Chia-Yi Wu1, Hsin Chi2, Ching-Chuan Liu3, Yhu-Chering Huang4, Yi-Chuan Huang5, Hsiao-Chuan Lin6, Yu-Huai Ho7, Li-Min Huang8, Ching-Yi Huang9, Shu-Man Shih9, Fang-Tzy Wu10, Jung-Jung Mu10, Chao A Hsiung11. 1. Department of Pediatrics, Mackay Children's Hospital, Mackay Medical College, Taipei, Taiwan. 2. Department of Pediatrics, Mackay Children's Hospital, Mackay Medical College, Taipei, Taiwan. Electronic address: chi.4531@mmh.org.tw. 3. Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 4. Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. 5. Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. 6. Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan. 7. Division of Infectious Disease, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan. 8. Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan. 9. Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan. 10. Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Taipei City, Taiwan. 11. Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan. Electronic address: hsiung@nhri.edu.tw.
Abstract
BACKGROUND: Norovirus is a common acute gastroenteritis (AGE) pathogen across all age groups worldwide, which is difficult to differentiate from other pathogens. This study aimed to understand the clinical characteristics and risk factors of norovirus gastroenteritis among children in Taiwan. METHODS: A prospective AGE surveillance study was conducted in children aged ≤5 years who were hospitalized in 10 major hospitals in Taiwan between 2014 and 2017. The non-AGE control group included healthy children who were matched based on age, gender, season, and geographic area. RESULTS: Overall, 674 norovirus gastroenteritis patients were enrolled. Fever (p < 0.001), mucoid stool (p < 0.001), and bloody stool (p < 0.001) occurred less frequently among norovirus gastroenteritis patients. Norovirus gastroenteritis patients yielded lower CRP values on admission (21.78 ± 36.81 vs. 46.26 ± 58.12 mg/L, p < 0.001) than non-norovirus controls. Norovirus gastroenteritis patients were associated with higher direct contact rates with AGE patients within 1 week (30.5% vs. 0.97%, p < 0.001), lower hand wash rates before meals (21.6% vs. 15.4%, p = 0.001), lower human milk (15.8% vs. 19.8%, p = 0.045) and guava consumption rates (17.8% vs. 24.3%, p = 0.002) than non-AGE participants. CONCLUSIONS: Body temperature, stool characteristics, and CRP value can help distinguish the norovirus from other pathogens. The major risk factor of norovirus AGE is contact with AGE patient. Higher frequency of hand wash, human milk, and guava intake may be protective against norovirus gastroenteritis.
BACKGROUND: Norovirus is a common acute gastroenteritis (AGE) pathogen across all age groups worldwide, which is difficult to differentiate from other pathogens. This study aimed to understand the clinical characteristics and risk factors of norovirus gastroenteritis among children in Taiwan. METHODS: A prospective AGE surveillance study was conducted in children aged ≤5 years who were hospitalized in 10 major hospitals in Taiwan between 2014 and 2017. The non-AGE control group included healthy children who were matched based on age, gender, season, and geographic area. RESULTS: Overall, 674 norovirus gastroenteritis patients were enrolled. Fever (p < 0.001), mucoid stool (p < 0.001), and bloody stool (p < 0.001) occurred less frequently among norovirus gastroenteritis patients. Norovirus gastroenteritis patients yielded lower CRP values on admission (21.78 ± 36.81 vs. 46.26 ± 58.12 mg/L, p < 0.001) than non-norovirus controls. Norovirus gastroenteritis patients were associated with higher direct contact rates with AGE patients within 1 week (30.5% vs. 0.97%, p < 0.001), lower hand wash rates before meals (21.6% vs. 15.4%, p = 0.001), lower human milk (15.8% vs. 19.8%, p = 0.045) and guava consumption rates (17.8% vs. 24.3%, p = 0.002) than non-AGE participants. CONCLUSIONS: Body temperature, stool characteristics, and CRP value can help distinguish the norovirus from other pathogens. The major risk factor of norovirus AGE is contact with AGE patient. Higher frequency of hand wash, human milk, and guava intake may be protective against norovirus gastroenteritis.
Authors: Neha Balachandran; Jordan Cates; Anita K Kambhampati; Vincent C Marconi; Alexis Whitmire; Elena Morales; Sheldon T Brown; Diki Lama; Maria C Rodriguez-Barradas; Rosalba Gomez Moronez; Gilberto Rivera Domiguez; David O Beenhouwer; Aleksandra Poteshkina; Zlatko Anthony Matolek; Mark Holodniy; Cynthia Lucero-Obusan; Madhuri Agarwal; Cristina Cardemil; Umesh Parashar; Sara A Mirza Journal: Open Forum Infect Dis Date: 2022-07-25 Impact factor: 4.423
Authors: Lisa C Lindesmith; Paul D Brewer-Jensen; Michael L Mallory; Mark R Zweigart; Samantha R May; Daniel Kelly; Rachel Williams; Sylvia Becker-Dreps; Filemón Bucardo; David J Allen; Judith Breuer; Ralph S Baric Journal: Viruses Date: 2022-06-14 Impact factor: 5.818