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The aim of this study was to investigate the burden of disease associated with gastroenteric viruses (rotavirus, norovirus, sapovirus, astrovirus and enteric adenovirus) using structured surveillance of children aged <6 years in the community. Faecal samples were collected between 2000 and 2003 from 685 children with symptoms of gastroenteritis. The children comprised three groups; 223 in the structured surveillance cohort, 203 in a community cohort and 259 in a cohort of hospitalized children. All samples were tested for the presence of viral pathogens using molecular methods. Questionnaires were sent to the parents/carers of the children recruited to the structured surveillance cohort in order to collect data that would allow an estimation of the severity of illness by means of the Vesikari score, and of the cost associated with gastrointestinal disease in this age group. A viral aetiological agent was detected in 53.5% of samples tested. Rotavirus was the most common pathogen found in all three cohorts followed by norovirus and enteric adenoviruses. Multiple viruses were found in 8% of the samples, and commonly involved rotavirus and any other virus. G1P[8] was the most commonly detected rotavirus strain and there was no significant difference in the distribution of rotavirus genotypes among the three cohorts. Analysis of the questionnaires indicated that rotavirus infections were likely to be more severe than any other virus infection, and children from whom a viral pathogen was identified were more likely to require rehydration therapy. [ABSTRACT FROM AUTHOR]

Rotavirus is the most common cause of gastroenteritis in children aged <5 years old, two new vaccines have recently been developed which can prevent associated morbidity and mortality. While apparently safe and efficacious, it is also important to establish whether rotavirus immunization is cost effective. A decision analytical model which employs data from a review of published evidence is used to determine the cost effectiveness of a rotavirus vaccine. The results suggest that some of the health sector costs, and all of the societal costs, of rotavirus gastroenteritis in children can be avoided by an immunization programme. The additional cost to the health sector may be considered worthwhile if there is a sufficient improvement in the quality-of-life of children and parents affected by gastroenteritis; this study did not find any evidence of research which has measured the utility gains from vaccination. [ABSTRACT FROM AUTHOR]

Rotavirus strains collected in the United Kingdom during the 1995-1996 season and genotyped as G2 by reverse transcription-PCR failed to serotype in enzyme-linked immunosorbent assays using three different G2-specific monoclonal antibodies. The deduced amino acid sequences of the antigenic regions A (amino acids 87 to 101), B (amino acids 142 to 152), and C (amino acids 208 to 221) of VP7 revealed that a substitution at position 96 (Asp-->Asn) correlated with the change in ability to serotype these G2 strains.

The clinical symptoms associated with rotavirus (RV) gastroenteritis are not sufficiently characteristic to distinguish between RV infection and other causes of gastroenteritis. Therefore, laboratory procedures, including electron microscopy (EM) (1), enzyme-linked immunosorbent assays (ELISA) (2), passive particle agglutination tests (PPAT) (3,4), polyacrylamide gel electrophoresis (PAGE) (5), or reverse transcription-polymerase chain reaction (RT-PCR) (6-8), are necessary to confirm a clinical diagnosis of RV gastroenteritis. Virus-shedding in the feces of RV-infected individuals, with up to 10(11) virus particles/mL feces at the peak of diarrhea, coincides with the duration of the diarrhea. However, virus-shedding can continue once symptoms have ceased (9). Laboratory diagnosis is relatively easy, either through the visualization of virus particles by EM, the detection of virus antigen (Ag) by ELISA or PPAT, or the detection of the virus genome by PAGE or RT-PCR.