Occurrence and impact of community-acquired and nosocomial rotavirus infections - a hospital-based study over 10 y

The need for a rotavirus vaccine in any particular country depends primaril y on the number of hospitalized cases. Since only limited data are availabl e for Germany, we undertook a retrospective hospital-based analysis in orde r to gather further information. From 1987 through 1996, a total of 3618 in patients were hospitalized with a diagnosis of gastroenteritis (ICD 9). In 892 (25%) of them the causative organism was a rotavirus. During the same p eriod, 1886 tout of 8383; 22%) stool specimens tested in the hospital labor atory were obtained from rotavirus-positive inpatients. In 49.2% the infect ion was community-acquired, and in the remainder of nosocomial origin. Infa nts under 4 months of age (n = 709; 38%) predominated among both the nosoco mial and community acquired infections. Premature neonates made up 26% of t he nosocomial, but only 2% of the community-acquired cases of diarrhoea. Th e winter peak (January) was most pronounced in the age group 4-12 months, b ut in those more than ly old the peak came a month later. The median hospit alization time for community-acquired cases was 4 d (mean 5.9 d). The morta lity was 0.1%. Rotavirus infection must therefore be regarded as a consider able burden, particularly with regard to infants and young children. Furthe rmore, the morbidity due to nosocomial infection with the rotavirus, analys ed here in a long-term observational study, is unexpectedly high.