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Volume 43, Number 6, December 2010

Epidemiology and Clinical Peculiarities of Norovirus and Rotavirus Infection in Hospitalized Young Children with Acute Diarrhea in Taiwan, 2009


Shu-Yan Yang, Kao-Pin Hwang, Fang-Tzy Wu, Ho-Sheng Wu, Chao Agnes Hsiung, Wan-Chi Chang, Jen-Shiou Lin, Shun-Cheng Yang, Sun-Lin Huang, Yhu-Chering Huang


Received: April 20, 2010    Revised: June 1, 2010    Accepted: June 20, 2010   

 

Corresponding author:

Division of Pediatric Infectious Disease, China Medical University Hospital, 2 Yuh Der Road, 40447 Taichung, Taiwan. E-mail: kapihw@mail.cmuh.org.tw 
Shu-Yan Yang and Kao-Pin Hwang contributed equally to this work.



 

Background and purpose: 

Acute diarrhea is one of the most common morbidities in pediatrics worldwide. We conducted a study to investigate the incidence of norovirus in young children hospitalized with acute diarrhea in Taiwan and its clinical peculiarity compared with rotavirus gastroenteritis.



 

Methods:

Between January and December, 2009, patients younger than 5 years and admitted to hospital with acute diarrhea were randomly selected; and their stool samples were collected and tested for presence of rotavirus and norovirus by enzyme immunoassay and reverse transcription-polymerase chain reaction, respectively. The clinical manifestations and laboratory findings of the enrolled patients were analyzed.



 

Results:

A total of 989 cases were enrolled with a mean age of 21.6 ± 13.7 months and a male proportion of 56.0%. Rotavirus and norovirus was detected in 20.2% and 14.6% of all patients, respectively. Genogroup II was the predominant strain of norovirus (80.6%). Children aged 6–36 months accounted for the majority
of patients positive for rotavirus and norovirus (73.0% and 81.3%, respectively). The incidences of norovirus  and rotavirus infection were higher during winter and early spring. Most patients with rotavirus and norovirus diarrhea experienced vomiting (74.9% vs.74.8%, respectively) and fever (94.7% vs. 71.3%, respectively).



 

Conclusion:

Most young diarrheal patients presenting with vomiting were likely to have norovirus or rotavirus infection. Patients with norovirus diarrhea experienced an absence of, or low-grade fever and longer duration of vomiting compared with those positive for rotavirus infection. A family history of current gastroenteritis may suggest the possibility of norovirus infection.



 

Key words:

acute diarrhea, norovirus, rotavirus, Taiwan, young children