Rotavirus and illness severity in children presenting with acute gastroenteritis at the primary care out-of-hours service

Abstract

Background

Rotavirus is a common cause of acute gastroenteritis in young children in the Netherlands, where rotavirus vaccination has not yet been implemented.

Objectives

To evaluate a difference in illness severity course depending on the presence of rotavirus infection and assess the prevalence of viruses and the referral rate in children with acute gastroenteritis.

Methods

A prospective cohort of children aged 6 months to 6 years presenting with acute gastroenteritis to a primary care out-of-hours service from October 2016 to March 2018. Faeces were sampled and sent to a laboratory where viral pathogens were identified and quantified by real-time polymerase chain reaction. Severe course of acute gastroenteritis was defined as a Modified Vesikari Score of ≥11. In addition, we assessed referral rates. Chi-square tests were used to evaluate differences between groups.

Results

We included 75 children (34 boys) with a median age of 1.5 years (interquartile range, 0.9–2.0 years). The prevalence of rotavirus was 65.3% (95% confidence interval, 53.5–76.0) with a median cycle threshold of 16.0. Severe course of acute gastroenteritis was present in 31 of 71 children (4 were lost to follow-up). Those with rotavirus (20/47) did not have a severe course more often than those without (11/24): odds ratio, 0.88 (95% confidence interval, 0.33–2.36). Referral rates were comparable for rotavirus (15.2%) and non-rotavirus (14.3%).

Conclusion

In out-of-hours primary care, rotavirus is common but not associated with increased severity and higher referral rates in children with acute gastroenteritis.

Keywords:

• After-hours care
• faeces/virology
• gastroenteritis/virology
• paediatrics
• primary care

Acknowledgement

We thank Dr Robert Sykes (www.doctored.org.uk) for providing editorial services.

Disclosure statement

The authors alone are responsible for the content and writing of the paper.

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Additional information

Funding

This work was supported by The Netherlands Organisation for Health Research and Development (ZonMW) under Grant 836031001 and The Department of General Practice and Elderly Medicine Care. The funder had no role in data collection, analysis, decision to publish or preparation of the manuscript.