Winter vomiting bug in children
By Olivia Fens
The winter vomiting bug or rotavirus (RV) constitutes a significant disease burden in children under five, with the health and economic costs associated with infection rising each year, according to new studies.
RV is characterised by the sudden onset of diarrhoea and vomiting, often with mild fever. Symptoms usually last for only a few days but in severe cases hospitalisation may be required due to dehydration.
Transmission can be rapid, through person-to-person contact, airborne droplets, or contact with contaminated objects such as toys.
According to a report by the Health Protection Surveillance Centre, 2,251 cases of RV were reported in Ireland in 2006, an increase on the previous year (1,600 in 2005), especially in the HSE west.
A further breakdown of figures revealed that the majority of infections occurred in children under two.
There has been a continuous increase in the number of cases affecting this age group over recent years.
In the EU, it is estimated that each year 87,000 children under five are hospitalised due to rotavirus gastroenteritis and there are over 700,000 visits to the GP with this condition.
"As rotavirus became notifiable in 2004 it is possible that figures for previous years underestimate the true burden of infection," the study authors said.
A recent multi-centre trial conducted during 2004-2005 in seven EU countries found that more than 50% of hospitalisation for acute gastroenteritis was from RV, and 30% of children seen by GPs tested positive for RV.
The study found that in 12 hospitals, 68% of acute gastroenteritis cases were from RV.
And up to 68% of children with RV, consulted their GP first, therefore a substantial percentage of patients visited more than one healthcare setting.
Other points of the EU study included:
- Almost 70% of those with rotavirus were given prescribed medication
- Up to 57% of children with rotavirus seen by GPs received both prescribed and over-the-counter medication
- In Italy 91% of children with rotavirus received IV fluids
- In the UK, children received oral rehydration solutions or both oral and IV rehydration therapy; none received only IV rehydration therapy
- Up to 94% of children in the study (with RV) had laboratory investigations performed in hospital
- More than 60% of children had laboratory tests when seen in the A&E, and 21% of patients seen by a GP, had laboratory investigations performed.
A study of two Dublin based hospitals in 2003 found that the costs incurred from RV were substantial in two paediatric hospitals.
The study, conducted at Crumlin and Temple Street children's hospitals, found that RV accounted for 1% of all admissions during the study period at a minimum cost of ¤728.40 per case.
A vaccine against rotavirus is now being developed.
Recent research published in the New England Journal of Medicine indicates that two new rotavirus vaccines, in a study setting, were effective and had a low incidence of side effects (particularly in relation to intussusception – a recognised complication with an older rotavirus vaccine).
The National Immunisation Advisory Committee in Ireland is currently reviewing the efficacy and safety of the new vaccines against RV.
my children had the winter vomiting bug last year, and were ill for a fortnight,if reinfected this year will it be as severe or will they be more immune.