Clinical features of rotavirus gastroenteritis

Five hundred and eighteen children under the age of five years admitted to hospital with a diagnosis of gastroenteritis over a twelve-month period were studied prospectively. Rotaviruses were demonstrated by stool electron microscopy (EM) in 132 of these cases (25·4 per cent), but in none of io8 age- and sex-matched controls. Non-specific cases, where no potentially pathogenic organism could be demonstrated in stools submitted for EM, viral and bacterial culture accounted for 46 per cent of cases. If EM of the stools had not been performed the proportion of non-specific cases would have risen to 85 per cent, thus demonstrating the importance of this technique in diagnosis. Rotaviruses were most commonly found in winter and between the ages of six and eighteen months. A history of contact with an adult with diarrheoa, vomiting occuring before diarrhoea, accompanying upper respiratory tract infection (URTI), otitis media and pyrexia and the need for administration of intravenous fluids were all significantly more prominent features of the rotavirus than the non-specific cases of gastroenteritis, and are suggested as pointers to such a diagnosis. Pneumonia is described in three patients as an accompanying illness with rotavirus gastroenteritis.