From Aug 2001 to July 2002 at St Paul Hospital in Hanoi, 300 fecal samples collected from 300 diarrhoea children aged from 3 months to 5 years old were studied. Results showed that in 51,9% of cases, rotavirus was the leading cause, Escherichia coli was the second, among which addhesive strains and invasive strains of coli were the most common. In first time, toxic gene was detected in the group of intestinal hemorrhagic Escherichia coli. Shigella and Campillobacter were still the common pathologic causes of pediatric diarrhoae
Diarrhea/etiology ; Child ; Epidemiology

Child, Preschool ; China ; epidemiology ; Diarrhea ; epidemiology ; etiology ; virology ; Humans ; Infant ; Rotavirus ; Rotavirus Infections ; epidemiology

OBJECTIVETo study molecular epidemiology of norovirus (NV) infections, stool specimens collected from children with acute diarrhea were tested by TaqMan real-time reverse transcription polymerase chain reaction (RT-PCR) for the viral specific nucleic acid segments.

METHODSFecal samples from a total of 1260 children who had watery diarrhea seen from December 2006 to December 2007 in Guangzhou were analyzed by real-time RT-PCR. The primers and probes used for rapid detection and typing of NV strain target NV sequences were at the ORF1-ORF2 junction, a highly conserved region of the NoV genome. The positive specimens were determined by nested PCR and sequenced.

RESULTSTotally 257 specimens were positive for NV with a positive rate of 20.40%. Shedding of NV type GI was detected in 6.90%, type GII in 16.98% respectively, while the positive number of mixed infection with GI and GII was 44. Of the NV strains that were cloned and sequenced, GI was GI-3, GI-2 and GI-4 detected in positive specimens respectively; meanwhile, GII-4 was most commonly seen in genome II, followed by GII-3 and GII-7. In addition, the average age of children infected with NV was less than 2 years. An epidemic occurred during the winter and early spring (December through the next March).

CONCLUSIONNV was one of the important pathogens for acute diarrhea among children in Guangzhou, which suggested GII-4 was the prevalent strain.

Caliciviridae Infections ; epidemiology ; Child, Preschool ; China ; epidemiology ; Diarrhea ; epidemiology ; etiology ; virology ; Feces ; virology ; Humans ; Infant ; Molecular Epidemiology ; Norovirus ; classification ; genetics ; RNA, Viral ; genetics ; Reverse Transcriptase Polymerase Chain Reaction

Objective: To understand the epidemiologic characteristics of outbreaks, caused by norovirus-GⅡ.2、GⅡ.17 and GⅡ.4/Sydney in Guangdong Province from 2013 to 2017 and to provide scientific evidence for epidemic prevention and control. Methods: Incidence data of norovirus outbreaks in Guangdong from January 1(st) 2013 to November 30(th) 2017 were collected from Public Health Emergency Management Information System. RT-PCR was performed for every case of each outbreak to detect norovirus nucleic acid and gene sequencing was conducted to identify the genotype of norovirus. Characteristics of norovirus GⅡ.2, GⅡ.17 and GⅡ.4/Sydney outbreaks were analyzed. Directly standardized method was used to calculate the proportion of symtoms as diarrhea and vomitting. Results: From January 1(st) 2013 to November 30(th) 2017, a total of 167 norovirus outbreaks were reported in Guangdong, and 115 outbreaks were caused by norovirus GⅡ.2, GⅡ.17 and GⅡ.4/Sydney respectively. The outbreaks caused by norovirus GⅡ.2 accounted for 39.68% (25/63) in primary schools, 28.57% (18/63) in child care settings, 25.40% (16/63) in middle schools and 6.35% (4/63) in universities. Outbreaks caused by norovirus GⅡ.17 accounted for 41.03% (16/39) in middle schools, 20.51% (8/39) at workplaces, 15.38% (6/39) in primary schools, 12.82% (5/39) in universities, 5.13% (2/39) in communities and child care settings respectively. The outbreaks caused by norovirus GⅡ.4/Sydney accounted for 53.85% (7/13) in universities, 15.38% (2/13) in child care settings and at workplaces respectively, 7.69%(1/13) in primary schools and middle schools respectively. The outbreaks caused by norovirus GⅡ.2 had 77.78% (49/63) of contact transmission, 17.46% (11/63) of food-borne transmission. The outbreaks caused by norovirus GⅡ.17 showed 53.85% (21/39) of food-borne transmission, 15.38% (6/39) of contract transmission, 12.82% (5/39) of water-borne transmission. The outbreaks caused by norovirus GⅡ.4/Sydney had 53.85% (7/13) of food-borne transmission, 38.46% (5/13) of the contact transmission. In terms of the clinical manifestations, the standardized proportion of vomit was 73.76% and the proportion of diarrhea was 42.85% in cases infected with norovirus GⅡ.2, the proportion of standardized of vomit was 76.37% and the proportion of diarrhea was 51.40% in cases infected with norovirus GⅡ.17, with the standardized proportion of vomit was 54.10% and the proportion of diarrhea was 55.95% in cases infected with norovirus GⅡ.4/Sydney. Conclusions: The outbreaks caused by norovirus GⅡ.2 through contact transmission mainly occurred in primary schools, child care settings and middle schools. The outbreaks caused by norovirus GⅡ.17 through food-borne transmission mainly occurred in middle schools and at workplaces. The outbreaks caused by norovirus GⅡ.4/Sydney food-borne transmission and contact mainly occurred in universities.
Adolescent ; Caliciviridae Infections/epidemiology* ; Child ; Child, Preschool ; Diarrhea/etiology* ; Disease Outbreaks ; Epidemics ; Gastroenteritis/epidemiology* ; Genotype ; Humans ; Norovirus/isolation & purification* ; Reverse Transcriptase Polymerase Chain Reaction ; Sentinel Surveillance ; Vomiting/etiology*

To investigate epidemiologic feature and genetic variance of Sapovirus among children in China, fecal specimens were collected from children under 5 years old with acute diarrhea from Feb 2006 to Jan 2007 in nine provinces including Anhui, Fujian et al. A total of 1,110 fecal samples were detected for Sapovirus by reverse transcriptase-PCR (RT-PCR). Ten samples (0.9%) were positive for Sapovirus. The PCR products were then sequenced and analysed by phylogenetic tree. The results indicated that the detected Sapovirus strains were classified into two genogroups and three genotypes, including G I/1, G I/3, G II/3.
Astroviridae Infections ; epidemiology ; etiology ; genetics ; Base Sequence ; Caliciviridae Infections ; epidemiology ; China ; epidemiology ; Diarrhea ; classification ; virology ; Feces ; virology ; Gastroenteritis ; epidemiology ; etiology ; virology ; Genetic Variation ; Humans ; Molecular Sequence Data ; Phylogeny ; Reverse Transcriptase Polymerase Chain Reaction ; Sapovirus ; classification ; genetics

OBJECTIVETo study the distributional feature and clinical characteristics of infectious diarrhea caused by enterohemorrhagic Escherichia coli O157:H7, and to understand its pollution to the environment and the carrier status among livestock and poultry.

METHODSTo describing the incidence of diarrhea, to isolate and culture the pathogenic bacteria from samples of the patients with diarrhea and livestock or poultry with methods of microbiology, molecular biology and cytology, and then to determine the toxic factors.

RESULTSIn the first epidemic area in Suixian county, Henan province, 35 cases had been found during 17 March and 6 July with 91% of them above age of 60. Of them, 32 were complicated with acute renal failure, including 28 death (death rate: 87.50%). One hundred and seven strains of O157:H7 were isolated from the samples of livestock or poultry and 48 strains were isolated from patients. It was found that 67 strains having toxic gene through microbiological, molecular biological and cytological technologies. Five types of toxic factors were found.

CONCLUSIONThe main factor causing death was the complicated acute renal failure from diarrhea infected by E. coli O157:H7. The pathogen from livestock or poultry with high carrying rate might infect people through polluted water, food flies and close contacts. The outbreak of acute hemolytic uremic syndrome in Suixian county was caused by Enterohemorrhagic Escherichia coli O157:H7 infection.

Acute Kidney Injury ; etiology ; Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Diarrhea ; epidemiology ; Disease Outbreaks ; Escherichia coli Infections ; complications ; epidemiology ; Escherichia coli O157 ; isolation & purification ; Female ; Humans ; Male ; Middle Aged

OBJECTIVES: In July 2 2010, a diarrhea outbreak occurred among the workers in a company in Gyeungju city, Korea. An epidemiological investigation was performed to clarify the cause and transmission route of the outbreak. METHODS: We conducted a questionnaire survey among 193 persons, and we examined 21 rectal swabs and 6 environmental specimens. We also delegated the Daegu Bukgu public health center to examine 3 food service employees and 5 environmental specimens from the P buffet which served a buffet on June 30. The patient case was defined as a worker of L Corporation and who participated in the company meal service and who had diarrhea more than one time. We also collected the underground water filter of the company on July 23. RESULTS: The attack rate of diarrhea among the employees was 20.3%. The epidemic curve showed that a single exposure peaked on July 1. The relative risk of attendance and non-attendance by date was highest for the lunch of June 30 (35.62; 95% CI, 2.25 to 574.79). There was no specific food that was statistically regarded as the source of the outbreak. Bacillus cereus was cultured from two of the rectal swabs, two of the preserved foods and the underground water filter. We thought the exposure date was lunch of June 30 according the latency period of B. cereus. CONCLUSIONS: We concluded the route of transmission was infection of dishes, spoons and chopsticks in the lunch buffet of June 30 by the underground water. At the lunch buffet, 50 dishes, 40 spoons, and chopsticks were served as cleaned and wiped with a dishcloth. We thought the underground water contaminated the dishes, spoons, chopsticks and the dishcloth. Those contaminated materials became the cause of this outbreak.
Adult ; Aged ; Bacillus cereus/*isolation & purification ; Diarrhea/etiology ; *Disease Outbreaks ; Female ; Foodborne Diseases/*epidemiology/microbiology ; Fresh Water/microbiology ; Gram-Positive Bacterial Infections/*epidemiology/microbiology ; Humans ; Male ; Middle Aged ; Questionnaires ; Rectum/microbiology

Cyclospora cayetanensis is a foodborne and waterborne pathogen that causes endemic and epidemic human diarrhea worldwide. A few epidemiological studies regarding C. cayetanensis infections in China have been conducted. During 2013, a total of 291 stool specimens were collected from patients with diarrhea at a hospital in urban Shanghai. C. cayetanensis was not detected in any of the stool specimens by traditional microscopy, whereas five stool specimens (1.72%, 5/291) were positive by PCR. These positive cases confirmed by molecular technology were all in the adult group (mean age 27.8 years; 2.94%, 5/170) with watery diarrhea. Marked infection occurred in the rainy season of May and July. Sequence and phylogenetic analyses of the partial 18S rRNA genes of C. cayetanensis isolated showed intra-species diversity of this parasite. This study showed, for the first time, that C. cayetanensis is a pathogen in outpatients with diarrhea in Shanghai, albeit at a low level. However, the transmission dynamics of this parasite in these patients remain uncertain.
Adolescent ; Adult ; China ; epidemiology ; Cyclospora ; genetics ; isolation & purification ; Cyclosporiasis ; epidemiology ; Diarrhea ; etiology ; parasitology ; Feces ; parasitology ; Female ; Humans ; Male ; Middle Aged ; Outpatients ; Phylogeny ; Polymerase Chain Reaction ; RNA, Ribosomal, 18S ; analysis ; Retrospective Studies ; Young Adult

We aimed to investigate differences in clinical manifestations and outcomes between adult and child patients with Henoch-Schonlein purpura (HSP), and to analyze the factors associated with poor prognosis for HSP nephritis. This retrospective 10-yr study enrolled 160 patients with HSP who visited Severance Hospital. Purpura was mostly detected in lower extremities, but purpura in upper extremities was more frequently observed in adults than children (41.7% vs 19.3%). Children had a greater frequency of arthralgia (55.4% vs 27.1%), while adults had a greater frequency of diarrhea (20% vs 1.6%). Anemia, elevated C-reactive protein, and level of IgA were more frequently observed in adults (25% vs 7.1%, 65.6% vs 38.4%, 26.3% vs 3.5%). Renal involvement in adults was more severe than in children (79.2% vs 30.4%). Chronic renal failure showed a significant difference in outcomes of HSP between adults (10.4%) and children (1.8%) after a follow up period of an average of 27 months. Furthermore, renal insufficiency at diagnosis was significantly related to the progression to chronic renal failure. Our results showed several differences in the clinical features of HSP between adults and children. Adults with HSP had a higher frequency of renal insufficiency and worse renal outcomes than children. Renal insufficiency at diagnosis might be of predictive value for the progression to chronic renal failure in HSP patients.
Adult ; Aged ; Aged, 80 and over ; Arthralgia/epidemiology/etiology ; C-Reactive Protein/analysis ; Child ; Child, Preschool ; Diarrhea/epidemiology/etiology ; Extremities/pathology ; Female ; Follow-Up Studies ; Humans ; Immunoglobulin A/blood ; Immunosuppressive Agents/therapeutic use ; Infant ; Middle Aged ; Odds Ratio ; Prognosis ; Purpura, Schoenlein-Henoch/complications/*diagnosis/drug therapy/*pathology ; Renal Insufficiency/epidemiology/etiology ; Retrospective Studies ; Young Adult

The morbidity of travelers' diarrhea (TD) is still high. This study examined the incidence of common pathogens and characteristics of TD among Korean travelers who visited South-East Asian countries. We performed a prospective study involving 479 Korean travelers with diarrheal disease from February 2009 to April 2009 and stool samples were examined and questionnaire surveys were done after arrival. Enterotoxigenic Escherichia coli (ETEC) was found in 36.0% of TD cases, as were the following: Enteroaggregative Escherichia coli (EAEC) in 27.0%, Vibrio parahaemolyticus in 13.1%, and Norovirus in 11.5%. The detected rate of classic TD was higher in men (P = 0.007), in patients who had a shorter duration trip (P = 0.023) and in patients who drank more than 1 liter of water per day (P = 0.037). Positive stool culture rates were higher in men (P = 0.005), in hospitalized patients (P = 0.013). and in those who consumed impure water or raw foods (P = 0.033). A higher severity of disease corresponded to a significantly higher culture positivity rate (P = 0.029). We should consider the possibility of other pathogens in addition to ETEC in patients with TD who visit South-East Asia. Travelers need to educate about risk factors associated with TD.
Adolescent ; Adult ; Aged ; Asia, Southeastern/epidemiology ; *Asian Continental Ancestry Group ; Caliciviridae Infections/epidemiology/virology ; Child ; Diarrhea/epidemiology/*etiology/microbiology/virology ; Escherichia coli/isolation & purification/pathogenicity ; Escherichia coli Infections/epidemiology/microbiology ; Feces/microbiology/virology ; Female ; Humans ; Male ; Middle Aged ; Norovirus/isolation & purification/pathogenicity ; Prospective Studies ; Questionnaires ; Republic of Korea ; Risk Factors ; *Travel ; Travel Medicine ; Vibrio parahaemolyticus/isolation & purification/pathogenicity ; Young Adult