Acute gastroenteritis among children in the developing world

Acute gastroenteritis represents a major cause of morbidity and mortality worldwide. Young children are affected most frequently, with three to 10 episodes of diarrhoea per subject per year, a rate that decreases to less than one episode annually for children over fve years of age and adults. Usually, deaths are a result of dehydration, but malnutrition also plays an important role. Furthermore, malnutrition increases the incidence and severity of diarrhoea, as well as of other infections. The clinician encounters acute gastroenteritis in three settings. The frst is sporadic gastroenteritis in infants, which is often caused by rotavirus. The second is epidemic gastroenteritis, which occurs either in semi-closed communities (e.g. families, institutions, on ships, at vacation spots) or as a result of classic food-borne or water borne pathogens. Most of these infections are caused by caliciviruses. The third is sporadic acute gastroenteritis of adults, which is most likely to be caused by caliciviruses, rotaviruses, astroviruses or adenoviruses.