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Unexpectedly high burden of rotavirus gastroenteritis in very young infants

H Fred Clark1, Amy E Marcello, Diane Lawley

  • 1Division of Infectious Diseases, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. clarkf@email.chop.edu

BMC Pediatrics
|June 15, 2010
PubMed

Insights

Rotavirus gastroenteritis commonly affects children aged 6-24 months. This study found a high incidence in infants younger than 3 months, challenging typical age distribution patterns for rotavirus disease.

Area of Science:

  • Pediatric Infectious Diseases
  • Virology
  • Epidemiology

Background:

  • Rotavirus gastroenteritis is a leading cause of severe diarrhea in infants and young children globally.
  • Maternal antibodies are believed to offer partial protection to very young infants.
  • The typical age distribution shows a peak incidence between 6 and 24 months of age.

Purpose of the Study:

  • To assess the age distribution of children with confirmed community-acquired rotavirus gastroenteritis.
  • To identify the incidence of rotavirus infection in different age groups, particularly in infants younger than 6 months and older than 24 months.
  • To compare observed age distribution with previously reported peak incidence in the prevaccine era.

Main Methods:

  • Retrospective analysis of stool specimens from children presenting with acute gastroenteritis.
  • ELISA testing for rotavirus antigen detection since the 1994-95 season.
  • Genotyping of rotavirus strains for serotype identification (VP7 serotype).

Main Results:

  • Over 12 rotavirus seasons, 1646 patients tested positive for rotavirus.
  • The predominant serotype was G1 (72% of cases).
  • A significant proportion of cases (48%) occurred outside the 6-24 month age range, including 27% in infants <6 months and 13% in infants <3 months. The highest incidence per month of age was observed in the second month of life.

Conclusions:

  • Rotavirus gastroenteritis incidence was relatively constant across the first year of life, contrary to the expected peak.
  • There was a high incidence of symptomatic rotavirus disease in infants younger than 3 months.
  • A substantial number of rotavirus cases occurred in children too young for current vaccination recommendations, highlighting the need for broader vaccination strategies.
Abstract

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