{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:43:45Z","timestamp":1790934225667,"version":"4.1.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2018,9,3]],"date-time":"2018-09-03T00:00:00Z","timestamp":1535932800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The rotavirus disease burden has declined substantially since rotavirus vaccine was introduced in the United States in 2006. The aim of this study was to determine the viral etiology of acute gastroenteritis (AGE) in US children aged &lt;2 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The New Vaccine Surveillance Network (NVSN) of geographically diverse US sites conducts active pediatric population-based surveillance in hospitals and emergency departments. Stool samples were collected from children aged &lt;2 years with symptoms of AGE (n = 330) and age-matched healthy controls (HCs) (n = 272) between January and December 2012. Samples were tested by real-time reverse-transcriptase polymerase chain reaction assays {adenovirus (type 40 and 41), norovirus, parechovirus A, enterovirus, sapovirus, and astrovirus} and an enzyme immunoassay (rotavirus). All samples that tested positive were genotyped.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Detection rates of pathogens in children with AGE versus those of HCs were, respectively, 23.0% versus 6.6% for norovirus (P &lt; .01), 23.0% versus 16.0% for adenovirus (P = .08), 11.0% versus 16.0% for parechovirus A (P = .09), 11.0% versus 9.0% for enterovirus (P = .34), 7.0% versus 3.0% for sapovirus (P = .07), 3.0% versus 0.3% for astrovirus (P = .01), and 3.0% versus 0.4% for rotavirus (P = .01). A high prevalence of adenovirus was detected at 1 surveillance site (49.0% for children with AGE and 43.0% for HCs). Norovirus GII.4 New Orleans was the most frequently detected (33.0%) norovirus genotype. Codetection of &gt;1 virus was more common in children with AGE (16.0%) than in HCs (10.0%) (P = .03).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Norovirus, astrovirus, sapovirus, and rotavirus were detected significantly more in children with AGE than in HCs, and norovirus was the leading AGE-causing pathogen in US children aged &lt;2 years during the year 2012.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jpids\/piy077","type":"journal-article","created":{"date-parts":[[2018,8,3]],"date-time":"2018-08-03T00:03:03Z","timestamp":1533254583000},"page":"414-421","source":"Crossref","is-referenced-by-count":81,"title":["Viral Etiology of Acute Gastroenteritis in &lt;2-Year-Old US Children in the Post\u2013Rotavirus Vaccine Era"],"prefix":"10.1093","volume":"8","author":[{"given":"Ferdaus","family":"Hassan","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Children\u2019s Mercy Hospitals and Clinics, Kansas City, Missouri"},{"name":"University of Missouri, School of Medicine, Kansas City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neena","family":"Kanwar","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Children\u2019s Mercy Hospitals and Clinics, Kansas City, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J","family":"Harrison","sequence":"additional","affiliation":[{"name":"University of Missouri, School of Medicine, Kansas City"},{"name":"Division of Infectious Diseases, Children\u2019s Mercy Hospitals and Clinics, Kansas City, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha B","family":"Halasa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D","family":"Chappell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet A","family":"Englund","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seattle Children\u2019s Hospitals, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen J","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seattle Children\u2019s Hospitals, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey A","family":"Weinberg","sequence":"additional","affiliation":[{"name":"University of Rochester School of Medicine and Dentistry, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter G","family":"Szilagyi","sequence":"additional","affiliation":[{"name":"University of Rochester School of Medicine and Dentistry, New York"},{"name":"Department of Pediatrics, University of California at Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E","family":"Moffatt","sequence":"additional","affiliation":[{"name":"University of Missouri, School of Medicine, Kansas City"},{"name":"Division of Emergency Medicine, Children\u2019s Mercy Hospitals and Clinics, Kansas City, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Steven","family":"Oberste","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William A","family":"Nix","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Rogers","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D","family":"Bowen","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Vinj\u00e9","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E","family":"Wikswo","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umesh D","family":"Parashar","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5871-911X","authenticated-orcid":false,"given":"Daniel C","family":"Payne","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rangaraj","family":"Selvarangan","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Children\u2019s Mercy Hospitals and Clinics, Kansas City, Missouri"},{"name":"University of Missouri, School of Medicine, Kansas City"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,9,3]]},"reference":[{"key":"2019110600560766200_CIT0001","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1542\/peds.2006-2876","article-title":"Cost-effectiveness and potential impact of rotavirus vaccination in the United States","volume":"119","author":"Widdowson","year":"2007","journal-title":"Pediatrics"},{"key":"2019110600560766200_CIT0002","first-page":"337","article-title":"Sustained decrease in laboratory detection of rotavirus after implementation of routine vaccination\u2014United States, 2000\u20132014","volume":"64","author":"Aliabadi","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2019110600560766200_CIT0003","doi-asserted-by":"crossref","first-page":"2282","DOI":"10.1001\/jama.2015.5571","article-title":"Acute gastroenteritis hospitalizations among US children following implementation of the rotavirus vaccine","volume":"313","author":"Leshem","year":"2015","journal-title":"JAMA"},{"key":"2019110600560766200_CIT0004","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1093\/infdis\/jit254","article-title":"Etiology of viral gastroenteritis in children <5 years of age in the United States, 2008\u20132009","volume":"208","author":"Chhabra","year":"2013","journal-title":"J Infect Dis"},{"key":"2019110600560766200_CIT0005","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1128\/JCM.02029-14","article-title":"Metagenomic analysis of viruses in feces from unsolved outbreaks of gastroenteritis in humans","volume":"53","author":"Moore","year":"2015","journal-title":"J Clin Microbiol"},{"key":"2019110600560766200_CIT0006","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1111\/j.1469-0691.2010.03390.x","article-title":"Prevalence of human parechovirus in Chinese children hospitalized for acute gastroenteritis","volume":"17","author":"Zhang","year":"2011","journal-title":"Clin Microbiol Infect"},{"key":"2019110600560766200_CIT0007","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1128\/JCM.01015-09","article-title":"Diversity of human parechoviruses isolated from stool samples collected from Thai children with acute gastroenteritis","volume":"48","author":"Pham","year":"2010","journal-title":"J Clin Microbiol"},{"key":"2019110600560766200_CIT0008","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1056\/NEJMsa1206589","article-title":"Norovirus and medically attended gastroenteritis in U.S. children","volume":"368","author":"Payne","year":"2013","journal-title":"N Engl J Med"},{"key":"2019110600560766200_CIT0009","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jpeds.2016.05.068","article-title":"Using multiplex molecular testing to determine the etiology of acute gastroenteritis in children","volume":"176","author":"Nicholson","year":"2016","journal-title":"J Pediatr"},{"key":"2019110600560766200_CIT0010","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.3201\/eid1908.130465","article-title":"Norovirus disease in the United States","volume":"19","author":"Hall","year":"2013","journal-title":"Emerg Infect Dis"},{"key":"2019110600560766200_CIT0011","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.3201\/eid1910.130448","article-title":"Clinical profile of children with norovirus disease in rotavirus vaccine era","volume":"19","author":"Wikswo","year":"2013","journal-title":"Emerg Infect Dis"},{"key":"2019110600560766200_CIT0012","doi-asserted-by":"crossref","first-page":"S56","DOI":"10.1097\/INF.0b013e3181fefdc0","article-title":"Uptake, impact, and effectiveness of rotavirus vaccination in the United States: review of the first 3 years of postlicensure data","volume":"30","author":"Tate","year":"2011","journal-title":"Pediatr Infect Dis J"},{"key":"2019110600560766200_CIT0013","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1542\/peds.2007-3378","article-title":"Active, population-based surveillance for severe rotavirus gastroenteritis in children in the United States","volume":"122","author":"Payne","year":"2008","journal-title":"Pediatrics"},{"key":"2019110600560766200_CIT0014","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1093\/infdis\/jiw233","article-title":"Rotavirus strain trends during the postlicensure vaccine era: United States, 2008\u20132013","volume":"214","author":"Bowen","year":"2016","journal-title":"J Infect Dis"},{"key":"2019110600560766200_CIT0015","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1128\/JCM.01982-12","article-title":"Optimization of a combined human parechovirus-enterovirus real-time reverse transcription-PCR assay and evaluation of a new parechovirus 3-specific assay for cerebrospinal fluid specimen testing","volume":"51","author":"Selvaraju","year":"2013","journal-title":"J Clin Microbiol"},{"key":"2019110600560766200_CIT0016","doi-asserted-by":"crossref","first-page":"2208","DOI":"10.1128\/JCM.00455-17","article-title":"Genetic and epidemiologic trends of norovirus outbreaks in the United States from 2013 to 2016 demonstrated emergence of novel GII.4 recombinant viruses","volume":"55","author":"Cannon","year":"2017","journal-title":"J Clin Microbiol"},{"key":"2019110600560766200_CIT0017","doi-asserted-by":"crossref","first-page":"2698","DOI":"10.1128\/JCM.00542-06","article-title":"Sensitive, seminested PCR amplification of VP1 sequences for direct identification of all enterovirus serotypes from original clinical specimens","volume":"44","author":"Nix","year":"2006","journal-title":"J Clin Microbiol"},{"key":"2019110600560766200_CIT0018","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jcv.2010.04.007","article-title":"Parechovirus typing in clinical specimens by nested or semi-nested PCR coupled with sequencing","volume":"48","author":"Nix","year":"2010","journal-title":"J Clin Virol"},{"key":"2019110600560766200_CIT0019","doi-asserted-by":"crossref","first-page":"1792","DOI":"10.1093\/cid\/civ872","article-title":"Long-term consistency in rotavirus vaccine protection: RV5 and RV1 vaccine effectiveness in US children, 2012\u20132013","volume":"61","author":"Payne","year":"2015","journal-title":"Clin Infect Dis"},{"key":"2019110600560766200_CIT0020","first-page":"1381","article-title":"Incidence of acute gastroenteritis and role of norovirus, Georgia, USA, 2004\u20132005","volume":"17","author":"Hall","year":"2011","journal-title":"Emerg Infect Dis"},{"key":"2019110600560766200_CIT0021","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1128\/JCM.02697-13","article-title":"Real-time PCR threshold cycle cutoffs help to identify agents causing acute childhood diarrhea in Zanzibar","volume":"52","author":"Elfving","year":"2014","journal-title":"J Clin Microbiol"},{"key":"2019110600560766200_CIT0022","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/S0140-6736(13)60844-2","article-title":"Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study","volume":"382","author":"Kotloff","year":"2013","journal-title":"Lancet"},{"key":"2019110600560766200_CIT0023","doi-asserted-by":"crossref","first-page":"1951","DOI":"10.1128\/JCM.00875-15","article-title":"Determination of a viral load threshold to distinguish symptomatic versus asymptomatic rotavirus infection in a high-disease-burden African population","volume":"53","author":"Bennett","year":"2015","journal-title":"J Clin Microbiol"},{"key":"2019110600560766200_CIT0024","doi-asserted-by":"crossref","first-page":"S303","DOI":"10.1093\/cid\/cis789","article-title":"Factors that explain excretion of enteric pathogens by persons without diarrhea","volume":"55","author":"Levine","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2019110600560766200_CIT0025","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1002\/jmv.21872","article-title":"Comparison of viral load and duration of virus shedding in symptomatic and asymptomatic neonatal rotavirus infections","volume":"82","author":"Ramani","year":"2010","journal-title":"J Med Virol"},{"key":"2019110600560766200_CIT0026","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.1128\/JCM.01925-10","article-title":"Replacing traditional diagnostics of fecal viral pathogens by a comprehensive panel of real-time PCRs","volume":"49","author":"Wolffs","year":"2011","journal-title":"J Clin Microbiol"},{"key":"2019110600560766200_CIT0027","doi-asserted-by":"crossref","first-page":"3292","DOI":"10.1017\/S095026881500059X","article-title":"Determination of cut-off cycle threshold values in routine RT-PCR assays to assist differential diagnosis of norovirus in children hospitalized for acute gastroenteritis","volume":"143","author":"Trang","year":"2015","journal-title":"Epidemiol Infect"},{"key":"2019110600560766200_CIT0028","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/1471-2334-9-63","article-title":"Diagnosing norovirus-associated infectious intestinal disease using viral load","volume":"9","author":"Phillips","year":"2009","journal-title":"BMC Infect Dis"},{"key":"2019110600560766200_CIT0029","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1128\/JCM.02251-14","article-title":"Comparison of test specificities of commercial antigen-based assays and in-house PCR methods for detection of rotavirus in stool specimens","volume":"53","author":"Ye","year":"2015","journal-title":"J Clin Microbiol"}],"container-title":["Journal of the Pediatric Infectious Diseases Society"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jpids\/article-pdf\/8\/5\/414\/30436994\/piy077.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jpids\/article-pdf\/8\/5\/414\/30436994\/piy077.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,11,6]],"date-time":"2019-11-06T00:56:43Z","timestamp":1573001803000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jpids\/article\/8\/5\/414\/5090096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,3]]},"references-count":29,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2018,9,3]]},"published-print":{"date-parts":[[2019,11,6]]}},"URL":"https:\/\/doi.org\/10.1093\/jpids\/piy077","relation":{},"ISSN":["2048-7193","2048-7207"],"issn-type":[{"value":"2048-7193","type":"print"},{"value":"2048-7207","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,11]]},"published":{"date-parts":[[2018,9,3]]}}}