Comparison of clinical features of childhood norovirus and rotavirus gastroenteritis in Taiwan.

BACKGROUND

Viral gastroenteritis is a common acute infectious disease in infants and young children. This study compared the incidence and clinical features of childhood norovirus (NV) and rotavirus (RV) gastroenteritis in Taiwan.

METHODS

Stool specimens were collected from children with acute gastroenteritis aged 6 months to 14 years who were treated at the Children's Medical Center of Taipei Veterans General Hospital between January 2004 and March 2005. The incidence, clinical manifestations, and laboratory findings of childhood NV gastroenteritis were analyzed and compared with those of patients with RV gastroenteritis. Patients with underlying diseases associated with diarrhea or those diagnosed with bacterial gastroenteritis were excluded. Stool specimens were tested for NV and RV using enzyme immunoassay (EIA). NV genogroups were determined by reverse-transcriptase polymerase chain reaction.

RESULTS

Among the 201 patients included in this study, NV was detected in 44 (21.9%) by 1 or more tests (22 by EIA). Five of these isolates were genogroup I (11.3%), and 39 were genogroup II (88.7%). Fifty-two (25.9%) specimens had a positive EIA result for RV. Compared with NV, patients with RV gastroenteritis had a significantly higher percentage of diarrhea (94 vs. 69%, p < 0.001), fever (82 vs. 26.2%, p < 0.001), and longer hospital stay (3.81 vs. 2.93 days, p = 0.048). Laboratory studies showed significantly higher liver enzymes and C-reactive protein levels in patients with RV infection. In contrast, white blood cell counts were significantly higher in patients with NV infection.

CONCLUSION

Norovirus is one of the leading agents of acute gastroenteritis in children in Taiwan, and genogroup II is the predominant type.