The Journal of Pediatrics
Volume 154, Issue 2 , Pages 253-257, February 2009

Prospective Study of Etiologic Agents of Acute Gastroenteritis Outbreaks in Child Care Centers

  • Whitney H. Lyman, DVM

      Affiliations

    • Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC
    • ,
  • Joan F. Walsh, PhD

      Affiliations

    • Department of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill, NC
    • ,
  • Jonathan B. Kotch, MD

      Affiliations

    • Department of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill, NC
    • ,
  • David J. Weber, MD

      Affiliations

    • Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC
    • ,
  • Elizabeth Gunn, BS

      Affiliations

    • Department of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill, NC
    • ,
  • Jan Vinjé, PhD

      Affiliations

    • Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC
    • Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA
    • Corresponding Author InformationReprint requests: Jan Vinjé, PhD, Division of Viral Diseases, Centers for Disease Control and Prevention, Mailstop G-04, Atlanta, GA 30333

Received 30 January 2008; received in revised form 11 June 2008; accepted 30 July 2008. published online 11 September 2008.

Objective

To investigate the etiology of outbreaks of acute gastroenteritis (AGE) in children attending childcare centers (CCCs) in North Carolina between October 2005 and March 2007.

Study design

In this prospective study of outbreaks of AGE in CCCs, stool specimens from symptomatic children and environmental surface swabs were tested for adenovirus group F, astrovirus, norovirus (NoV), rotavirus group A, and sapovirus using real-time and conventional reverse transcription-polymerase chain reaction assays, and viruses were genotyped by sequencing.

Results

A total of 29 AGE outbreaks were evaluated, of which 13 (45%) were caused by a single virus, including rotavirus group A (17%), NoV (10%), astrovirus (10%), and sapovirus (7%). Multiple viruses were detected in 3 outbreaks (10%). Environmental swabs from 13 of 22 outbreaks (59%) tested positive for at least 1 virus and confirmed the findings of the same virus in the fecal specimens for 10 of the outbreaks (45%).

Conclusions

This study confirms that viruses are major causes of AGE outbreak in CCCs. Our finding of widespread environmental contamination during such outbreaks suggests the need to study the effectiveness of current surface disinfectants against multiple gastroenteritis viruses in CCCs.

Abbreviations: AGE, Acute gastroenteritis, CCC, Childcare center, NoV, Norovirus

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 30.00 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

 Supported by the Thrasher Research Fund (grant 02821-5). The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the funding agency or the Centers for Disease Control and Prevention. The authors declare no conflicts of interest, real or perceived.

PII: S0022-3476(08)00674-4

doi:10.1016/j.jpeds.2008.07.057

The Journal of Pediatrics
Volume 154, Issue 2 , Pages 253-257, February 2009

Article Tools