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P Ciruela1, C Izquierdo1, M Oviedo1
1Direcció General de Salut Pública. Departament de Sanitat i Seguretat Social. Barcelona. España.
Insights
Rotavirus is the primary cause of viral acute gastroenteritis (AGE) in young children, particularly infants, with a winter predominance. Adenovirus 40-41 also affects young children, with higher incidence in autumn. Vaccination against rotavirus is crucial.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Public Health Surveillance
Context:
- Rotavirus is a leading cause of severe diarrhea in children under five, contributing significantly to global child morbidity and mortality.
- Enteric viral infections pose a substantial public health challenge, necessitating accurate etiological data for effective management.
Purpose:
- To determine the etiology of enteric viruses, specifically rotavirus and adenovirus 40-41, within the Catalan Microbiology Notification System (CMNS).
- To evaluate the epidemiological importance and disease burden of rotavirus and adenovirus 40-41 in pediatric acute gastroenteritis (AGE).
Summary:
- Rotavirus accounted for 94.3% of viral AGE cases, predominantly in children under two years old and during winter months.
- Adenovirus 40-41 represented 5.7% of cases, also primarily affecting children under two, with a higher prevalence in autumn.
- Rotavirus and adenovirus 40-41 were significant etiological agents in children under five, ranking second and fourth respectively among bacterial and viral enteritis pathogens.
Impact:
- The findings underscore rotavirus as the principal viral agent of AGE in infants and young children, highlighting the need for vaccination.
- Understanding the seasonality and age distribution of rotavirus and adenovirus 40-41 aids in public health planning and resource allocation.
- This study emphasizes the importance of systematic viral detection for a comprehensive understanding of enteric disease epidemiology.
Introduction:
Rotavirus is the main cause of severe diarrhea in children aged less than 5 years, leading to elevated morbidity and mortality worldwide. The aim of the present study was to determine the etiology of enteric viruses reported to the Catalan Microbiology Notification System (CMNS) (rotavirus and adenovirus 40-41) and to evaluate the importance of these viruses in enteric disease.
Material And Methods:
We retrospectively reviewed the notifications made from 1995-2002 by the laboratories of hospitals participating in the CMNS. Cases of acute gastroenteritis (AGE) were diagnosed by antigen detection in stools. The variables analyzed were: age, sex, month, and year of isolation. Statistical analysis was performed using the X2 test and Fisher's test and proportions were compared using the binomial test. The level of statistical significance was set at 0.05.
Results:
Rotavirus was detected in 6708 cases of AGE (94.3%) and adenovirus 40-41 in 409 (5.7%). Viral AGE produced greater morbidity in children aged less than 2 years with 76% of cases caused by rotavi-rus and 68% of those caused by adenovirus 40-41 occurring in this age group. Rotavirus was isolated mainly in winter (68%), while adenovi-rus, although stable throughout the seasons, was more frequent in autumn (35.2%). Of cases of bacterial and viral enteritis detected by the CMNS, rotavirus was the second etiological agent and adenovirus the fourth in children aged less than 5 years after Campylobacter and Salmonella.
Conclusions:
Of the various viruses that can cause AGE, some are highly frequent, such as calcivirus and astrovirus, which are not systematically detected and consequently the frequencies reported in the present study should be interpreted with caution. Nevertheless, rotavirus is the main cause of viral AGE, affecting small children, especially infants aged 1-11 months, with a clear predominance in winter. Adenovirus 40-41 mainly affects children aged less than 2 years and is more frequent in autumn. Vaccination against rotavirus should be a priority to reduce the high rates of morbidity and mortality caused by this disease.