Acute Gastroenteritis Disease Burden in Infants With Medical Risk Conditions in the Netherlands

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Josephine A P van Dongen1, Elsbeth D M Rouers1,2, Rob Schuurman3

  • 1From the Julius Center for Health Sciences and Primary Care, Epidemiology of Infectious Diseases, UMCU Utrecht.

The Pediatric Infectious Disease Journal
|November 24, 2020
PubMed

Insights

Infants with medical conditions face a high burden of acute gastroenteritis (AGE), primarily caused by norovirus and rotavirus. Prioritizing prevention strategies for these vulnerable infants is crucial.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Infants with medical risk conditions are highly susceptible to infections like acute gastroenteritis (AGE).
  • Understanding AGE epidemiology in this population is vital for developing targeted prevention programs.
  • This study focused on medical risk infants in the Netherlands.

Purpose of the Study:

  • To quantify the incidence, severity, and viral prevalence of AGE in medically at-risk infants.
  • To inform public health strategies for preventing AGE in this vulnerable group.

Main Methods:

  • A prospective cohort study (RIVAR-project) involving 631 infants with prematurity, low birth weight, or severe congenital conditions.
  • 18 months of follow-up with monthly health questionnaires, parental reporting of AGE episodes, and stool sample collection.
  • Real-time polymerase chain reaction (PCR) analysis of stool samples for common gastroenteritis viruses (rotavirus, norovirus, adenovirus, astrovirus) and Modified Vesikari Severity scoring.

Main Results:

  • A total of 559 AGE episodes were recorded over 9125 person-months, with an incidence rate of 73.5 per 100 person-years.
  • AGE incidence increased with age; 38.1% of episodes led to healthcare visits, and 26.8% were severe.
  • Norovirus (25.6%) and rotavirus (17.7%) were the most prevalent viruses, with rotavirus-associated episodes being the most severe.

Conclusions:

  • Medically at-risk infants experience a significant burden of AGE, characterized by high incidence and severity.
  • Norovirus and rotavirus are the leading causes of AGE in this cohort.
  • Enhanced AGE prevention strategies are essential for this vulnerable infant population.
Abstract

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