Child/Adolescent Health

Rotavirus was culprit in one-fourth of children's diarrhea-related emergency department visits prior to vaccine

Rotavirus is the leading cause of severe vomiting and diarrhea among children worldwide. In fact, rotavirus contributed to about one-fourth of all diarrhea-associated outpatient and emergency department (ED) visits among U.S. children under 5 years old, according to a new study. What's more, the rate of diarrhea-associated outpatient and ED visits among these children changed little from 1995 through 2004. These data will help determine the impact of the new rotavirus vaccine introduced in 2006, which is given during the first year of infant life, on reducing diarrhea-related visits, note the researchers.

They examined the number of diarrhea-related visits per 10,000 patient-years to outpatient clinics and EDs by children under age 5. Outpatient clinic rates of 932 visits per 10,000 patient-years for 1995-1996 rose only slightly to 1,011 visits per 10,000 patient-years for 2003-2004. The rate for ED visits also remained essentially stable over these years, at 345 and 327 per 10,000 patient-years for 1995-1996 and 2003-2004, respectively.

The total rate of ambulatory visits was comparable among white and black children (1,298 and 1,236 per 10,000 patient-years, respectively). However, black children had a lower rate of diarrhea-related visits to outpatient clinics than did white children (716 versus 1,107 visits per 10,000 patient-years), but a higher rate of such visits to the ED (520 versus 286 visits per 10,000 patient-years). Black children with diarrhea-related illnesses were less likely than white children to be seen at an outpatient clinic, even when both groups had private insurance. In comparison, black children with Medicaid/State Children's Health Insurance Program were more likely to go to an ED than were similarly insured white children.

The researchers obtained their data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Care Survey for 1995-2004. Their study was funded in part by the Agency for Healthcare Research and Quality (HS13833). More details are in "National rates of diarrhea-associated ambulatory visits in children," by Stephen J. Pont, M.D., M.P.H., Carlos G. Grijalva, M.D., M.P.H., Marie R. Griffin, M.D., M.P.H., and others in the Journal of Pediatrics 155(1), pp. 56-61, 2009.

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