Key result
Norovirus sheds longer than rotavirus and adenovirus, remaining detectable in ~70% of children at four weeks.
Why the study?
Acute gastroenteritis is a major cause of morbidity and mortality in children under 5 years of age worldwide, with norovirus, rotavirus, and enteric adenovirus being the leading causes.
Does norovirus have a longer duration of shedding compared to rotavirus and adenovirus in children with acute gastroenteritis?
Cohort (n=173)
Yes
Does norovirus have a longer duration of shedding compared to rotavirus and adenovirus in children with acute gastroenteritis?
Absolute Event Rate: 70% vs 52.4%
p-value: p=<0.001
Norovirus is shed in stool for a significantly longer duration compared to rotavirus and adenovirus in children with acute gastroenteritis.
Prolonged norovirus shedding may guide pediatric infection-control duration; leaves open transmission risk and need for prospective trials.
Worldwide, acute gastroenteritis (AGE) is a major cause of morbidity and mortality in children under 5 years of age. Viruses, including norovirus, rotavirus, and enteric adenovirus, are the leading causes of pediatric AGE. In this prospective cohort study, we investigated the viral load and duration of shedding of norovirus, rotavirus, and adenovirus in stool samples collected from 173 children (median age: 15 months) with AGE who presented to emergency departments (EDs) across Canada on Day 0 (day of enrollment), and 5 and 28 days after enrollment. Quantitative RT-qPCR was performed to assess the viral load. On Day 0, norovirus viral load was significantly lower compared to that of rotavirus and adenovirus (p < 0.001). However, on Days 5 and 28, the viral load of norovirus was higher than that of adenovirus and rotavirus (p < 0.05). On Day 28, norovirus was detected in 70% (35/50) of children who submitted stool specimens, while rotavirus and adenovirus were detected in 52.4% (11/24) and 13.6% (3/22) of children (p < 0.001), respectively. Overall, in stool samples of children with AGE who presented to EDs, rotavirus and adenovirus had higher viral loads at presentation compared to norovirus; however, norovirus was shed in stool for the longest duration.
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Qiu et al. (2023) conducted a cohort in Acute gastroenteritis (n=173). Norovirus vs. Rotavirus and adenovirus was evaluated on Viral detection in stool at Day 28 (p=<0.001). Norovirus was shed in stool for a significantly longer duration than rotavirus and adenovirus, with detection in 70% of children at 28 days compared to 52.4% and 13.6%, respectively (p<0.001).
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