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Structured surveillance of infectious intestinal disease in pre-school children in the community: 'The Nappy Study'

M Iturriza-Gómara1, A J Elliot, C Dockery

  • 1Enteric Virus Unit, Health Protection Agency Centre for Infections, London, UK. Miren.Iturriza@hpa.org.uk

Epidemiology and Infection
|November 20, 2008
PubMed

Insights

Infectious intestinal disease (IID) in young children is common, with viruses like norovirus and rotavirus being the primary causes. Molecular testing identified pathogens in 62% of samples, highlighting the need for surveillance.

Area of Science:

  • Pediatric Infectious Diseases
  • Gastroenterology
  • Molecular Epidemiology

Background:

  • Infectious intestinal disease (IID) is a significant cause of illness in children under five.
  • Understanding the incidence and causative agents of IID in primary care is crucial for public health.
  • Previous studies may not fully capture the spectrum of pathogens in this age group presenting to general practitioners.

Purpose of the Study:

  • To estimate the incidence and identify the causes of infectious intestinal disease (IID) in children under five years old presenting to general practitioners (GPs).
  • To characterize the prevalent viral genotypes of rotavirus and norovirus in pediatric IID cases.
  • To compare the detected genotypes with national surveillance data.

Main Methods:

  • A prospective study involving the collection of soiled nappies from children with IID symptoms across 65 GP practices in England over 12 months.
  • Utilized molecular methods for detecting a wide range of enteric viruses, bacteria, and parasites.
  • Performed genotyping on rotavirus and norovirus isolates to determine specific strains.

Main Results:

  • A pathogen was detected in 361 out of 583 collected specimens (62%).
  • Norovirus (24.5%), rotavirus (19.0%), and sapovirus (12.7%) were the most frequently identified pathogens, with mixed infections occurring in 11.7% of cases.
  • Common rotavirus genotypes included G1P[8], G4P[4], and G9P[8], while GII-3 and GII-4 were the predominant norovirus genotypes, with the latter showing a significant difference from national distributions.

Conclusions:

  • Molecular detection in nappy samples is an effective method for identifying pathogens causing IID in young children presenting to primary care.
  • Norovirus and rotavirus are major contributors to pediatric IID, with specific genotype distributions observed.
  • Findings highlight the importance of ongoing molecular surveillance for understanding pediatric infectious intestinal disease trends and informing public health interventions.

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