The emerging importance of norovirus as the etiology of pediatric gastroenteritis in Taipei

Abstract

Background/purpose: Rotavirus is a major causative agent of pediatric gastroenteritis throughout the world. However, other viruses such as norovirus also play an important role, but have seldom been studied in Taipei, Taiwan. The aim of this study was to survey the prevalence and clinical manifestations of different types of viral gastroenteritis in Taipei, focusing especially on the disease burden of norovirus.

Methods: Between November 2004 and April 2005, stool samples were collected from hospitalized pediatric patients with a diagnosis of acute gastroenteritis. Clinical manifestations, laboratory data, and hospitalization course of the patients were all analyzed. Stool cultures for bacteria and rotavirus antigens were performed. All samples were tested for norovirus, enteric adenovirus, and astrovirus using enzyme-linked immunosorbent assays.

Results: A total of 75 stool specimens were collected during the 6-month period. Fifteen (20.0%) were positive for norovirus (3 genogroup I and 12 genogroup II). Three (4.0%) were positive for enteric adeno-virus, and one (1.3%) for astrovirus. Nine (12.0%) patients had positive rotavirus antigen tests. Bacterial pathogens were found in 12 patients (16.0%), including seven cases of Salmonella, and five of Campylobacter. The patients with norovirus gastroenteritis were aged between 1.5-7.5 years old (median 20 months old). Fever was found in six patients (40.0%), and bloody, mucoid stools in three (20.0%). The mean hospitalization time was 3.3 days. None of them had complications.

Conclusion: During the study period, norovirus was the most common pathogen causing hospitalized pediatric gastroenteritis in our hospital. Genogroup II was the predominant type (80.0%). Clinicians in Taipei should, therefore, be aware of the emergence of norovirus infections.