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Enteric Viral Pathogens in Infants in the United States: 2017-2020

Jennifer L Cannon1, Julia M Baker2, Claire P Mattison2,3

  • 1CDC Foundation, Atlanta, Georgia.

Pediatrics
|April 8, 2026
PubMed

Insights

Young children experience frequent enteric viral infections, with norovirus being common. Many infections are asymptomatic, highlighting the need for better understanding of viral gastroenteritis in infants.

Area of Science:

  • Pediatric infectious diseases
  • Virology
  • Epidemiology

Background:

  • Rotavirus vaccines have reduced disease burden, leading to a relative increase in other viral gastroenteritis pathogens.
  • Understanding the community-level burden of enteric viral pathogens in young children is crucial.

Purpose of the Study:

  • To determine the community-level burden of enteric viral pathogens in a US cohort during the first two years of life.
  • To characterize the incidence and clinical manifestations of viral acute gastroenteritis (AGE) in infants.

Main Methods:

  • Weekly stool samples and AGE symptom surveys collected from mother-child pairs in the PREVAIL cohort from birth to age 2.
  • Stools tested for 5 enteric viral pathogens; infections defined by proximal viral detections of the same genotype.
  • Calculated rates of infection and AGE symptoms.

Main Results:

  • 245 children followed, 13,944 stools tested, 836 AGE episodes recorded between 2017-2020.
  • Children averaged 3.8 enteric viral infections per year; over two-thirds had symptomatic infections by age 2.
  • Norovirus Genogroup II (0.4/child-year) and sapovirus (0.2/child-year) were most common symptomatic infections; most infections were asymptomatic and not medically attended.

Conclusions:

  • Enteric viral infections, especially norovirus, pose a significant burden in young US children.
  • A high frequency of asymptomatic infections was observed, improving understanding of viral gastroenteritis epidemiology.
  • Symptomatic infections were rare before six months of age.
Abstract

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