Hospitalizations for rotavirus gastroenteritis in Gipuzkoa (Basque country), Spain.

new adherent form of an attaching and effacing Escherichia coli (eaeA+,bfp-) to the intestinal epithelial cells of chicks. To the Editor: Rotavirus is the main cause of severe acute gastroenteritis among children both in developing and in industrialized countries. The incidence of rotavirus gastroenteritis in northern Europe is similar to or greater than the estimated incidence of the disease in the United States (1-3); however, little is known about the impact of rotavirus infection on health in southern Europe. We examined the incidence of hospitalization for rotavirus gastroenteritis during 3 years (July 1993-June 1996) in Gipuzkoa (population 400,480, of whom 58,896 are <15 years of age). The presence of rotavirus antigen was prospectively investigated by enzyme immunoanalysis (IDEIA Rotavirus, Dako Diagnostics, UK) in stool samples from all patients <15 years of age in the study area for whom a microbiologic analysis was requested for acute gastroenteritis. Children hospitalized for rotavirus gastroenteritis were sought retrospectively through searching both the computerized records of microbiology laboratory and hospital medical records for the diagnoses 558.9 (other gastroenteritis and presumably noninfectious colitis) and 008.6-009.3 (enteritis due to specific viruses and presumably infectious intestinal disorders) (4). All children in this study lived in the study area, had been hospitalized for gastroenteritis, and had one stool sample positive for rotavirus in the first 5 days of hospitalization without another gastroenteritis agent detected in the stool. One hundred fifty-two (82 male and 70 female) of 1,004 children <15 years of age with rotavirus gastroenterititis had been hospitalized for rotavirus infection. No deaths were recorded. Cases usually occurred in epidemic waves, with the highest incidence in January-March. An additional 133 children with rotavirus in stools had been hospitalized but were not included in this study because they had hospital-acquired infections (67 cases), were coinfected by another microorganism (11 cases), came from outside the geographic study area (19 cases), or had a main reason for hospitalization other than gastroen-teritis (36 cases). The mean annual incidence of hospitalization was 0.86 per 1,000 children (1 month to 14 years old) and 3.11 per 1,000 children (1 month to 5 years old). The maximum incidence occurred in 6-to 11-month-old children (11.81 per 1,000 children). Children were hospitalized for a mean of 4.8 ± 2.2 days. Rotavirus gastroenteritis was responsible for 152 (2%) of 7,403 pediatric admissions. For the 1-to 35-month age group, community-acquired rotavirus gastroenteritis was responsible for 140 (4.6%) of 3,026 admissions. …