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2013 ; 368
(12
): 1121-30
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Norovirus and medically attended gastroenteritis in U S children
#MMPMID23514289
Payne DC
; Vinjé J
; Szilagyi PG
; Edwards KM
; Staat MA
; Weinberg GA
; Hall CB
; Chappell J
; Bernstein DI
; Curns AT
; Wikswo M
; Shirley SH
; Hall AJ
; Lopman B
; Parashar UD
N Engl J Med
2013[Mar]; 368
(12
): 1121-30
PMID23514289
show ga
BACKGROUND: Cases of rotavirus-associated acute gastroenteritis have declined
since the introduction of rotavirus vaccines, but the burden of
norovirus-associated acute gastroenteritis in children remains to be assessed.
METHODS: We conducted active surveillance for laboratory-confirmed cases of
norovirus among children younger than 5 years of age with acute gastroenteritis
in hospitals, emergency departments, and outpatient clinical settings. The
children resided in one of three U.S. counties during the years 2009 and 2010.
Fecal specimens were tested for norovirus and rotavirus. We calculated
population-based rates of norovirus-associated acute gastroenteritis and reviewed
billing records to determine medical costs; these data were extrapolated to the
U.S. population of children younger than 5 years of age. RESULTS: Norovirus was
detected in 21% of young children (278 of 1295) seeking medical attention for
acute gastroenteritis in 2009 and 2010, with norovirus detected in 22% (165 of
742) in 2009 and 20% (113 of 553) in 2010 (P=0.43). The virus was also detected
in 4% of healthy controls (19 of 493) in 2009. Rotavirus was identified in 12% of
children with acute gastroenteritis (152 of 1295) in 2009 and 2010. The
respective rates of hospitalization, emergency department visits, and outpatient
visits for the norovirus were 8.6, 146.7, and 367.7 per 10,000 children younger
than 5 years of age in 2009 and 5.8, 134.3, and 260.1 per 10,000 in 2010, with an
estimated cost per episode of $3,918, $435, and $151, respectively, in 2009.
Nationally, we estimate that the average numbers of annual hospitalizations,
emergency department visits, and outpatient visits due to norovirus infection in
2009 and 2010 among U.S. children in this age group exceeded 14,000, 281,000, and
627,000, respectively, with more than $273 million in treatment costs each year.
CONCLUSIONS: Since the introduction of rotavirus vaccines, norovirus has become
the leading cause of medically attended acute gastroenteritis in U.S. children
and is associated with nearly 1 million health care visits annually. (Funded by
the Centers for Disease Control and Prevention.).
|Acute Disease
[MESH]
|Ambulatory Care/statistics & numerical data
[MESH]
free
free
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