Rotavirus or Norovirus: They’re both spread by poo and lousy handwashing

Rotavirus is a leading cause of acute gastroenteritis (AGE) in children and is highly transmissible. In this study, we assessed the presence of AGE in household contacts (HHCs) of pediatric patients with laboratory-confirmed rotavirus.


Between December 2011 and June 2016, children aged 14 days to 11 years with AGE were enrolled at 1 of 7 hospitals or emergency departments as part of the New Vaccine Surveillance Network. Parental interviews, medical and vaccination records, and stool specimens were collected at enrollment. Stool was tested for rotavirus by an enzyme immunoassay and confirmed by real-time or conventional reverse transcription-polymerase chain reaction assay or repeated enzyme immunoassay. Follow-up telephone interviews were conducted to assess AGE in HHCs the week after the enrolled child’s illness. A mixed-effects multivariate model was used to calculate odds ratios.

Overall, 829 rotavirus-positive subjects and 8858 rotavirus-negative subjects were enrolled. Households of rotavirus-positive subjects were more likely to report AGE illness in ≥1 HHC than were rotavirus-negative households (35% vs 20%, respectively; P < .0001). A total of 466 (16%) HHCs of rotavirus-positive subjects reported AGE illness. Of the 466 ill HHCs, 107 (23%) sought healthcare; 6 (6%) of these encounters resulted in hospitalization. HHCs who were <5 years old (odds ratio, 2.2 [P = .004]) were more likely to report AGE illness than those in other age groups. In addition, 144 households reported out-of-pocket expenses (median, $20; range, $2–$640) necessary to care for an ill HHC.

Rotavirus-associated AGE in children can lead to significant disease burden in HHCs, especially in children aged <5 years. Prevention of pediatric rotavirus illness, notably through vaccination, can prevent additional illnesses in HHCs.

Evidence for household transmission of rotavirus in the United States, 2011-2016


Journal of the Pediatric Infectious Diseases Society,

Mary E Wikswo, Umesh D Parashar, Benjamin Lopman, et al

Pinto defense: We meet all standards, after 1 dead and six sickened at Perth childcare

In the Aussie form of see, hear and speak no evil, evidence has emerged that a child has died following an outbreak of gastro at a lower North Shore (Perth) childcare centre.

see-no-evilSix children at Little Zak’s Academy in Artarmon — aged between 11 months and four years — developed high fevers and vomiting over the past week caused by rotavirus gastroenteritis, health authorities have confirmed.

But a seventh child died, with the causes so far unknown, although the death is not being directly attributed to the outbreak.

Northern Sydney Public Health Unit director Dr Michael Staff said four of the sick children had to be admitted to hospital.

“Tragically, another child who also attends the centre died in hospital on October 23, but at this stage it appears unrelated to the gastroenteritis outbreak,” he said.

He said they were working with specialist paediatricians to understand the cause of the child’s death.

Parents were tonight in shock over the news of the death.

pintoexplodingAn email from the local health district informing them of what had happened was only sent through this afternoon.

Michael Kendall, father to five-year-old Charlotte, said that he was “furious” and would not be bringing his child back to the child care centre.

He said the centre should have been shut down during the outbreak — and that he only just found out about what had happened.

“It’s the most disgusting thing I’ve ever heard in my life, I only found about it 15 minutes ago, I just heard that a child has died.

“If I knew my child wouldn’t have been here.

“I used to run a big centre down at the snow and our first priority was to take care of people especially kids, once you have an outbreak you’re supposed to tell the parents and shut the premises down.”

A spokesman for the centre said Public Health Unit advice was that “the outbreak appears to be under control and it is safe for children to continue to attend the Centre.”

Little Zak’s said in a statement, “Please be assured our Artarmon Centre is fully accredited and compliant with all health and regulatory requirements, and we endeavour at all times to operate to the highest standards of care and hygiene. As confirmed by the Northern Sydney Local Health District, we will continue to work closely with its Public Health Unit to ensure these high standards are maintained.”

Pinto defense.


6 dead, 1700 sick from rotavirus in Solomon Islands

Health authorities in the Solomon Islands have identified the cause of a diarrhea outbreak which has so far claimed the lives of six children.

eight_col_SCHOOL2There are 1,700 confirmed cases across six provinces.

The chairperson of the ministry of health’s emergency and operations committee says lab results just back from Australia and Fiji indicate the presence of rotavirus in all patient samples.

Chris Becha says a tailored response strategy is being finalised and will be made public tomorrow.

Vaccines work: Viral gastro reduced in Israel

Both rotavirus vaccines RotaTeq and Rotarix were efficacious against severe rotavirus gastroenteritis in clinical trials; yet real-world data on the effect of rotavirus vaccines on mild to moderate disease are limited.

rotavirus.vaccineWe used a large computerised database of Maccabi Health Services Health Maintenance Organisation (HMO), the second largest HMO in Israel covering 25% of the Israeli population, to compare the incidence of acute gastroenteritis (AGE) clinic visits in community settings (n = 302,445) before (2005–10) and after (2011–13) the introduction of universal rotavirus immunisation in Israel.

We retrieved laboratory results of rotavirus antigen tests (n = 18,133) and using a weighted analysis, we estimated the impact of rotavirus immunisation on the disease burden of rotavirus AGE clinic visits. Following the introduction of universal rotavirus immunisation, the typical winter peaks of rotavirus AGE were substantially lower and significant reductions of 14.8% (95% confidence interval (CI): 13.5–16.1) in all-cause AGE clinic visits and of 59.7% (95% CI: 59.8–62.6) in rotavirus AGE clinic visits were observed. The decrease was observed in all age groups, but it was greater in children aged 0 to 23 months than those aged 24 to 59 months. Continued rotavirus laboratory surveillance is warranted to monitor the sustainability of these changes.

Change in incidence of clinic visits for all-cause and rotavirus gastroenteritis in young children following the introduction of universal rotavirus vaccination in Israel

Eurosurveillance, Volume 20, Issue 42, 22 October 2015

K Muhsen, G Chodick, S Goren, E Anis, T Ziv-Baran, V Shalev,  D Cohen

Caf?? Rotavirus – a barf poem by John Estes

There’s an upside to getting written up in Slate magazine, as did last week, and it’s that a new audience can be reached.

Like the barf poetry crowd.

John Estes, who teaches at the University of Missouri, wrote me this morning to say he discovered through the Slate article, and that,

“Since you have no barf poetry (it’s a niche genre) I wanted to offer my poem, ‘Cafe Rotavirus.’"

So here it is (and that’s John’s son, Jonah, with their dog, Sophie, right)..

Cafe Rotavirus

Last time we all
ate here, a Sunday, after
the baby played with
—chewed on—
their toys: six
days and nights
of puke and diarrhea.
This stuff kills
starving kids in Africa,
underdeveloped as
electrolyte industries
are there.

But I cannot stop
returning and returning.
What pathogenesis
makes me weak
for, so consoled by,
this biscuits and gravy—
though I cannot
stop imagining
trillions of rotifer-driven
microbes racing
around this apparent
locus amoenus
like, but not like,
animated soap
bubbles scrubbing up
bathtub scum?

To believe in history,
now that fixed
stars are not so fixed,
might be to believe
each instant struggles—
fatally, hopefully—
to loose itself from
some unoriginate whole.
But, and this makes
instinctual sense
so long as instinct is
nothing but undigested
experience, it may also,
or maybe instead,
be the collective orgy
clearing its gorge,
suffusing each instant
with the particles
of every other
but in tastier order,
because nothing is real
until it means
and nothing means
until it returns,
returns like a dog returns,
as it will with verve,
to a baby’s vomit.

John Estes teaches at the University of Missouri and lives in Columbia. Recent poems have appeared (or will) in West Branch, Southern Review, New Orleans Review, Tin House, and other places. He is author of Kingdom Come (C&R Press, forthcoming) and two chapbooks: Breakfast with Blake at the Laocoön (Finishing Line Press, 2007) and Swerve (Poetry Society of America, 2009) which won a National Chapbook Fellowship.  See his website for more poems and prose.