University of Tampere Medical School, FM3, Biokatu 10, 33520 Tampere, Finland.
Eur J Pediatr. 2011 Nov;170(11):1413-8. doi: 10.1007/s00431-011-1443-4. Epub 2011 Apr 5.
Noroviruses (NoVs) are second only to rotaviruses (RVs) as causative agents of acute gastroenteritis (AGE) in children. The proportional role of NoVs is likely to increase after control of RV by vaccination. We investigated NoVs in children seen in Tampere University Hospital either treated as outpatients or hospitalized because of AGE before universal RV vaccination was implemented in Finland. This prospective study was conducted from September 2006 to August 2008. A total of 1,128 children <15 years of age with symptoms of AGE were enrolled either in the hospital clinic or in a ward, and stool samples for NoV studies were obtained from 759 children. NoVs were found in 196 (26%) cases. In the first year, NoVs were found in 116 (34%) out of 341, and in the second year, in 80 (19%) out of 418 cases. RVs were found respectively in 128 (38%) and 260 (62%) cases in these two seasons. Both RV and NoV were present in 24 cases. NoV genotype GII.4 predominated with a 96% share of the NoV cases in the first season and an 80% share in the second season. Other NoV genotypes seen infrequently were GII.7, GIIb, GI.6, GII.1, GII.2, and GIIc. The median clinical severity of NoV AGE was 14 compared to 16 for RV AGE on a 20-point scale.
NoVs were nearly as common as RVs as causative agents of severe AGE in children seen in hospital. After implementing universal RV vaccination, the importance of NoVs will still increase further.
诺如病毒（NoV）是仅次于轮状病毒（RV）的导致儿童急性肠胃炎（AGE）的病原体。在芬兰实施 RV 疫苗接种以控制 RV 后，NoV 的比例可能会增加。我们调查了坦佩雷大学医院就诊的因 AGE 而接受门诊或住院治疗的儿童中的 NoV，在此之前芬兰已普遍实施 RV 疫苗接种。这项前瞻性研究于 2006 年 9 月至 2008 年 8 月进行。共有 1128 名年龄<15 岁、有 AGE 症状的儿童参加了医院诊所或病房的研究，从 759 名儿童中获得了用于 NoV 研究的粪便样本。在 196 例（26%）病例中发现了 NoV。在第一年，341 例中有 116 例（34%），第二年，418 例中有 80 例（19%）。在这两个季节，分别有 128 例（38%）和 260 例（62%）发现 RV。24 例同时存在 RV 和 NoV。在第一个季节，NoV 基因型 GII.4 占 96%，在第二个季节占 80%。偶尔还会出现其他 NoV 基因型，包括 GII.7、GIIb、GI.6、GII.1、GII.2 和 GIIc。NoV AGE 的临床严重程度中位数为 14，而 RV AGE 为 16，均采用 20 分制进行评分。
在因 AGE 住院的儿童中，NoV 是 RV 导致严重 AGE 的病原体，其重要性与 RV 相当。在实施普遍 RV 疫苗接种后，NoV 的重要性还会进一步增加。
