Rotavirus Disease in Germany-A Prospective Survey of Very Severe Cases
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vor 11 Jahren
Objective: Rotavirus (RV) gastroenteritis is a notifiable disease
in Germany. The reports to the authorities contain few data
concerning the severity of disease. The aims of this study were to
determine incidence and outcome of very severe cases of RV disease.
Methods: Cases of very severe RV disease were collected by the
German Paediatric Surveillance Unit for rare diseases
(Erhebungseinheit fur seltene padiatrische Erkrankungen in
Deutschland) using anonymous questionnaires based on hospitalized
patients between April 2009 and March 2011. Inclusion criteria were
detection of RV antigen in feces, patient aged 0-16 years and 1 or
more of the following criteria: intensive care treatment,
hypernatremia or hyponatremia (> 155 mmol/ L or < 125 mmol/
L), clinical signs of encephalopathy (somnolence, seizures, apnea)
and RV-associated death. Results: During 2 years, 130 cases of very
severe RV disease were reported, 101 of 130 were verified.
Seventeen patients had nosocomial infection, of whom 14 were
neonates in intensive care. Among those, 12 infants had verified or
suspected necrotizing enterocolitis. Eighty-four community-acquired
cases were reported, median age was 10.5 months (0-108 months). The
median hospital stay was 6 days, and 48 patients needed intensive
care treatment. Among children less than 5 years of age, the yearly
incidence of community-acquired very severe RV disease was 1.2 of
100,000 (95% confidence interval: 0.9-1.4/100,000). A total of 26
of 84 and 10 of 84 patients had severe hypernatremia or
hyponatremia, respectively, and 58 of 84 patients had signs of
encephalopathy. Three deaths were reported (1 nosocomial and 2
community acquired). Conclusions: RV infection in Germany can have
a life-threatening course. A substantial number are nosocomial
infections.
in Germany. The reports to the authorities contain few data
concerning the severity of disease. The aims of this study were to
determine incidence and outcome of very severe cases of RV disease.
Methods: Cases of very severe RV disease were collected by the
German Paediatric Surveillance Unit for rare diseases
(Erhebungseinheit fur seltene padiatrische Erkrankungen in
Deutschland) using anonymous questionnaires based on hospitalized
patients between April 2009 and March 2011. Inclusion criteria were
detection of RV antigen in feces, patient aged 0-16 years and 1 or
more of the following criteria: intensive care treatment,
hypernatremia or hyponatremia (> 155 mmol/ L or < 125 mmol/
L), clinical signs of encephalopathy (somnolence, seizures, apnea)
and RV-associated death. Results: During 2 years, 130 cases of very
severe RV disease were reported, 101 of 130 were verified.
Seventeen patients had nosocomial infection, of whom 14 were
neonates in intensive care. Among those, 12 infants had verified or
suspected necrotizing enterocolitis. Eighty-four community-acquired
cases were reported, median age was 10.5 months (0-108 months). The
median hospital stay was 6 days, and 48 patients needed intensive
care treatment. Among children less than 5 years of age, the yearly
incidence of community-acquired very severe RV disease was 1.2 of
100,000 (95% confidence interval: 0.9-1.4/100,000). A total of 26
of 84 and 10 of 84 patients had severe hypernatremia or
hyponatremia, respectively, and 58 of 84 patients had signs of
encephalopathy. Three deaths were reported (1 nosocomial and 2
community acquired). Conclusions: RV infection in Germany can have
a life-threatening course. A substantial number are nosocomial
infections.
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