MANIFESTATIONS AND COMPLICATIONS OF ROTAVIRUS-POSITIVE GASTROENTERITIS AND ROTAVIRUS-NEGATIVE GASTROENTERITIS IN PRESCHOOL CHILDREN

Abstract

Background. The cumulative annual statistics of rotavirus-associated gastroenteritis are about 25 million outpatient visits, 2 million hospitalizations, and 180,000–450,000 deaths in children under 5 years of age. Aim: To analyze the manifestations and complications of rotavirus compared with non-rotavirus gastroenteritis in UK children. Materials and methods. A retrospective hospital-based case-control study was conducted at three sites in East London, Great Britain. Cases were children aged 1 month to 16 years who were diagnosed with acute gastroenteritis between June 1, 2011, and December 31, 2013, and who were positive for rotavirus by PCR (polymerase chain reaction) on stool virology. They were compared by age, gender and month of referral to a control group with rotavirus-negative gastroenteritis. Results. Data were collected from 116 children (50 cases and 66 controls). Children with rotavirus gastroenteritis were more likely to have metabolic acidosis (pH 7.30 vs. 7.37) and fever (74% vs. 46%) and were more likely to require hospitalization compared with children with non-rotavirus gastroenteritis. (93% vs. 73%). Neurological complications were the most common extraintestinal manifestations, but did not differ significantly between children with rotavirus-positive gastroenteritis (RPG) and rotavirus-negative gastroenteritis (RNG) (24% vs. 15%, respectively). Encephalopathy occurred only in children with rotavirus infection. Conclusion. Therefore, rotavirus is an important cause of morbidity and mortality in preschool children. Seizures and milder neurologic signs were common and associated with multiple pathogens, but encephalopathy occurred only in children with rotavirus-positive gastroenteritis (RPG). Timely vaccination against rotavirus can prevent serious consequences.