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.