Published online October 31, 2008
PEDIATRICS Vol. 122 No. 5 November 2008, pp. 971-977 (doi:10.1542/peds.2007-1609)
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Rotavirus Infections
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ARTICLE

Burden of Rotavirus Disease Among Children Visiting Pediatric Emergency Departments in Cincinnati, Ohio, and Oakland, California, in 1999–2000

Eileen L. Yee, MDa,b, Mary Allen Staat, MD, MPHc, Parvin Azimi, MDd, David I. Bernstein, MD, MAc, Richard L. Ward, PhDc, Charles Schubert, MDe, David O. Matson, MD, PhDf, Reina M. Turcios-Ruiz, MDb, Umesh Parashar, MD, MPHb, Marc-Alain Widdowson, VetMB, MScb and Roger I. Glass, MD, PhDb

a Epidemic Intelligence Service Program, Office of Workforce and Career Development
b Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
c Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
d Department of Pediatrics, Children's Hospital and Research Center Oakland, Oakland, California
e Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
f Department of Pediatrics, Center for Pediatric Research, Norfolk, Virginia

OBJECTIVE. We assessed the incidence of rotavirus disease requiring an emergency department visit among children <5 years of age.

METHODS. We conducted active surveillance for acute gastroenteritis in pediatric emergency departments in Cincinnati, Ohio, and Oakland, California, from March 1999 to May 2000, among children 2 weeks to 59 months of age with acute diarrhea and/or vomiting. We obtained clinical and demographic information from participants and tested their stool specimens for rotavirus.

RESULTS. Approximately 9% of all emergency department visits at the study sites were attributable to acute gastroenteritis. A total of 1433 children were eligible at the 2 sites; 85% were enrolled and 68% provided a stool specimen. Overall, rotavirus was detected in specimens from 27% of children (30% in Cincinnati and 24% in Oakland). Rotavirus detection was higher in bulk stools, compared with rectal swabs, at both Cincinnati (37% vs 23%) and Oakland (46% vs 18%). Patients with rotavirus had more-severe disease than did those with nonrotavirus gastroenteritis. We estimated that the mean annual incidence of emergency department visits attributable to rotavirus was 12 cases per 1000 children in Cincinnati and 15 cases per 1000 children in Oakland. Through extrapolation, we estimated that rotavirus infection causes ~260 910 emergency department visits per year among US children.

CONCLUSION. Active surveillance demonstrated that the burden of laboratory-confirmed rotavirus disease treated in emergency department settings among US children is substantial and greater than estimated previously.

Key Words: rotavirus • epidemiology • incidence • emergency department • gastroenteritis

Abbreviations: ED—emergency department

Accepted Jan 24, 2008.


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