Jin-Xia Wang1, Hong-Lu Zhou1, Zhao-Jun Mo2, Song-Mei Wang3, Zhi-Yong Hao4, Yue Li1, Shan-Shan Zhen1, Can-Jing Zhang1, Xin-Jiang Zhang4, Jing-Chen Ma5, Chao Qiu1, Gan Zhao6, Baoming Jiang7, Xi Jiang8, Rong-Cheng Li2, Yu-Liang Zhao9, Xuan-Yi Wang10. 1. Key Laboratory of Medical Molecular Virology of Ministry of Education & Ministry of Health, and Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, People's Republic of China. 2. Guangxi Center for Disease Control and Prevention, Nanning 530028, People's Republic of China. 3. Laboratory of Molecular Biology, Training Center of Medical Experiments, School of Basic Medical Sciences, Fudan University, Shanghai 200032, People's Republic of China. 4. Zhengding County Center for Disease Control and Prevention, Zhengding 050800, People's Republic of China. 5. Hebei Province Center for Disease Control and Prevention, Shijiazhuang 050021, People's Republic of China. 6. Key Laboratory of Medical Molecular Virology of Ministry of Education & Ministry of Health, and Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, People's Republic of China; Children's Hospital, Fudan University, Shanghai 201102, People's Republic of China. 7. Viral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. 8. Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, University of Cincinnati, College of Medicine, Cincinnati, OH, USA. 9. Hebei Province Center for Disease Control and Prevention, Shijiazhuang 050021, People's Republic of China. Electronic address: yuliang_zh@163.com. 10. Key Laboratory of Medical Molecular Virology of Ministry of Education & Ministry of Health, and Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, People's Republic of China; Children's Hospital, Fudan University, Shanghai 201102, People's Republic of China. Electronic address: xywang@shmu.edu.cn.
Abstract
BACKGROUND: Despite the considerable disease burden caused by the disease, rotavirus vaccine has not been introduced into routine national immunization schedule, and norovirus vaccines are being developed without a comprehensive understanding of gastroenteritis epidemiology. To bridge this knowledge gap, we investigated the disease burden of viral gastroenteritis in rural China. METHODS: Between October 2011 and December 2013, population-based surveillance was conducted in Zhengding and Sanjiang counties in China. Stool samples were collected from children <5 years of age with diarrhea. All specimens were tested for rotaviruses, noroviruses, sapoviruses, enteric adenoviruses, and astroviruses. RESULTS: The most common pathogen causing diarrhea was rotavirus (54.7 vs 45.6 cases/1,000 children/year in Zhengding and Sanjiang, respectively), followed by norovirus (28.4 vs 19.3 cases/1,000 children/year in Zhengding and Sanjiang, respectively). The highest incidence of these viruses was observed in children 6-18 months of age. Among the 5 viral pathogens, rotaviruses caused the most severe illness, followed by noroviruses. CONCLUSION: Rotavirus and norovirus are the 2 most important viral pathogens causing childhood diarrhea in both northern and southern China; they should be the major targets for viral gastroenteritis prevention strategies among children in China.
BACKGROUND: Despite the considerable disease burden caused by the disease, rotavirus vaccine has not been introduced into routine national immunization schedule, and norovirus vaccines are being developed without a comprehensive understanding of gastroenteritis epidemiology. To bridge this knowledge gap, we investigated the disease burden of viral gastroenteritis in rural China. METHODS: Between October 2011 and December 2013, population-based surveillance was conducted in Zhengding and Sanjiang counties in China. Stool samples were collected from children <5 years of age with diarrhea. All specimens were tested for rotaviruses, noroviruses, sapoviruses, enteric adenoviruses, and astroviruses. RESULTS: The most common pathogen causing diarrhea was rotavirus (54.7 vs 45.6 cases/1,000 children/year in Zhengding and Sanjiang, respectively), followed by norovirus (28.4 vs 19.3 cases/1,000 children/year in Zhengding and Sanjiang, respectively). The highest incidence of these viruses was observed in children 6-18 months of age. Among the 5 viral pathogens, rotaviruses caused the most severe illness, followed by noroviruses. CONCLUSION: Rotavirus and norovirus are the 2 most important viral pathogens causing childhood diarrhea in both northern and southern China; they should be the major targets for viral gastroenteritis prevention strategies among children in China.