Morbidity and hospital admissions due to rotavirus infection in Germany

Background. Rotavirus (RV) is the most common cause of severe diarrhea in children worldwide. Up to the present time only a few systematically evaluated data on the incidence of RV gastroenteritis and its impact on health care in Germany have exited. Therefore a prospective epidemiological study was performed to collect representative data on RV disease in Germany.

Method. Six hospitals in five German regions were selected to investigate severe cases of RV gastroenteritis in Germany. From June 1997 until may 1998,stools of all children up to four years of age hospitalized due to symptoms of acute gastroenteritis (AGE),were tested for RV antigen, followed by genotyping of the viruses by PCR. Date of admission,age, and sex were recorded for all patients. Further data on severity and course of the disease, concomitant diagnosis and treatment regimens were collected for a subgroup of patients (n = 99).

Results. A total of 15.182 children up to 4 years of age were hospitalized at the six participating hospitals. 1521 patients (10,0%) were hospitalized due to an episode of AGE. Of these patients, 626 (41,2%) were RV antigen positive. On the basis of data from the RV season 1997/98,the yearly rate of hospitalization is 7,7 per 1000 children (n = 24.149) per year (4,1% of 589.000 hospitalized patients 0-48 months of age). More than 70% of RV cases occurred during the winter season (December 1997-April 1998).The mean duration of hospitalization for RV patients was 4,9+/-1.9 days. RV cases scored significantly higher for disease severity compared to non-RV cases (p=0.005). Stool samples of 547 patients were analyzed to determine RVG- and P-types. Predominantly RV type G1/P(8) (76%) and G4/P(8) (18%) were detected.

Conclusions. In spite of a mild rotavirus winter epidemic in 1997-1998, results from this study demonstrate that RV AGE is a frequent cause of hospitalization for children up to four years of age in Germany.