV studies were obtained from 759 children. NoVs were found in 196 (26%) cases. In the first year, NoVs were found in 116 (34%) out of 341, and in the second year, in 80 (19%) out of 418 cases. RVs were found respectively in 128 (38%) and 260 (62%) cases in these two seasons. Both RV and NoV were present in 24 cases. NoV genotype GII.4 predominated with a 96% share of the NoV cases in the first season and an 80% share in the second season. Other NoV genotypes seen infrequently were GII.7, GIIb, GI.6, GII.1, GII.2, and GIIc. The median clinical severity of NoV AGE was 14 compared to 16 for RV AGE on a 20-point scale.

Conclusion: NoVs were nearly as common as RVs as causative agents of severe AGE in children seen in hospital. After implementing universal RV vaccination, the importance of NoVs will still increase further.

Show MeSH
Related in: MedlinePlus