Prospective Study of Etiologic Agents of Acute Gastroenteritis Outbreaks in Child Care Centers
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.
aDepartment of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC
bDepartment of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill, NC
cDivision of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC
dDivision of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA
Reprint requests: Jan Vinjé, PhD, Division of Viral Diseases, Centers for Disease Control and Prevention, Mailstop G-04, Atlanta, GA 30333
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.
ABSTRACT