BACKGROUND AND OBJECTIVESDifferent types of viruses are the leading cause of acute diarrhea among infants and young children worldwide. Epidemiological surveillance of viral agents is critical for the development of effective preventive measures, including vaccines. This study aimed to determine the prevalence of the four major enteropathogenic viruses—rotavirus, norovirus, adenovirus and astrovirus—in children over 7 years of age.DESIGN AND SETTINGA cross-sectional descriptive study conducted on stool specimens of children with acute gastroenteritis admitted to the Pediatrics Unit of 17 Shahrivar Hospital in Borazjan, Iran from October 2008 to September 2010.PATIENTS AND METHODSAcute gastroenteritis was defined as ≥3 loose watery stools per 24 hours. A total of 375 stool samples were collected from hospitalized children aged <7 years old with acute gastroenteritis. All samples were investigated by using enzyme-linked immunosorbent assay for the presence of viral antigens.RESULTSRotavirus was detected in 91 (24.3%) of the patients whereas the prevalence of norovirus, adenovirus and astrovirus was 12.5%, 5.1% and 2.4%, respectively. On average, 75.9% of children with viral diarrhea were younger than 2 years old (P=.023). All the strains of viral gastroenteritis studied peaked in the autumn, except for adenovirus which peaked in spring (P=.015). The most common clinical symptoms included diarrhea (92.2%), vomiting (68.7%), abdominal cramp (60.8%) and moderate dehydration (57.2%).CONCLUSIONSince nearly half of gastroenteritis cases (44.3%) were due to viral agents, testing for the viral antigens may guide the clinical approach to those patients with acute diarrhea particularly in the case of children less than 2 years old, and during cold seasons.

Background: Noroviruses are one of the most common causes of acute diarrhea in both developed and developing countries. They are responsible for more than 50% of all gastroenteritis outbreaks around the world.Objectives: This study was conducted to assess the prevalence, seasonality and clinical characteristics of norovirus infection in hospitalized Iranian children.Patients and Methods: Between 2008 and 2010, a cross-sectional descriptive study was conducted on 375 stool samples from children under 7 years of age, who suffered from acute gastroenteritis and who were admitted to the Pediatrics Unit of the 17 Shahrivar Hospital in the city of Borazjan. Acute gastroenteritis was defined as > 3 loose watery stools every 24 hours. All the stool specimens were tested for norovirus antigens with enzyme immunoassays (EIA). Demographic and clinical data were analyzed using SPSS software.Results: Of the total collected samples, noroviruses were detected in 47 out of 375 (12.53%). The highest infection rate was among children under two years of age (76.6%) (P = 0.001). Diarrhea (95.74%), vomiting (87.23%) and fever (82.98%) were the most frequently reported clinical symptoms in children with norovirus gastroenteritis. The highest prevalence of the virus was observed in autumn (63.83%) and the lowest in summer (6.38%) (P = 0.015).Conclusions: Regarding the emergence of noroviruses as a relevant cause of acute diarrhea in Iranian children, there is a great need to introduce a routine norovirus testing of hospitalized patients with gastroenteritis, particularly in children under 2 years old during the cold season

Enteric adenoviruses are one of the most significant etiological agents of severe viral gastroenteritis among infants and young children worldwide. This study was conducted to evaluate the clinical and epidemiological features of enteric adenovirus gastroenteritis in hospitalized children less than 7 years of age in Borazjan, Bushehr Province, Iran. From October 2008 to September 2010, stool specimens from 375 children suffering from acute diarrhea were investigated for the presence of enteric adenoviruses using enzyme immunoassays (EIA). Demographic and clinical information were obtained through a standard questionnaire and analyzed by SPSS software. Out of the total collected samples, 5.1% were positive for enteric adenoviruses. Of the adenovirus episodes, 68.42% occurred during the first 2 years of life (P = 0.640). The highest prevalence of infection was identified in the spring (63.16%), followed by the autumn (21.05%), winter (10.53%) and summer (5.26%) seasons, respectively (P = 0.001). The most common clinical symptoms included diarrhea (84.21%), moderate dehydration (63.16%), fever (57.89%) and vomiting (42.10%). Overall, 69.23% of the children with acute gastroenteritis were not breast-fed and 23.08% were breastfeeding at the time of presentation of the adenovirus infection (P = 0.04). This study highlights the importance of enteric adenoviruses as an etiological agent of acute gastroenteritis, particularly among children less than 2 years old and during the cold seasons.