Viral gastroenteritis in children.

Gastroenteritis is one of the most common causes of morbidity and mortality in children worldwide and accounts for 2 to 3 million deaths per year with most occurring in young children in developing countries. The causes of gastroenteritis in children vary with the location, time of year, and population studied. Bacterial and parasitic gastrointestinal infections have decreased in frequency as a result of the provision of safe drinking water and disposal of sewage. However, viral gastroenteritis has not declined in a comparable fashion. Viruses are the most common pathogens causing gastroenteritis in the United States. Before universal rotavirus immunization was adopted in the United States, approximately one half of all hospitalizations for nonbacterial gastroenteritis in children were caused by rotaviruses. Currently, noroviruses are the most important cause of nonbacterial acute gastroenteritis. In children, other viral pathogens that have been proven to cause gastroenteritis are sapoviruses, astroviruses, and enteric adenoviruses. The viral gastroenteritis pathogens all infect the intestine and cause gastrointestinal symptoms. In contrast, enteroviruses may infect the intestine but predominantly produce manifestations at extraintestinal sites.