Gastroenteritis in children under 5 years of age in England and Wales.

Gastroenteritis is a major cause of illness in young children worldwide. The magnitude of this problem is underestimated, as many cases may not present for medical treatment and many that do present are not asked to provide a faecal specimen. In this study, laboratory reports of pathogens responsible for gastroenteritis in children under 5 years in England and Wales reported to the PHLS Communicable Disease Surveillance Centre from January 1990 to December 1994 were analysed. These reports were compared with food poisoning notifications and mortality attributable to gastroenteritis collated by the Office of Population Censuses and Surveys in the same age group over the same period. Thirty-nine per cent of the 167630 laboratory faecal identifications were of rotavirus. Reports were commonest in children under 1 year of age during the winter months. Salmonellas and campylobacters were isolated from 16% and 15% of the specimens reported respectively. During the study period salmonella reporting rates rose by 48% in this age group. Improving the microbiological quality of food and raising standards of food hygiene, together with increasing parental awareness of the possibility of food poisoning in young children, will help to reduce morbidity in this age group. The majority of childhood deaths attributable to gastroenteritis were associated with rotavirus infection. The introduction of recently developed vaccines against rotavirus could substantially reduce the level of morbidity in this age group.