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Gastroenteritis symptoms more severe in children with rotavirus vs. norovirus
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BETHESDA, Md. — Children with rotavirus develop more severe gastroenteritis symptoms and are more likely to experience fever, dehydration and hospitalization than children with norovirus, according to data presented at the 2014 Annual Conference on Vaccine Research.
Margaret K. Doll, MPH, of McGill University, and colleagues assessed 445 patients aged 8 weeks to 3 years admitted to the ED for gastroenteritis between February 2012 and December 2013. Researchers evaluated parent/guardian interviews, medical charts and stool samples from adolescent patients.
The study cohort consisted of 139 children with rotavirus, 87 with norovirus and 219 children considered to have “gastroenteritis of unknown etiology” based on negative test results for rotavirus, norovirus and sapovirus. Twelve children who tested positive for sapovirus were not included in the study.
Researchers found that children with rotavirus were 6.1 months older than those with norovirus and 5.8 months older than those with nonspecific gastroenteritis. Children with rotavirus were more likely to attend day care or school than children with gastroenteritis.
After adjusting for age, children with rotavirus had a risk difference of 37.1% for fever, 18.6% for dehydration and 12.3% for hospitalization compared with children with norovirus. Children with nonspecific gastroenteritis were similar to those with norovirus, except for fever, for which there was a 30% risk difference. Children with rotavirus had an age-adjusted difference of 3.1 diarrheal episodes compared with those with norovirus. Children with nonspecific gastroenteritis were less likely to experience vomiting than those with norovirus.
“In summary, what we saw is that rotavirus patients experienced greater clinical severity of gastroenteritis symptoms in comparison with norovirus patients,” Doll said during a presentation.
“More specifically, after adjustment for age, we found that rotavirus patients were more likely to experience fever, dehydration, hospitalization, and report a higher frequency of the maximum number of diarrhea episodes in a 24-hour period in comparison with norovirus patients. Largely, we found that [gastroenteritis of unknown etiology] patients and norovirus patients were clinically similar, although [gastroenteritis of unknown etiology] patients were more likely to experience fever, and norovirus patients reported a greater number of maximum vomiting episodes in a 24-hour period than [gastroenteritis of unknown etiology] patients.
For more information:
Doll MK. Abstract #S4. Presented at: Annual Conference on Vaccine Research; April 28-30, 2014; Bethesda, Md.
Disclosure: One researcher reports financial relationships with Merck, Sanofi Pasteur MSD, and Wyeth. Two researchers report financial relationships with GlaxoSmithKline.