Diarrhoea in children: aetiology and clinical aspects Diarrea nei bambini: eziologia ed aspetti clinici

R otavirus is a very common cause of acute diarrhoea in infant and young children throughout both the developing and developed world, occurring more frequently during the winter [1]. Person-to-person transmission is principally via faecal-oral contamination and exposure. The debilitating nature of rotavirus is reflected in the fact that an estimated one-third of all nosocomial paediatric diarrhoea cases globally can be attributed to this viral agent [2]. In the developed world the actual number of rotavirus infections with associated diarrhoea may well be much greater because severity appears diminished, resulting from immunological tolerance evolving from repeat exposures [3-5]. In developing countries, where young children are often already immunologically compromised in relation to poor nutritional status, severe, debilitating diarrhoea and associated fatalities are frequently attributed to this enteric viral pathogen [6-8]. Persistent and recurrent acute diarrhoea frequently caused by rotavirus infection is one of the three main causes of morbidity and mortality worldwide, accounting for an estimated annual five million deaths among infants under 5 years, particularly in developing countries [9]. Given the importance of rotavirus infection for the epidemiology of acute childhood diarrhoea and the fact that improved hygiene conditions have failed to decrease the incidence of rotavirus-associated diarrhoea, a vaccine against rotavirus has been intensely researched. However, the first vaccine was withdrawn from the market only a few months after becoming commercially available due to an association with intestinal intussusception [9-13]. Another safer, efficacious vaccine against rotavirus is already available in several countries. However, more data on the impact of rotavirus infection on the epidemiology of acute diarrhoea in children, especially in the most severe cases, are required to support massive vaccination [14-16]. Clinical presentation of rotaviral disease ranges from asymptomatic to severe dehydration pictures, albeit generally characterized by abdominal pain, vomit, fever and watery diarrhoea, with incubation ranging from 24 to 72 hours. The aim of this retrospective study was to determine the prevalence and clinical aspects of rotavirus infection in a group of children under five years of age affected by acute diarrhoea.