Incidence and symptoms of gastroenteritis in hospitalized children out of a cohort of 10271

Objective: A pertussis vaccine efficacy trial included a prospective follow up of all hospitalizations involved. This allowed us to calculate the rate s of hospitalization due to acute gastroenteritis in a large cohort of infa nts and children in Germany. Methods: 10271 healthy children were enrolled at the age of 2-4 months and followed up for a mean of 2.5 years. All hospitalizations during follow-up of the study were registered and letters of discharge from hospital in chil dren with gastroenteritis were evaluated for the present analysis. Results: A total of 179 episodes of hospitalization due to a gastroenteriti s were reported in 173 children (total observation years 25284). The mean c alculated incidence was 7.1/1000 observation years, with a maximum of 11.2/ 1000 years in 7-12 month old children. Rotavirus and Salmonella spp. were t he mast frequently identified agents. Rotavirus infections were most preval ent during the cold season and the maximum incidence was between 7 and 12 m onths of age. Characteristic symptoms of rotavirus infections were diarrhea (90%), vomiting (85%) and signs of dehydration (58%). In contrast most Sal monella infections occurred between July and September with a peak between 19 and 24 months of age. Salmonella infections were characterized by enteri tis (92%), high fever (56% > 39 degrees C) and significantly increased valu es for the c-reactive protein (68%). In this study rotavirus and Salmonella infections leading to hospitalization were associated with febrile seizure s in 5% and 12% of Eases,respectively. Conclusion: Gastroenteritis frequently leads to hospitalization in previous ly healthy infants and young children. Rotavirus and Salmonella spp. are th e predominant causative agents.