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costs associated with office visits for diarrhea in infants and toddlers.we determined costs associated with diarrhea in a < 36-month-old ambulatory population. children with acute diarrhea were enrolled during the rotavirus season at three centers. questionnaires to assess costs of both medical and nonmedical factors were administered at the enrollment visit and 1 week later. office computer records were reviewed to identify all visits by children with diarrhea during 1 year. fifty-one patients were enrolled. the average cost per episode of diarrhea was $289, which ...19938265277
anti-rotavirus g type-specific and isotype-specific antibodies in children with natural rotavirus infections.serum vp7 (g) type- and isotype-specific anti-rotavirus antibodies were assessed among children monitored longitudinally over one or two rotavirus seasons in day care centers. seventy-five pairs of blood specimens from 63 children were tested for anti-rotavirus antibodies. stool specimens were collected weekly and tested for rotavirus antigen. g typing of detected rotaviruses showed that seven outbreaks of g1 and one of g3 occurred during the two seasons. g type-specific responses to the outbrea ...19948158022
etiology and epidemiology of diarrheal diseases in the united states.accurate data on the frequency of acute diarrheal illness and the distribution of pathogens are not available for several reasons, including the facts that only a small fraction of cases come to the attention of physicians and that available diagnostic tests establish an etiology in only about half of these. in a survey of three groups of patients in a community (upper-middle class and lower class outpatients and hospitalized infants), a possible cause was found in fewer than 20 percent of outpa ...19853893118
rna electropherotypes of human rotaviruses from north and south america.between april 1979 and december 1982, viral agents were found in 231 of 695 children admitted to the texas children's hospital with gastroenteritis. electron microscopic analysis showed that rotaviruses were the most common viral agents, and a seasonal pattern of rotavirus disease was observed. the migration patterns of the rna segments of these rotaviruses on electrophoresis in polyacrylamide gels were compared with those of rotaviruses collected from other areas of the united states of america ...19846329538
molecular epidemiology of rotavirus in children attending day care centers in houston.serotype distribution of group a rotavirus in children attending day care centers has not been previously reported. fifteen centers in houston participated in longitudinal monitoring of rotavirus infection during one to three consecutive rotavirus seasons. monitoring included daily recording of the presence of diarrhea and weekly stool collection. stool specimens containing rotavirus were analyzed by a monoclonal antibody (mab)-based elisa specific for the vp7 protein of serotypes 1, 2, 3, and 4 ...19902169496
sustained protection from pentavalent rotavirus vaccination during the second year of life at a large, urban united states pediatric hospital.fecal specimens from children presenting to texas children's hospital with acute gastroenteritis were tested for the presence of rotavirus. children were grouped according to vaccination status, and pentavalent rotavirus vaccine effectiveness was calculated. pentavalent rotavirus vaccine effectiveness against severe rotavirus gastroenteritis was sustained during the first 2 years of the vaccination program. overall 3-dose effectiveness was 83% to 86%; it was 92% to 93% among children 6 to 11 mon ...201020634776
effectiveness of pentavalent rotavirus vaccine in a large urban population in the united states.the goal was to assess the effectiveness of complete (3-dose) or partial (1- or 2-dose) immunization with pentavalent rotavirus vaccine (rv5) against rotavirus acute gastroenteritis (age) in us clinical practice.201020083525
child day care increases the risk of clinic visits for acute diarrhea and diarrhea due to rotavirus.a case-control study of risk factors for acute diarrhea was conducted among children under 3 years of age attending a health maintenance organization clinic in houston, texas. during a 19-month period from september 1985 through march 1987, 339 children with diarrhea and 363 age- and season-stratified controls were enrolled. a total of 90% of cases were under age 2 years. compared with children cared for at home, the risk of clinic visits for diarrhea was significantly greater for children recei ...19938434578
rotavirus in infant-toddler day care centers: epidemiology relevant to disease control strategies.a 15-month prospective longitudinal study of diarrhea and rotavirus (rv) infection was conducted concurrently in infants and toddlers in day care centers (dccs) and in a large pediatric clinic in houston. the mean number of children in the dccs was 223; the diarrhea rate during the first 12 months was 2.62 episodes per child-year. rotavirus accounted for approximately 10% of the total episodes of diarrhea in the pediatric clinic and dcc populations, but 50% during the winter months. the occurren ...19882842485
analysis of serotypes and electropherotypes of equine rotaviruses isolated in the united states.equine group a rotaviruses isolated over a 10-year period in new york state, new jersey, kentucky, and texas were compared serotypically and electropherotypically. all isolates were determined to be serotype 3 by reaction with hyperimmune antiserum to the serotype 3 h-2 strain of equine rotavirus. all displayed rna electrophoretic migration patterns related to that of the h-2 strain but distinct from that of serotype 5 strain h-1. a serologic survey of 184 mares in kentucky, which was done to de ...19911647407
serotype variation of human group a rotaviruses in two regions of the usa.the first longitudinal study of group a rotavirus serotype distribution in the usa is reported. elisas incorporating neutralizing monoclonal antibodies specific for the vp7 protein of serotypes 1, 2, 3, and 4 were used to determine the antigenic variation of group a rotaviruses in two collections of stool specimens. stool samples were collected from children hospitalized during 1979-1989 at texas children's hospital, houston, and from children from a more rural population hospitalized during 198 ...19902167332
impact of rotavirus infection at a large pediatric hospital.information is limited about national patterns of rotavirus infection throughout the usa. discharge records and laboratory rotavirus detection for 1979-1989 at the texas children's hospital, houston, were evaluated to determine the impact of rotavirus gastroenteritis at a large children's hospital. the availability since 1983 of diagnostic assays less expensive than electron microscopy was associated with increased rotavirus detection. only 67% of rotavirus-positive samples came from children li ...19902167331
prospective study of enteropathogens in children with diarrhea in houston and mexico.during a 22-month period, 595 children with diarrhea and 210 age-matched controls attending clinics in houston (367 children) and mexico (438) were prospectively evaluated for enteric pathogens. enteropathogens associated with disease were shigella (18%), rotavirus (14%), salmonella (9%), toxigenic escherichia coli (6%), and others (12%), including 14 proteus isolates that caused rounding of adrenal cells. enteropathogens were isolated from a greater (p less than 0.001) number of children with d ...1978211215
comparison of human rotavirus disease in tropical and temperate settings.human rotaviruses (hrv) are a common cause of acute nonbacterial gastroenteritis in pediatric patients. a prospective study of hrv disease in a temperate (dallas) and a tropical (san jose, costa rica) setting demonstrated differences in seasonal distribution. in both locales, hrv accounted for 50% to 60% of acute nonbacterial gastroenteritis episodes from december through february; this period corresponded to the cooler months of winter in dallas and to the dry season in san jose. during the res ...1978210656
diarrhea caused by shigella, rotavirus, and giardia in day-care centers: prospective study.we conducted a 19-month prospective study of children attending 20-day-care centers to determine the occurrence, causes, and transmission of gastroenteritis among children, staff, and family members. nine centers had 15 outbreaks of diarrhea involving 195 patients. an enteropathogen was identified in all outbreaks. shigella was detected in five outbreaks, rotavirus in two, giardia in one, and in the remaining seven multiple enteropathogens were identified. rotavirus and giardia occurred only in ...19816265616
detection of rotaviruses in the day care environment by reverse transcriptase polymerase chain reaction.group a rotavirus is an important cause of morbidity among infants and toddlers in day care centers. transmission by the fecal-oral route is well established, but fomites and environmental surfaces may also play an important role in transmission. a highly sensitive polymerase chain reaction (pcr) assay was used to detect rotavirus rna in day care environments. areas sampled included floors, diaper change areas, toy balls, and other surfaces. in two centers undergoing outbreaks of rotavirus, 7 (3 ...19921380049
outbreaks of human enteric adenovirus types 40 and 41 in houston day care centers.human enteric adenovirus (ead) types 40 and 41 cause diarrhea in young children, but little is known about their association with outbreaks of diarrhea in the child care setting. this study evaluated ead as a cause of outbreaks of diarrhea among infants and toddlers in day care centers.19921313095
diarrhea in children newly enrolled in day-care centers in houston.diarrhea is a common illness among children in day-care centers (dcc). we hypothesized that the incidence of diarrhea was greater among children in their first 1 or 2 months after enrollment in a dcc than in any subsequent period in day care. we followed 442 children younger than 2 years of age enrolled in 13 randomly selected dccs for the occurrence of diarrhea during a 14 1/2-month period. parents completed standardized baseline questionnaires and research nurses visited the dcc twice weekly t ...19912062623
the effect of diaper type and overclothing on fecal contamination in day-care centers.fecal coliform contamination of environmental surfaces and hands in the day-care center is common. this study evaluated the effect of two diaper types on fecal contamination. ten rooms in four day-care centers containing 141 children were studied in a prospective, randomized, crossover study. a total of 2946 samples were cultured during the 9-week study. fecal coliforms were isolated from 307 inanimate objects (15%), 73 toy balls (46%), and 131 hands (17%). the number of contaminated inanimate o ...19912005734
longitudinal study of giardia lamblia infection in a day care center population.an enzyme-linked immunosorbent assay was used to detect giardia lamblia in stool specimens collected during a 15-month longitudinal study of diarrhea in 82 children 1 to 24 months old attending a day care center (dcc) in houston. a total of 2727 stool specimens were collected on a weekly basis from the dcc children and were evaluated for rotavirus and giardia. for dcc children who developed diarrhea stool specimens were also cultured for bacterial enteropathogens. during the 15-month study perio ...19902336299
seasonal occurrence of rotavirus in sewage.a seasonal distribution was observed for rotaviruses in sewage by using indirect immunofluorescence. levels were low from may through september and generally higher during winter and spring. in contrast, no seasonal pattern was observed for total enteroviruses. limitations of the indirect immunofluorescence assay and enzyme immunoassay for environmental samples are discussed.19846324678
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