ETIOLOGY OF ACUTE GASTROENTERITIS IN HOSPITALIZED CHILDREN IN MELBOURNE, AUSTRALIA, FROM APRIL 1980 TO MARCH 1993

Acute infectious diarrhea is common in children, Control requires know ledge of causes, Few comprehensive long-term studies of etiology have been undertaken in developed countries, This report is of a 13-year su rvey of 4,637 children from 0 to 14 years of age, admitted to a large children's hospital for treatment of gastroenteritis, in which viruses , bacteria, and parasites were sought, A recognized enteric pathogen w as identified in 56.6% of children, Group A rotaviruses occurred in 39 .6% of children overall and in 55% of children 12 to 23 months of age, They were a frequent cause (18.7%) of acute gastroenteritis in childr en under 6 months and in those aged 5 to 13 years (16%). Rotaviruses w ere almost entirely responsible for winter admission peaks, Enteric ad enovirus types 40 and 41 (6% overall),were more frequent in children u nder 12 months (9.4%), Salmonella spp, (5.8%) and Campylobacter jejuni (3.4%) were more common in children over 5 years (13.1% and 6.7%, res pectively), The 43.5% of cases (60% in children under 6 months) where no enteric pathogen was identified are cause for concern. The involvem ent of small viruses (including caliciviruses and astroviruses) may be clarified when molecular biology techniques are utilized to address t his gap in our knowledge, This comprehensive 13-year study of the caus e of acute infectious diarrhea in children in developed countries rein forces the importance of rotavirus and highlights a large group for wh om the etiology remains unknown, an issue of particular concern,vith b abies under 6 months of age. New techniques have the potential to iden tify old and new pathogens causing disease in these vulnerable infants .