Surveillance of norovirus infection in a study of sporadic childhood gastroenteritis in South West England and South Wales, during one winter season (1999-2000)

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Abstract
Reverse transcriptase polymerase chain reaction (RT-PCR), electron microscopy (EM) and a genotype II specific antigen capture enzyme immunoassay (EIA), (Lordsdale strain) were used to establish the prevalence of Norwalk-like viruses (NLV) among sporadic cases of childhood gastroenteritis in South West England over a winter season. Samples of 3,172 stools from cases of gastroenteritis in children aged under 7 years sent to the Bristol Public Health Laboratory over the 1999/2000 winter 'season' were tested prospectively by EM, EIA and RT-PCR. The results from sporadic cases were compared with 1,360 samples from 285 outbreaks of gastroenteritis which were sent to the laboratory over the same period. In total NLV was established as the causal agent in 326 cases (10.3%) of sporadic gastroenteritis by one or more of the tests (EM 30 (0.9%), EIA 132 (4.2%) and RT-PCR 276 (8.7%)). The presence of other enteric viruses was established using EM and rotavirus EIA. Rotaviruses were the most common cause of viral gastroenteritis with 684 cases (21.6%). Other viruses detected included, adenovirus 124 cases (3.9%), astrovirus 97 cases (3.1%) and calicivirus in 7 cases (0.2%). NLV was the second most common viral agent indicating a significant role in cases of sporadic childhood gastroenteritis.