Abstract
BackgroundThe highest incidence of rotavirus gastroenteritis has generally been reported in children 6-24 months of age. Young infants are thought to be partially protected by maternal antibodies acquired transplacentally or via breast milk. The purpose of our study was to assess the age distribution of children with confirmed community-acquired rotavirus gastroenteritis presenting to an urban referral hospital.MethodsChildren presenting to The Children's Hospital of Philadelphia with acute gastroenteritis have been monitored for the presence of rotavirus antigen in the stool by ELISA (followed by genotyping if ELISA-positive) since the 1994-95 epidemic season.ResultsOver the last 12 rotavirus seasons prior to the introduction of the pentavalent rotavirus vaccine in 2006, stool specimens from 1646 patients tested positive for community-acquired rotavirus infection. Gender or age was not recorded in 6 and 5 cases, respectively. Overall, 58% of the cases occurred in boys. G1 was the predominant VP7 serotype, accounting for 72% of cases. The median (IQR) age was 11 (5-21) months. A total of 790 (48%) cases occurred in children outside the commonly quoted peak age range, with 27% in infants <6 months of age and 21% in children >24 months of age. A total of 220 (13%) cases occurred during the first 3 months of life, and the highest number of episodes per month of age [97 (6%)] was observed during the second month of life.ConclusionsThe incidence of community-acquired rotavirus gastroenteritis monitored over 12 seasons in the prevaccine era at a major university hospital was nearly constant for each month of age during the first year of life, revealing an unexpectedly high incidence of symptomatic rotavirus disease in infants <3 months old. A sizeable fraction of cases occurred in children too young to have been vaccinated according to current recommendations.
Highlights
The highest incidence of rotavirus gastroenteritis has generally been reported in children 6-24 months of age
We examined the age distribution of children presenting to The Children's Hospital of Philadelphia (CHOP) with community-acquired rotavirus gastroenteritis prior to the recent introduction of the new rotavirus vaccines to assess the burden of rotavirus infection serious enough to motivate hospital visits in neonates and young infants
In contrast to the prevaccine era, the median age of children presenting to CHOP with community-acquired rotavirus gastroenteritis during the 2007-08 season was 20 months and during the 2008-09 season was 23.5 months
Summary
The highest incidence of rotavirus gastroenteritis has generally been reported in children 6-24 months of age. Young infants are thought to be partially protected by maternal antibodies acquired transplacentally or via breast milk. The purpose of our study was to assess the age distribution of children with confirmed community-acquired rotavirus gastroenteritis presenting to an urban referral hospital. For the first few months of life, infants are thought to be partially protected by maternal antibodies acquired transplacentally or through breast feeding [24,25,26]. We examined the age distribution of children presenting to The Children's Hospital of Philadelphia (CHOP) with community-acquired rotavirus gastroenteritis prior to the recent introduction of the new rotavirus vaccines to assess the burden of rotavirus infection serious enough to motivate hospital visits in neonates and young infants
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