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SUMMARYRotavirus is the most common cause of gastroenteritis in children aged

SUMMARYThe aim of this study was to investigate the burden of disease associated with gastroenteric viruses (rotavirus, norovirus, sapovirus, astrovirus and enteric adenovirus) using structured surveillance of children aged

Of a total of 508 stool specimens from children with acute diarrhoea, mostly under the age of 5 years, collected in nine cities in the western and southeastern regions of Turkey between May 2000 and October 2002, 119 (23.4%) were found positive for rotaviruses (RV) by ELISA. Positive samples were characterized by electropherotyping and G and P genotyping. A subset of G and P types were confirmed by nucleic acid sequencing. The most prevalent types found in this collection included G4P[8], accounting for 27/64 (42.2%) of the fully characterized strains. G1P[8], G2P[4] and G3P[8] were found in 17 (26.6%), 2 (3.1%) and one (1.5%) samples respectively. Less common strains such as G9P[8] were found in two (3.2%) samples and G2P[8], G1P[6], G2P[6] and G4P[6], possible reassortant viruses, were found in five (7.8%), 2 (3.1%), one (1.5%) and four (6.3%) samples respectively. Mixed infections were found in six (7.3%) samples and were associated with combinations of G1 + G2, G1 + G4, G1 + G9 and G4 + G9 strains. This is the first molecular epidemiology study of its kind to be carried out in Turkey and suggests a significant diversity of co-circulating rotavirus strains.

An outbreak of acute gastroenteritis of suspected viral aetiology occurred in April 2003 in the British Royal Fleet Auxillary ship (RFA) Argus deployed in the Northern Arabian Gulf. There were 37 cases amongst a crew of 400 personnel. Of 13 samples examined from cases amongst the crew, six enteric viruses were detected by reverse transcriptase polymerase chain reaction (RT–PCR). Five different viruses were identified including, three norovirus genotypes, a sapovirus and a rotavirus. No multiple infections were detected. A common food source was implicated in the outbreak and epidemiological analysis showed a statistically significant association with salad as the source of the outbreak, with a relative risk of 3·41 (95% confidence interval of 1·7–6·81) of eating salad on a particular date prior to the onset of symptoms. Faecal contamination of the salad at source was the most probable explanation for the diversity of viruses detected and characterized.

SUMMARYRotavirus (RV) infections progressively confer natural immunity against subsequent infection. Similarly to natural infection, vaccination with a live attenuated vaccine potentially reduces RV transmission and induces herd protection. A mathematical transmission model was developed to project the impact of a vaccination programme on the incidence of RV infection and disease for five countries in the European Union. With vaccination coverage rates of 70%, 90% and 95% the model predicted that, in addition to the direct effect of vaccination, herd protection induced a reduction in RV-related gastroenteritis (GE) incidence of 25%, 22% and 20%, respectively, for RV-GE of any severity, and of 19%, 15%, and 13%, respectively, for moderate-to-severe RV-GE, 5 years after implementation of a vaccination programme.

SUMMARYThe incidence and causes of infectious intestinal disease (IID) in children aged P

SUMMARYAsymptomatic enteric infections are important where sequelae or protection from subsequent illness is an outcome measure. The use of reverse transcription–polymerase chain reaction (RT–PCR) to identify asymptomatic enteric infections in a birth cohort followed for rotaviral infections in a south Indian urban slum is reported. Of 1191 non-diarrhoeal samples from 371 children collected in May–June 2003, 22 (1·9%) were positive by ELISA. A total of 147 (40·6%) of 362 samples tested by VP6 RT–PCR were positive. In those samples that could be typed, a high diversity of G types including G1, G2, G4, G8, G9 and G10, and a high proportion (34·4%) of mixed infections were detected. Noroviruses were identified in 6/28 (21·4%) samples tested. The identification of infections undetectable by conventional techniques indicates the importance of the use of sensitive diagnostic techniques in research studies. Asymptomatically infected children may also act as a source of infection for other susceptible hosts.

SUMMARYRotavirus infections are the main cause of gastroenteritis in infants and children and it is expected that by the age of 5 years, nearly every child will have experienced at least one episode of rotavirus gastroenteritis. While severe cases are hospitalized, milder disease is either treated at home or by the GP, and as such the true prevalence of rotavirus infection in the community, and the burden of disease, is unknown. This paper reports the results of a cost-of-illness study which was conducted alongside a structured community surveillance study. Forty-eight percent of our sample was found to have rotavirus acute gastroenteritis; and the average total cost of a child presenting with rotavirus gastroenteritis ranged between £59 and £143 per episode, depending on the perspective. Given the prevalence and severity of the disease, the estimated burden of rotavirus gastroenteritis to society is £11.5 million per year.