Etiology of acute gastroenteritis in children in Israel: role of human reoviruslike agent and bacterial pathogens

Abstract

A study of acute gastroenteritis in children was carried out with the aim of establishing the prevalence of human reoviruslike agent (HRLA) and its relation to other enteric pathogens in Israel. The stools of 384 children with acute diarrhea referred to a pediatric emergency service were screened for HRLA by counterimmunoelectroosmorphoresis (CIEOP) and for pathogenic bacteria. Evidence of HRLA infection was found in 65 patients (17%). The highest infection rate prevailed during the cool season (25%), with a peak prevalence (41%) in November, when both the temperature and humidity were low. A very high proportion of HRLA was found in children younger than 36 months and no HRLA infection was observed in those older than nine years. The highest prevalence occurred in infants younger than six months, a situation rarely encountered in other countries. The main clinical features of HRLA infection were fever, vomiting, dehydration, signs of upper respiratory infection and carbohydrate intolerance. Bacterial pathogens accounted for 45% of enteric infections. Shigella species predominated (28%) during the summer season, especially in older children. In 38% of the study group, no etiologic agent could be detected. None of the 50 control subjects showed evidence of viral or bacterial pathogens in stools.