Norovirus infection as a cause of diarrhea-associated benign infantile seizures

Shih Yen Chen, Chi Neu Tsai, Ming Wei Lai, Chih Yen Chen, Kuang Lin, Tzou Yien Lin, Cheng Hsun Chiu

Research output: Contribution to journalArticle

94 Citations (Scopus)

Abstract

Background. Norovirus and rotavirus cause outbreaks of diarrheal disease worldwide. This prospective observational study was undertaken to investigate the clinical characteristics and complications, with a focus on convulsive disorders, of gastroenteritis caused by norovirus and rotavirus in hospitalized pediatric patients in northern Taiwan. Methods. Children hospitalized with acute gastroenteritis in Chang Gung Children's Hospital from August 2004 through January 2007 were enrolled in the study. Rotavirus and norovirus were detected by reverse-transcriptase polymerase chain reaction with fecal specimens and were genotyped by sequence analysis. The symptoms and complications, in particular convulsions, of acute gastroenteritis caused by rotavirus and norovirus were reviewed and compared. The occurrence of convulsions associated with norovirus infection was specifically analyzed and discussed. The neurological outcomes for all norovirus-infected patients with or without convulsions were followed up for 1 year. Results. Among the 353 patients with acute viral gastroenteritis without coinfection, rotavirus and norovirus isolates were detected in 101 patients (28.6%) and 64 patients (18.1%), respectively. We compared the symptoms between the 2 groups and found that rotavirus caused a higher frequency and longer duration of vomiting and a higher body temperature than did norovirus. Norovirus infection, on the other hand, caused significantly longer hospital stays (mean duration of stay [interquartile range], 6 [5-8] days vs. 5 [4-7] days; P <.001) and a significantly higher incidence of convulsions than did rotavirus infection (29.7% vs. 5%; P<.001). Three of the 19 patients with convulsions showed an abnormal record on electroencephalogram, but none had any neurological sequelae at the subsequent 1-year follow-up. The majority of norovirus strains (41 of the 56 genotypeable strains) belonged to genogroup GGII/4. Conclusions. Norovirus is a major cause of acute gastroenteritis in children. This study identified norovirus as an emerging agent causing convulsive disorder in children, particularly in young infants. Long-term neurological sequelae are uncommon.

Original languageEnglish
Pages (from-to)849-855
Number of pages7
JournalClinical Infectious Diseases
Volume48
Issue number7
DOIs
Publication statusPublished - Apr 1 2009
Externally publishedYes

Fingerprint

Norovirus
Diarrhea
Seizures
Rotavirus
Infection
Gastroenteritis
Rotavirus Infections
Hospitalized Child
Body Temperature
Reverse Transcriptase Polymerase Chain Reaction
Coinfection
Taiwan
Vomiting
Observational Studies
Disease Outbreaks
Sequence Analysis
Electroencephalography
Length of Stay

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Chen, S. Y., Tsai, C. N., Lai, M. W., Chen, C. Y., Lin, K., Lin, T. Y., & Chiu, C. H. (2009). Norovirus infection as a cause of diarrhea-associated benign infantile seizures. Clinical Infectious Diseases, 48(7), 849-855. https://doi.org/10.1086/597256

Norovirus infection as a cause of diarrhea-associated benign infantile seizures. / Chen, Shih Yen; Tsai, Chi Neu; Lai, Ming Wei; Chen, Chih Yen; Lin, Kuang; Lin, Tzou Yien; Chiu, Cheng Hsun.

In: Clinical Infectious Diseases, Vol. 48, No. 7, 01.04.2009, p. 849-855.

Research output: Contribution to journalArticle

Chen, SY, Tsai, CN, Lai, MW, Chen, CY, Lin, K, Lin, TY & Chiu, CH 2009, 'Norovirus infection as a cause of diarrhea-associated benign infantile seizures', Clinical Infectious Diseases, vol. 48, no. 7, pp. 849-855. https://doi.org/10.1086/597256
Chen, Shih Yen ; Tsai, Chi Neu ; Lai, Ming Wei ; Chen, Chih Yen ; Lin, Kuang ; Lin, Tzou Yien ; Chiu, Cheng Hsun. / Norovirus infection as a cause of diarrhea-associated benign infantile seizures. In: Clinical Infectious Diseases. 2009 ; Vol. 48, No. 7. pp. 849-855.
@article{8a3d22bbfdae4bcf956564a2af2a3e80,
title = "Norovirus infection as a cause of diarrhea-associated benign infantile seizures",
abstract = "Background. Norovirus and rotavirus cause outbreaks of diarrheal disease worldwide. This prospective observational study was undertaken to investigate the clinical characteristics and complications, with a focus on convulsive disorders, of gastroenteritis caused by norovirus and rotavirus in hospitalized pediatric patients in northern Taiwan. Methods. Children hospitalized with acute gastroenteritis in Chang Gung Children's Hospital from August 2004 through January 2007 were enrolled in the study. Rotavirus and norovirus were detected by reverse-transcriptase polymerase chain reaction with fecal specimens and were genotyped by sequence analysis. The symptoms and complications, in particular convulsions, of acute gastroenteritis caused by rotavirus and norovirus were reviewed and compared. The occurrence of convulsions associated with norovirus infection was specifically analyzed and discussed. The neurological outcomes for all norovirus-infected patients with or without convulsions were followed up for 1 year. Results. Among the 353 patients with acute viral gastroenteritis without coinfection, rotavirus and norovirus isolates were detected in 101 patients (28.6{\%}) and 64 patients (18.1{\%}), respectively. We compared the symptoms between the 2 groups and found that rotavirus caused a higher frequency and longer duration of vomiting and a higher body temperature than did norovirus. Norovirus infection, on the other hand, caused significantly longer hospital stays (mean duration of stay [interquartile range], 6 [5-8] days vs. 5 [4-7] days; P <.001) and a significantly higher incidence of convulsions than did rotavirus infection (29.7{\%} vs. 5{\%}; P<.001). Three of the 19 patients with convulsions showed an abnormal record on electroencephalogram, but none had any neurological sequelae at the subsequent 1-year follow-up. The majority of norovirus strains (41 of the 56 genotypeable strains) belonged to genogroup GGII/4. Conclusions. Norovirus is a major cause of acute gastroenteritis in children. This study identified norovirus as an emerging agent causing convulsive disorder in children, particularly in young infants. Long-term neurological sequelae are uncommon.",
author = "Chen, {Shih Yen} and Tsai, {Chi Neu} and Lai, {Ming Wei} and Chen, {Chih Yen} and Kuang Lin and Lin, {Tzou Yien} and Chiu, {Cheng Hsun}",
year = "2009",
month = "4",
day = "1",
doi = "10.1086/597256",
language = "English",
volume = "48",
pages = "849--855",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "7",

}

TY - JOUR

T1 - Norovirus infection as a cause of diarrhea-associated benign infantile seizures

AU - Chen, Shih Yen

AU - Tsai, Chi Neu

AU - Lai, Ming Wei

AU - Chen, Chih Yen

AU - Lin, Kuang

AU - Lin, Tzou Yien

AU - Chiu, Cheng Hsun

PY - 2009/4/1

Y1 - 2009/4/1

N2 - Background. Norovirus and rotavirus cause outbreaks of diarrheal disease worldwide. This prospective observational study was undertaken to investigate the clinical characteristics and complications, with a focus on convulsive disorders, of gastroenteritis caused by norovirus and rotavirus in hospitalized pediatric patients in northern Taiwan. Methods. Children hospitalized with acute gastroenteritis in Chang Gung Children's Hospital from August 2004 through January 2007 were enrolled in the study. Rotavirus and norovirus were detected by reverse-transcriptase polymerase chain reaction with fecal specimens and were genotyped by sequence analysis. The symptoms and complications, in particular convulsions, of acute gastroenteritis caused by rotavirus and norovirus were reviewed and compared. The occurrence of convulsions associated with norovirus infection was specifically analyzed and discussed. The neurological outcomes for all norovirus-infected patients with or without convulsions were followed up for 1 year. Results. Among the 353 patients with acute viral gastroenteritis without coinfection, rotavirus and norovirus isolates were detected in 101 patients (28.6%) and 64 patients (18.1%), respectively. We compared the symptoms between the 2 groups and found that rotavirus caused a higher frequency and longer duration of vomiting and a higher body temperature than did norovirus. Norovirus infection, on the other hand, caused significantly longer hospital stays (mean duration of stay [interquartile range], 6 [5-8] days vs. 5 [4-7] days; P <.001) and a significantly higher incidence of convulsions than did rotavirus infection (29.7% vs. 5%; P<.001). Three of the 19 patients with convulsions showed an abnormal record on electroencephalogram, but none had any neurological sequelae at the subsequent 1-year follow-up. The majority of norovirus strains (41 of the 56 genotypeable strains) belonged to genogroup GGII/4. Conclusions. Norovirus is a major cause of acute gastroenteritis in children. This study identified norovirus as an emerging agent causing convulsive disorder in children, particularly in young infants. Long-term neurological sequelae are uncommon.

AB - Background. Norovirus and rotavirus cause outbreaks of diarrheal disease worldwide. This prospective observational study was undertaken to investigate the clinical characteristics and complications, with a focus on convulsive disorders, of gastroenteritis caused by norovirus and rotavirus in hospitalized pediatric patients in northern Taiwan. Methods. Children hospitalized with acute gastroenteritis in Chang Gung Children's Hospital from August 2004 through January 2007 were enrolled in the study. Rotavirus and norovirus were detected by reverse-transcriptase polymerase chain reaction with fecal specimens and were genotyped by sequence analysis. The symptoms and complications, in particular convulsions, of acute gastroenteritis caused by rotavirus and norovirus were reviewed and compared. The occurrence of convulsions associated with norovirus infection was specifically analyzed and discussed. The neurological outcomes for all norovirus-infected patients with or without convulsions were followed up for 1 year. Results. Among the 353 patients with acute viral gastroenteritis without coinfection, rotavirus and norovirus isolates were detected in 101 patients (28.6%) and 64 patients (18.1%), respectively. We compared the symptoms between the 2 groups and found that rotavirus caused a higher frequency and longer duration of vomiting and a higher body temperature than did norovirus. Norovirus infection, on the other hand, caused significantly longer hospital stays (mean duration of stay [interquartile range], 6 [5-8] days vs. 5 [4-7] days; P <.001) and a significantly higher incidence of convulsions than did rotavirus infection (29.7% vs. 5%; P<.001). Three of the 19 patients with convulsions showed an abnormal record on electroencephalogram, but none had any neurological sequelae at the subsequent 1-year follow-up. The majority of norovirus strains (41 of the 56 genotypeable strains) belonged to genogroup GGII/4. Conclusions. Norovirus is a major cause of acute gastroenteritis in children. This study identified norovirus as an emerging agent causing convulsive disorder in children, particularly in young infants. Long-term neurological sequelae are uncommon.

UR - http://www.scopus.com/inward/record.url?scp=63649093102&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=63649093102&partnerID=8YFLogxK

U2 - 10.1086/597256

DO - 10.1086/597256

M3 - Article

C2 - 19239351

AN - SCOPUS:63649093102

VL - 48

SP - 849

EP - 855

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 7

ER -