The prevalence of norovirus infection in 0-5 years old children with acute gastroenteritis

Norovirus causes severe gastroenteritis especially in children under five years old requiring hospitalization. We aimed to investigate the prevalence of norovirus in 0-5 years old children with acute gastroenteritis in two large hospitals in Ankara.Stool samples were obtained from 1,000 children of 0-5 years old with acute gastroenteritis attended between October 2004-June 2011 to the Department of Paediatrics, Ministry of Health Ankara Training and Education Hospital and Hospital of Gazi University Faculty of Medicine. Antigens of norovirus GI and GII in stool specimens were detected by ELISA (RIDASCREEN® Norovirus (C1401) 3rd Generation, r-biopharm, Darmstadt, Germany).Norovirus GI and GII antigens were determined in 141 (14.1 %) samples. Statistically significant difference was not found between the diversity of ELISA positivity and age (p>0.05). In spring, summer, autumn and winter the prevalence of norovirus infection was 13.8%, 17.7%, 14.7 % and 11.2%, respectively; seasonal variation was not found in the prevalence of norovirus infection. However analysis of the monthly prevalence, statistically significant difference was found (p<0.05) between the prevalence of norovirus infection in July (24.2%) and November (4.1%). Fifty one percent of patients infected with norovirus had vomiting but this was not statistically significant (p>0.05) when compared with patients without norovirus infection. Parasites were detected in 3.3% of patients with norovirus infection. No diarrhoeagenic bacteria were found in norovirus infected samples.Norovirus was detected in 14% of samples with diarrhea, which is significantly high in Turkey. We consider that the prevalence of norovirus will increase in 0-5 years old children as a result of increasing use of rotavirus vaccine in Turkey. We consider that the need for norovirus diagnosis in routine laboratory will be increasing. Consequently, routine diagnosis of norovirus might be cost-effective by preventing redundant antibiotic consumption in patients with acute gastroenteritis related to norovirus infection.