1112. Detection of Enteric Viruses in Children with Acute Gastroenteritis
Session: Poster Abstract Session: Enteric Infections
Friday, October 5, 2018
Room: S Poster Hall
Posters
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  • Background:

    Acute gastroenteritis (AGE) is a major cause of morbidity in children. Viral pathogens are the most common infectious agents. Differences in illness characteristics of AGE with and without virus detection are poorly defined. We compared AGE illness characteristics between children with and without any-virus detected, and with single vs. multiple viruses detected.

    Methods:

    Children between 15 days and 17 years with AGE defined as diarrhea (>3 loose stools/ 24 hrs) or any vomiting within 10 days duration were enrolled in Vanderbilt Children’s Hospital inpatient, ED, and outpatient settings from 12/2012 to 11/2015. Stool specimens were tested by RT-qPCR for norovirus, sapovirus, and astrovirus and by ELISA (VP6 antigen [Rotaclone®]) for rotavirus.

    Results:
    Of 3705 children enrolled, 2892 (78%) specimens were collected. A single virus was detected in 1109 (38%) stools [51% norovirus, 20% rotavirus, 21% sapovirus, and 8% astrovirus], viral co-detections were found in 115 (4%) stools, and 1665 (58%) had no detected viruses.
    Table 1 compares children with and without any-virus detected. Children with a single-virus detected were older than those with >1 virus detected (1.8 vs. 1.5 years [p<0.05]) with no other significant differences.

    Table 1

    No-Virus Detected
    (n=1665)

    Any-Virus Detected
    (n=1224)

    P-value

    Age (Years)

    2.0 (0.79-5.65)†

    1.8 (0.96-4.00)†

    0.21

    Diarrhea

    1102 (66.2%)

    891 (72.8%)

    <0.01

    Max no. of diarrheal stools/24 hr

    5 (3-7)†

    5 (3-7)†

    0.30

    Vomiting

    1298 (78.1%)

    1101 (89.9%)

    <0.01

    Max no. vomiting episodes/ 24hr

    3 (2-5)

    4 (3-7)

    <0.01

    Fever

    1112 (66.8%)

    690 (56.4%)

    <0.01

    Max temperature

    102 (101-103)

    101 (100-103)

    <0.01

    Sick contact

    447 (26.9%)

    429 (35.1%)

    <0.01

    Modified Vesikari Score (MVS)

    6 (4-8)

    7 (5-9)

    <0.01

    Days of Illness

    2 (2-4)

    2 (1-4)

    0.01

    Data are in n(%)
    † Median (IQR).
    *Pearson’s χ2/Wilcoxon rank-sum tests.

    Conclusion:

    Children with any-virus detected had more severe symptoms, higher MVS, and more frequently reported sick contacts compared to no-virus detected. Children with no-virus detected were more likely to present with fever and higher temperatures, which may be due to bacterial organisms. These data highlight the importance of infection-prevention precautions in the community and the need for additional testing to define the etiologic spectrum of AGE in children.

    Lubna Hamdan, MD1, Einas Batarseh, MD1, Bhinnata Piya, MPH1, Laura Stewart, PhD1, Chris Fonnesbeck, PhD2, James D. Chappell, MD, PhD1, Daniel C. Payne, PhD, MSPH3, Aron J. Hall, DVM, MSPH4, John Dunn, DVM, PhD5, Mary E. Wikswo, MPH3 and Natasha Halasa, MD, MPH1, (1)Vanderbilt University Medical Center, Nashville, TN, (2)Biostatistics, Vanderbilt University, Nashville, TN, (3)Centers for Disease Control and Prevention, Atlanta, GA, (4)Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, (5)Division of Communicable and Environmental Diseases and Emergency Preparedness, Tennessee Department of Health, Nashville, TN

    Disclosures:

    L. Hamdan, None

    E. Batarseh, None

    B. Piya, None

    L. Stewart, None

    C. Fonnesbeck, None

    J. D. Chappell, None

    D. C. Payne, None

    A. J. Hall, None

    J. Dunn, None

    M. E. Wikswo, None

    N. Halasa, Sanofi Pasteur: Investigator , Research support . GSK: Consultant , Consulting fee . Moderna: Consultant , Consulting fee .

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