Molecular epidemiology of rotavirus in children attending day care centers in Houston

Article Abstract:

Rotaviruses are responsible for outbreaks of childhood diarrhea all over the world. The success of intervention and prevention programs depends on knowledge of the epidemiology and molecular virology of the agents involved. Early efforts to characterize the distribution of similar strains of rotaviruses were complicated by the variability in strain identification; different laboratories reported different results after testing the same specimens. More recent analytical identification of the antigens of these viruses (serotypes) has permitted simpler and more clinically relevant classification. Five rotavirus groups (A-E) have been separated on the basis of exclusive properties of an inner capsid protein. Rotaviruses of Group A are associated with diarrhea in children and are rapidly and readily detected by differences in inner and outer capsid proteins. An ELISA method, using specific monoclonal antibodies, permits direct determination of rotavirus serotypes in stool specimens. Serotypes and virus exposure vary within and among different areas of the country. The previous failure to recognize this diversity may have been due to the fact that many studies were conducted in a geographic area where a single serotype caused most infections. Children attending day care are at increased risk of developing rotavirus infection. To explore the distribution of serotypes of group A rotavirus among children attending day care in a specific geographic area, a study was undertaken in Houston. Patients were drawn from licensed day care centers with at least 10 children, from birth to 32 months of age. A total of 318 children from 15 centers were monitored during the longitudinal study, which included 3 consecutive rotavirus seasons. Monitoring included recording the presence of diarrhea and examining weekly stool collections. The children had a total of 362 rotavirus episodes, of which 149 could be serotyped. Many infections were asymptomatic. The serotype distribution resembled that of hospitalized patients in the Houston area. Further research in the epidemiologic and immunological aspects of rotaviruses is needed before effective preventive measures can be developed (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Texas, Identification and classification, Day care centers, Houston, Texas

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Impact of rotavirus infection at a large pediatric hospital

Article Abstract:

Rotavirus infection is very common; approximately 3 to 5 billion cases are diagnosed each year, resulting in 5 to 10 million deaths. Infection with rotavirus causes gastroenteritis (inflammation of the stomach and intestine) and diarrhea, and rotavirus is the most common cause of gastroenteritis in children. Viral gastroenteritis is recognized as a major cause of illness and death. Nonbacterial gastroenteritis is the second most common family disease in the United States. The Centers for Disease Control have estimated that, between 1979 and 1984, 209,000 children under 5 years of age were hospitalized with diarrhea in the US. It is estimated that two-thirds of these cases were caused by rotavirus infection. Hospital laboratory and medical records were used to determine the prevalence of gastroenteritis due to rotavirus between June 1979 and July 1989, at the Texas Children's Hospital in Houston. The records revealed that, during the 10-year study period, 473 children were hospitalized because of rotavirus infection. These cases represented 1.5 million dollars per year in hospital bed costs, and 3 percent of all hospital days at this medical facility. Based on extrapolation, these results predict an annual hospitalization cost of 352 million dollars for infected children, and indicate that rotavirus infection is a major cause of illness among children in the US. (Consumer Summary produced by Reliance Medical Information, Inc.)

Economic aspects, Disease transmission

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Rotavirus infection in infants as protection against subsequent infections

Article Abstract:

Two doses of vaccine against rotavirus should completely protect children from this infection, which kills about 870,000 children in developing countries. Researchers followed 200 Mexican babies and tested blood and stool samples for rotavirus whenever the infants developed diarrhea. They diagnosed 316 rotavirus infections during the 2-year study. The risk of moderate to severe rotavirus infection dropped substantially once the children had one or more rotavirus infections. Two episodes of infection protected the children completely from severe rotavirus infections.

Prevention, Children, Child health

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