Astrovirus and adenovirus in children with diarrhea

Astrovirus and adenovirus in children with diarrhea – Tips from Other Journals

Children who attend day care centers are at increased risk of contracting diarrhea. Adenoviruses and astroviruses are believed to be likely etiologic agents, although etiologies of diarrhea can be identified in less than half of all episodes. Lew and colleagues conducted a prospective study to determine the relative importance of astroviruses and adenoviruses as etiologic agents of diarrhea in children cared for in day care settings.

The study included children who were cared for in day care centers, day care homes or their own homes. Year-round surveillance was conducted to collect stool specimens from children with diarrhea. Diarrhea was defined as unusually loose stools or frequent stools. A control group consisted of asymptomatic children who were cared for in the same day care setting where an outbreak of diarrhea was occurring. The specimens were initially tested for Campylobacter, shigella, Salmonella and Giardia.

Stool specimens were screened for adenovirus and astrovirus with two new indirect double-antibody assays and for enteric adenoviruses with an exzyme immunoassay specific for serotype 40 and 41. Of 662 stool specimens that were screened, 3 percent were positive for astrovirus and 8 percent were positive for adenovirus. Thirty percent of adenovirus-positive specimens with sufficient volume for serotyping were enteric types 40 or 41. Astrovirus infection was significantly more common in children with diarrhea (4 percent) than in children with the control group (less than 1 percent). Detection of adenoviruses, however, was the same in children with diarhea and in the control subjects. Astrovirus infection was significantly more common in children under 18 months of age.

Diarrhea associated with astrovirus and enteric adenovirus infection was clinically similar, while diarrhea associated with rotavirus infection was more severe for all five sumptoms evaluated (fever, vomiting, anorexia, abdominal pain and respiratory symptoms). Astrovirus infections were more common in children with diarrhea who were cared for in day care homes and in their own home than in children with diarrhea who attended day care centers.

The authors conclude that viral agents appear to be the most common pathogens identified in children with diarrhea who are cared for in day care settings. The incidence of astrovirus-assciated diarrhea was comparable to that of other enteric viruses detected, including rotavirus. Even with improved testing methods, the pathogens of nearly two-thirds of diarrheal episodes were not identified. (Journal of Infectious Diseases, October 1991, vol. 164, p. 673.)

COPYRIGHT 1992 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group