Abstract

Background

Infections by previously underdiagnosed viruses astrovirus and sapovirus are poorly characterized compared with norovirus, the most common cause of acute gastroenteritis.

Methods

Children <18 years old with acute gastroenteritis were recruited from pediatric emergency departments in Alberta, Canada between 2014 and 2018. We described and compared the clinical course of acute gastroenteritis in children with astrovirus, sapovirus, and norovirus.

Results

Astrovirus was detected in 56 of 2688 (2.1%) children, sapovirus was detected in 146 of 2688 (5.4%) children, and norovirus was detected in 486 of 2688 (18.1%) children. At illness onset, ~60% of astrovirus cases experienced both diarrhea and vomiting. Among sapovirus and norovirus cases, 35% experienced diarrhea at onset and 80% of 91% (sapovirus/norovirus) vomited; however, diarrhea became more prevalent than vomiting at approximately day 4 of illness. Over the full course of illness, diarrhea was 18% (95% confidence interval [CI], 8%– 29%) more prevalent among children with astrovirus than norovirus infections and had longer duration with greater maximal events; there were a median of 4.0 fewer maximal vomiting events (95% CI, 2.0–5.0). Vomiting continued for a median of 24.8 hours longer (95% CI, 9.6–31.7) among children with sapovirus versus norovirus. Differences between these viruses were otherwise minimal.

Conclusions

Sapovirus infections attended in the emergency department are more similar to norovirus than previously reported, whereas astrovirus infections have several distinguishable characteristics.

中文翻译：

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2014-2018 年艾伯塔省儿​​科急诊科儿童星状病毒、札幌病毒和诺如病毒相关急性胃肠炎的临床概况

摘要

背景

与诺如病毒（急性胃肠炎的最常见原因）相比，以前未被充分诊断的病毒（星状病毒和札幌病毒）感染的特征较差。

方法

2014 年至 2018 年期间，从加拿大艾伯塔省的儿科急诊科招募了 <18 岁的急性胃肠炎儿童。我们描述并比较了星状病毒、札幌病毒和诺如病毒患儿急性胃肠炎的临床过程。

结果

在 2688 名儿童中的 56 名 (2.1%) 中检测到星状病毒，在 2688 名儿童中的 146 名 (5.4%) 中检测到札幌病毒，在 2688 名儿童中的 486 名 (18.1%) 中检测到诺如病毒。在发病时，约 60% 的星状病毒病例同时出现腹泻和呕吐。在札幌病毒和诺如病毒病例中，35% 在发病时出现腹泻，91%（札幌病毒/诺如病毒）中的 80% 出现呕吐；然而，大约在患病第 4 天，腹泻比呕吐更普遍。在整个病程中，星状病毒感染患儿的腹泻发生率比诺如病毒感染患儿高 18%（95% 置信区间 [CI]，8%– 29%），并且持续时间更长，最大事件也更多；最大呕吐事件的中位数减少了 4.0 (95% CI, 2.0–5.0)。呕吐持续时间中位数延长了 24.8 小时（95% CI，9.6–31. 7) 在感染札幌病毒和诺如病毒的儿童中。这些病毒之间的差异很小。

结论

在急诊科就诊的札幌病毒感染与诺瓦克病毒比之前报道的更相似，而星状病毒感染有几个明显的特征。