The burden of rotavirus gastroenteritis and hospital-acquired rotavirus gastroenteritis among children aged less than 6 years in Japan: A retrospective, multicenter epidemiological survey

BMC Pediatrics (Impact Factor: 1.93). 05/2013; 13(1):83. DOI: 10.1186/1471-2431-13-83
Source: PubMed


BACKGROUND: Rotavirus is a leading worldwide cause of acute gastroenteritis in young children. This retrospective hospital-based study assessed the burden of rotavirus gastroenteritis in children younger than 6 years in Japan. METHODS: Children admitted to eight hospitals for acute gastroenteritis between 2008 and 2009 were identified from hospital admission databases. Diagnosis of acute gastroenteritis/rotavirus gastroenteritis and hospital-acquired rotavirus gastroenteritis was confirmed based on either the International Classification of Diseases and Related Health Problems 10th revision (ICD10) codes (intestinal infectious diseases [AA00-AA09] and rotavirus gastroenteritis [A08.0]) or from rapid rotavirus diagnostic test results. RESULTS: Of 13,767 hospitalized children, 11.9% (1,644), 4.8% (665) and 0.6% (81) were diagnosed with acute gastroenteritis, rotavirus gastroenteritis and hospital-acquired rotavirus gastroenteritis, respectively. Among acute gastroenteritis hospitalizations, 40.5% (665/1,644; ICD10 and rapid test) and 57.7% (645/1,118; rapid test only) were confirmed as rotavirus positive. Of 1,563 children with community-acquired acute gastroenteritis, 584 (37.4%) cases were confirmed as rotavirus positive. The median durations of hospitalization for all and community-acquired rotavirus gastroenteritis were 5.0 days (range:2.0-133.0 days) and 5.0 days (range:2.0-34.0 days), respectively. Among rotavirus gastroenteritis hospitalizations, 12.2% (81/665) of cases were hospital-acquired and the median duration of hospitalization was 10.0 days (range:2.0-133.0 days). The median duration of additional hospitalization due to hospital-acquired rotavirus gastroenteritis was 3.0 days (range:0--14 days). The overall incidence rate of hospital-acquired rotavirus gastroenteritis was 1.0 per 1,000 children hospital-days. The number of rotavirus gastroenteritis cases peaked between February and May in both 2008 and 2009, and the highest number of cases was reported in March 2008 (21.8%; 145/665). The highest number of rotavirus gastroenteritis hospitalizations (24.1%; 160/665) was observed in children aged 12--18 months. The proportion of hospital-acquired rotavirus gastroenteritis was higher in children aged below 18 months as compared to children at least 18 months of age (0.94[95%CI:0.71-1.21]vs.0.39[95%CI:0.25-0.58]) and for children hospitalized for at least 5 days compared to those hospitalized for less than 5 days (0.91[95%CI:0.72-1.14]vs.0.15[95%CI:0.05-0.32]). CONCLUSIONS: Both community- and hospital-acquired rotavirus gastroenteritis are significant public health problems in Japan. Data from this study justify the need for the introduction and implementation of rotavirus vaccination in the Japanese national immunization program.Trial registration:, NCT01202201.

Download full-text


Available from: Mats Rosenlund,
  • [Show abstract] [Hide abstract]
    ABSTRACT: We report a 35 month-old boy with acute renal failure caused by an obstructive ureteral stone associated with norovirus gastroenteritis. He visited his family physician because of fever, abdominal pain and vomiting. He was diagnosed as acute gastroenteritis. The symptoms relieved once, but abdominal pain and vomiting recurred two days after the visit and the volume of urine decreased. He was diagnosed as norovirus gastoenteritis and acute renal failure which was unresponsive to fluid replacement. Ultrasound study of the abdomen showed a solitary kidney with mild hydronephrosis. He was then admitted to our hospital. He was finally diagnosed as acute postrenal failure due to obstructive ureteral stone with left solitary kidney by abdominal computer tomography (CT). We performed transurethral catheterization immediately. The creatinine and blood urea nitrogen returned to normal level in 2 days. The CT performed on the 28th day post operation showed disappearance of the stone after uric alkalization. Recently, some cases of postrenal failure due to bilateral obstructive ureteral stones, mainly ammonium acid urate stones, associated with viral gastroenteritis were reported. As clinical features, they are common in boys three years or younger after an episode of rotavirus gastroenteritis with high uric acid concentration. By far, the most common cause of acute renal failure in patients with severe gastroenteritis is prerenal failure resulting from hypovolemia. But postrenal cause due to bilateral obstructive stones should be taken in a consideration.
    Nippon Hinyōkika Gakkai zasshi. The japanese journal of urology 10/2014; 105(4):224-8. DOI:10.5980/jpnjurol.105.224
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Aim: Rotavirus infection is a serious gastrointestinal infection that is usually prevalent during winter months and often seen in infants and young children. Studies on genotypes of prevalent rotavirus strains are important for preventing infection, developing vaccines, and its evaluation. The purpose of this study was to make an investigation of a rotavirus infection in the Nasu Region of Tochigi, Japan and to compare findings to those of other regions. Materials and methods: We examined the clinical findings in 147 patients who attended the Department of Pediatrics at International University of Health and Welfare Hospital in the Nasu-shiobara City, Tochigi Prefecture, Japan during April 1, 2008 to March 31, 2010. Results: We analyzed the clinical findings of 37 patients with a fecal sample positive for rotavirus antigen. Furthermore, viral genotypes were determined using rotavirus-positive samples from 27 of these 37 patients. The genotypes were determined as G1P [8] in 5 samples, G3P [8] in 5 samples, G9P [8] in 3 samples, and G6P [9] in 2 samples. We were able to analyze the phylogenetic trees of these genotypes. Conclusion: Of particular note, we detected G6P [9] which were extremely rare in humans but common in cattle. Studies on changes in prevalent strains after vaccine introduction need to be conducted.
    In vivo (Athens, Greece) 11/2014; 28(6):1141-1147. · 0.97 Impact Factor