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Viral Etiology of AGE in Post-Rotavirus Vaccine Era
J Pediatr Infect Dis Soc; ePub 2018 Sep 3; Hassan, et al
Norovirus, astrovirus, sapovirus, and rotavirus were detected significantly more in children with acute gastroenteritis (AGE) than in healthy controls (HCs), and norovirus was the leading AGE-causing pathogen in US children aged <2 years during the year 2012. This according to a recent study that aimed to determine the viral etiology of AGE in US children aged <2 years in the post-rotavirus vaccine era. Stool samples were collected from children aged <2 years with symptoms of AGE (n=330) and age-matched healthy controls (HCs) (n=272) between January and December 2012. Researchers found:
- Detection rates of pathogens in children with AGE vs those of HCs were, respectively, 23.0% vs 6.6% for norovirus, 23.0% vs 16.0% for adenovirus, 11.0% vs 16.0% for parechovirus A, 11.0% vs 9.0% for enterovirus, 7.0% vs 3.0% for sapovirus, 3.0% vs 0.3% for astrovirus, and 3.0% vs 0.4% for rotavirus.
- A high prevalence of adenovirus was detected at 1 surveillance site (49.0% for children with AGE and 43.0% for HCs).
- Norovirus GII.4 New Orleans was the most frequently detected (33.0%) norovirus genotype.
Hassan F, Kanwar N, Harrison CJ, et al. Viral etiology of acute gastroenteritis in <2-year-old US children in the post–rotavirus vaccine era. [Published online ahead of print September 3, 2018]. J Pediatr Infect Dis Soc. doi:10.1093/jpids/piy077.
The epidemiology of acute gastroenteritis (AGE) in children has changed significantly since the introduction of rotavirus vaccine in 2006. This study looked at a number of different AGE-associated viruses and their prevalence in children with AGE or healthy matched controls. Interesting findings include the high prevalence of norovirus at all 4 sites, as well as a high prevalence of many of the viruses (particularly parechovirus A) in healthy, asymptomatic children. All viruses were seen in both children with AGE and those without symptoms. Data suggest asymptomatic children have lower viral loads, which may explain the different symptomatology.—Sarah Rawstron, MB, BS, FAAP, FIDSA; Pediatric Residency Program Director, The Brooklyn Hospital Center, NY; Clinical Associate Professor, Icahn School of Medicine, Mount Sinai, NY.