Epidemiological Profiles of Rotavirus and Norovirus in Pediatric Acute Gastroenteritis

Background: Acute gastroenteritis (AGE) is the common reason for morbidity in children across the globe. Historically, rotavirus was the main cause of this burden, but the epidemiological landscape has changed with vaccine introduction. Recently, norovirus and other pathogens may be on the rise. Methods: A hospital-based, cross-sectional study was conducted from January 2024 to January 2025. Stool samples were collected from 980 children under five years of age who presented with acute gastroenteritis. Samples were screened for rotavirus and norovirus using the rapid chromatographic immunoassay test and enzyme-linked immunosorbent assay (ELISA). Demographic and clinical data were collected and analyzed to identify risk factors and compare disease severity using the Vesikari scoring system. Results: Out of the 980 children, 220 (22.5%) tested positive for norovirus, 194 (19.8%) for rotavirus, and 40 (4.1%) had a co-infection. Norovirus was the most frequently detected single pathogen. The highest prevalence for both viruses was in the 12–23 month age group. Norovirus infections peaked in the autumn and winter months, whereas rotavirus cases were concentrated in the late winter and early spring. Clinically, rotavirus infections were associated with a significantly higher mean Vesikari score (14.8 vs. 12.5, p < 0.01), longer duration of diarrhea (5.8 days vs. 4.5 days, p < 0.05), and a higher rate of severe dehydration (56% vs. 32%, p < 0.01) compared to norovirus. Conclusion: Norovirus had been the predominant cause of viral AGE in this pediatric cohort post-rotavirus vaccine era, but rotavirus continued to be associated with greater disease severity. Altogether, these results indicated that norovirus causes a large disease burden and support the continued development and eventual implementation of a norovirus vaccine.