Yee Eileen L, Staat Mary Allen, Azimi Parvin, Bernstein David I, Ward Richard L, Schubert Charles, Matson David O, Turcios-Ruiz Reina M, Parashar Umesh, Widdowson Marc-Alain, Glass Roger I
Division of Viral Diseases, Epidemic Intelligence Service Program, Office of Workforce and Career Development, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Pediatrics. 2008 Nov;122(5):971-7. doi: 10.1542/peds.2007-1609.
We assessed the incidence of rotavirus disease requiring an emergency department visit among children <5 years of age.
We conducted active surveillance for acute gastroenteritis in pediatric emergency departments in Cincinnati, Ohio, and Oakland, California, from March 1999 to May 2000, among children 2 weeks to 59 months of age with acute diarrhea and/or vomiting. We obtained clinical and demographic information from participants and tested their stool specimens for rotavirus.
Approximately 9% of all emergency department visits at the study sites were attributable to acute gastroenteritis. A total of 1433 children were eligible at the 2 sites; 85% were enrolled and 68% provided a stool specimen. Overall, rotavirus was detected in specimens from 27% of children (30% in Cincinnati and 24% in Oakland). Rotavirus detection was higher in bulk stools, compared with rectal swabs, at both Cincinnati (37% vs 23%) and Oakland (46% vs 18%). Patients with rotavirus had more-severe disease than did those with nonrotavirus gastroenteritis. We estimated that the mean annual incidence of emergency department visits attributable to rotavirus was 12 cases per 1000 children in Cincinnati and 15 cases per 1000 children in Oakland. Through extrapolation, we estimated that rotavirus infection causes approximately 260,910 emergency department visits per year among US children.
Active surveillance demonstrated that the burden of laboratory-confirmed rotavirus disease treated in emergency department settings among US children is substantial and greater than estimated previously.
我们评估了5岁以下儿童因轮状病毒疾病前往急诊科就诊的发生率。
1999年3月至2000年5月，我们在俄亥俄州辛辛那提市和加利福尼亚州奥克兰市的儿科急诊科，对2周龄至59月龄患有急性腹泻和/或呕吐的儿童进行了急性胃肠炎的主动监测。我们从参与者那里获取了临床和人口统计学信息，并对他们的粪便标本进行轮状病毒检测。
研究地点所有急诊科就诊病例中约9%归因于急性胃肠炎。两个地点共有1433名儿童符合条件；85%的儿童入组，68%的儿童提供了粪便标本。总体而言，27%的儿童标本中检测到轮状病毒（辛辛那提市为30%，奥克兰市为24%）。在辛辛那提市（37%对23%）和奥克兰市（46%对18%），与直肠拭子相比，大量粪便中轮状病毒检测率更高。感染轮状病毒的患者比非轮状病毒胃肠炎患者病情更严重。我们估计，辛辛那提市因轮状病毒导致的急诊科就诊年平均发生率为每1000名儿童12例，奥克兰市为每1000名儿童15例。通过推算，我们估计轮状病毒感染每年导致美国儿童约260,910次急诊科就诊。
主动监测表明，美国儿童在急诊科接受治疗的实验室确诊轮状病毒疾病负担较重，且比之前估计的更大。
