The CNS symptoms of Rotavirus infections under the age of two

Background Since isolation of the Rotavirus (RV), there is rapidly growing concern about the possible involvement of RV in Central Nervous System (CNS ) disorders, especially in Japan. We looked for symptomatic CNS involvement in a large series of RV infections and it's possible risk factors in a Eur opean setting. Methods Two-year retrospective survey based at the University Children's Ho spital of Freiburg, Germany, a secondary and tertiary care centre with a ur ban and rural catchment area of 400 000 people. First, the case records of all 366 inpatients aged under two years excreting RV were searched for sign s and symptoms of CNS involvement. Second, records of all 32 patients hospi talised with meningitis/encephalitis during the study period were checked f or evidence of RV infection. Results In 15 of 366 children signs of CNS involvement (seizures, meningeal and encephalitic signs) were found. They were older (p=0.023), had higher temperatures (p = 0.001) and CRP values (p = 0.019). Five of the fifteen ha d underlying neurological diseases, two had an additional salmonella infect ion and one suffered from hypernatraemic toxicosis. In the remaining seven children, higher temperature (p=0.037) and older age (p=0.05) remained sign ificant risk factors. CNS-signs occurred in 2% of RV-excreting children, a rate equal to the prevalence of febrile seizures among all inpatients durin g the study period (2.2%). Of all 32 patients hospitalised with a diagnosis of meningitis of encephali tis only four had their stools tested for RV, all with a negative result. Conclusions CNS symptoms in children aged less than two years with rotaviru s diarrhoea have the same clinical epidemiology as febrile seizures and thu s, in general, don't need additional diagnostic procedures.