Acute Gastroenteritis in Children Attending Day-Care Centres with Special Reference to Rotavirus Infections

Acute gastroenteritis (GE) among 214 children (aged 6 months – 7 years) attending day-care centres (DDCs) in the Copenhagen County was studied during a 12-month period. A total of 197 cases of GE was observed in 109 children (i.e. 51% of the participants). The aetiology was as follows: rotavirus ( n =48) (24%), pathogenic bacteria ( n =11) (6%), Giardia lamblia ( n =3) (2%), while the aetiology of 68% remains unknown. The pathogenic bacteria included Yersinia enterocolitica , thermophilic Campylobacter, Clostridium difficile (±toxin) and enteropathogenic E. coli. In 4% of the GE the infections were multiple and Cryptosporidium was seen in one of these cases. The rate of GE declined with age from 1.35 GE per child per year (age group 1.0– <2.0 years) to 0.36 (6.0 – <8.0 years). Serum sampled at the start of the study period showed that the frequency of detectable rotavirus IgG increased with age from 48% in the 6 months – <1.0 year group to 96% in the 4.0 – <7.0 year group. The highest rates of rotavirus GE occurred from January to April (i.e. the rotavirus season). Moreover, rotavirus GE was almost absent after the age of 4. Hence, the rates of rotavirus GE per rotavirus season per child were 0.80 (age group 6 months–<1.0 year), 0.32 (1.0–<2.0), 0.14 (2.0–<3.0), 0.16 (3.0–<4.0), 0.06 (4.0–<5.0) and 0.04 (5.0–<6.0). Only 2 out of the 48 rotavirus GE were reinfections. The 32 children with asymptomatic rotavirus infections and those with rotavirus GE showed a similar distribution of age and season. A cross-sectional study of the prevalence of rotavirus excretion during the rotavirus season revealed only a single true asymptomatic excretor.