A Comparison of Pathogen Detection and Risk Factors among Symptomatic Children with Gastroenteritis Compared with Asymptomatic Children in the Post-rotavirus Vaccine Era.

Creator(s)

Brian R. Lee, Children's Mercy HospitalFollow
Christopher J. Harrison, Children's Mercy HospitalFollow
Ferdaus Hassan
Anjana Sasidharan, Children's Mercy HospitalFollow
Mary Moffatt, Children's Mercy HospitalFollow
Kirsten Weltmer, Children's Mercy Kansas CityFollow
Daniel C. Payne
Mary E. Wikswo
Umesh Parashar
Rangaraj Selvarangan, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

10-2023

Identifier

DOI: 10.1016/j.jpeds.2023.113551

Abstract

OBJECTIVE: To describe demographics, pathogen distribution/seasonality, and risk factors in children seeking care for acute gastroenteritis (AGE) at a midwestern US emergency department during 5 postrotavirus vaccine years (2011-2016), and further, to compare the same data with matched healthy controls (HC).

STUDY DESIGN: AGE and HC participants≥3 diarrhea episodes or ≥1 vomiting episode. Each HC's age was similar to an AGE participant's age. Pathogens were analyzed for seasonality effects. Participant risk factors for AGE illness and pathogen detections were compared between HC and a matched subset of AGE cases.

RESULTS: One or more organisms was detected in 1159 of 2503 children (46.3%) with AGE compared with 99 of 537 HC (17.3%). Norovirus was detected most frequently among AGE (n = 568 [22.7%]) and second-most frequently in HC (n = 39 [6.8%]). Rotavirus was the second most frequently detected pathogen among AGE (n = 196 [7.8%]). Children with AGE were significantly more likely to have reported a sick contact compared with HC, both outside the home (15.6% vs 1.4%; P < .001) and inside the home (18.6% vs 2.1%; P < .001). Daycare attendance was higher among children with AGE (41.4%) compared with HC (29.5%; P < .001). The Clostridium difficile detection rate was slightly higher among HC (7.0%) than AGE (5.3%).

CONCLUSIONS: Norovirus was the most prevalent pathogen among children with AGE. Norovirus was detected in some HC, suggesting potential asymptomatic shedding among HC. The proportion of AGE participants with a sick contact was approximately 10 times greater than that of HC.

Journal Title

The Journal of pediatrics

Volume

261

First Page

113551

Last Page

113551

MeSH Keywords

Humans; Child; Infant; Rotavirus Vaccines; Rotavirus Infections; Gastroenteritis; Rotavirus; Norovirus; Feces; Risk Factors

Keywords

norovirus; pediatric gastroenteritis; rotavirus

Recommended Citation

Lee BR, Harrison CJ, Hassan F, et al. A Comparison of Pathogen Detection and Risk Factors among Symptomatic Children with Gastroenteritis Compared with Asymptomatic Children in the Post-rotavirus Vaccine Era. J Pediatr. 2023;261:113551. doi:10.1016/j.jpeds.2023.113551