Viral Gastroenteritis in Children

Year 2016, Volume: 8 Issue: 4, 12 - 16, 08.07.2016

Doç. Dr. İlker Devrim

Abstract

Abstract

Viral gastroenteritis constitute approximately 70-80% of all gastroenteritis andis an important factor of mortality especially among under 5 years old children indeveloping countries. The studies showed that rotavirus has been observed to be responsible from 30-50% of diarrhea in under 5 years old children in Turkey. The adenovirus is the second most common group of viruses that required hospitalization.Astroviruses, Norovirus and other human calicivirus can also cause viral gastroenteritis. Diagnosis of viral gastroenteritis is made by showing the virus in stool or ELISA and other immunological tests. Rehydration is the main treatment of viral gastroenteritis. Studies have shown that probiotics are safe agents and beneficial effected in reducing acute infectious diarrhea duration and stool frequency. However, itshould be noted that the beneficial effect is strain-specific and dose-dependent. Sanitation, improving hygiene conditions, to avoid humanwaste contaminating drinking water, and the placementof hand-washing are measures to preventing the develop-ment of viral acute gastroenteritis. Rotavirus vaccineswhich are important for preventing rotavirus associated gastroenteritis, have been introduced after obtaining thelicense in many countries since 2006.

Keywords

Children, gastroenteritis, probiotics, rotavirus

Çocuklarda Viral Gastroenteritler Çocuklarda Viral Gastroenteritler

Abstract

Öz

Viral gastroenteritler tüm gastroenteritlerin yaklaşık %70-80’ini oluşturur ve gelişmekte olan ülkelerde özellikle 5 yaş altı çocuk ölümlerinin önemli bir etkenidir.Türkiye’de yapılan çalışmalarda 5 yaş altı çocuklarda görülen ishallerin %30-50’sinden rotavirusların sorumlu olduğu görülmüştür. Enterik adenoviruslar rotaviruslardan sonra en sık yatış gerektiren ikinci virus grubudur. Astroviruslar, Noroviruslarve diğer insan calicivirusları da diğer viral gastroenterit etkenleri arasında sayılabilir. Viral gastroenteritlerin tanısı dışkıda virusun gösterilmesi veya ELISA testleri vediğer immünolojik testler ile saptanması ile konulur. Yeterli rehidratasyon viral gastroenteritlerin ana tedavisini oluşturur. Probiyotiklerin akut enfeksiyöz ishalin süresini ve dışkı sıklığını azaltmakta yararlı etkileri ve güvenilir ajanlar olduğu çalışmalarla gösterilmiştir. Ancak, yararlı etkilerinin suşa özgü ve doza bağımlı olduğu unutulmamalıdır. Sanitasyon, hijyen koşullarının iyileştirilmesi, insan atıklarının içmesuyuna karışmasının engellenmesi ve el yıkamanın yerleştirilmesi viral akut gastroenterit gelişmesini engelleyen önlemlerdir. Özellikle rotaviruse bağlı gastroenterit-lerin önlenmesinde önemli rol oynayan Rotavirus aşıları 2006 yılından itibaren birçok ülkede lisans alarak kullanıma girmiştir.

Keywords

Çocuk, gastroenterit, probiyotik, rotavirus

References

• Kaynaklar 1.Bresee JS, Parashar UD, Widdowson MA, Gentsch JR, Stee-le AD, Glass RI. Update on rotavirus vaccines. Pediatr InfectDis J 2005; 24: 947-52. 2.Parashar UD, Hummelman EG, Bresee JS, Miller MA,Glass RI. Global illness and deaths caused by rotavirus di-sease in children. Emerg Infect Dis 2003; 9: 565-72. 3.Ficher TK, Vibaud C, Parashar U, et al. Hospitalizations andDeaths from Diarrhea and Rotavirus among Children <5 Ye-ars of Age in the United States, 1993-2003. J Infect Dis 2007;195: 1117-25. 4.WHO. 5th Anual Global Immunization Meeting. February 2,2010, Geneva, Switzerland. 5.Kurugöl Z, Geylani S, Karaca Y, et al. Rotavirus gastroente-ritis among children under five years of age in İzmir, Turkey.Turk J Ped 2003; 45: 290-94. 6.Kurugöl Z, Devrim İ. Gastrointestinal Infections. J Pediatr Inf2014; 8: 71-81. 7.Ceyhan M, Alhan E, Salman N, et al. Multicenter prospecti-ve study on the burden of rotavirus gastroenteritis in Turkey,2005-2006: a hospital-based study. J Infect Dis 2009; 200(Suppl 1): S234-38. 8.Ogilvie I, Khoury H, El Khoury AC, Goetghebeur MM. Bur-den of rotavirus gastroenteritis in the pediatric population inCentral and Eastern Europe: serotype distribution and bur-den of illness. Hum Vaccin 2011; 7: 523-33. 9.American Academy of Pediatrics (Rotavirus). In: Pickering LK,Baker CJ, Kimberlin DW, Long SS, eds. Red Book: 2009 Re-port of the Committee on Infectious Diseases. 28th ed. Elk Gro-ve Village, IL: American Academy of Pediatrics; 2009: 576-79. 10.American Academy of Pediatrics (Norovirus). In: PickeringLK, Baker CJ, Kimberlin DW, Long SS, eds. Red Book: 2009Report of the Committee on Infectious Diseases. 28th ed. ElkGrove Village, IL: American Academy of Pediatrics; 2009:241-42. 11.Goodgame RW. Viral causes of diarrhoea. Gastroenterol ClinN Am 2001; 30: 779-95. 12.Midthun K, Black RE. Viral diarrheas. In: GT Strickland, ed.Hunter’s Tropical Medicine and Emerging Infectious Diseases,8th ed. WB Saunders Company: Philadelphia, 2000: 220-26. 13.Bresee JS, Widdowson MA, Monroe SS, Glass RI. Foodbor-ne viral gastroenteritis: challenges and opportunities. Clin In-fect Dis 2002; 35: 748-53. 14.Mead PS, Slutsker L, Dietz V, et al. Food-related illness anddeath in the United States. Emerg Infect Dis 1999; 5: 607-25.15.Koo HL, Ajami N, Atmar RL, DuPont HL. Noroviruses: Theleading cause of gastroenteritis worldwide. Discov Med2010; 10: 61-70. 16.Uyar Y, Carhan A, Ozkaya E, Ertek M. Evaluation of labo-ratory diagnosis of the first norovirus outbreak in Turkey in2008. Mikrobiyol Bul 2008; 42: 607-15. 17.Altindis M, Bányai K, Kalayci R, et al. Frequency of norovi-rus in stool samples from hospitalized children due to acutegastroenteritis in Anatolia, Turkey, 2006-2007. Scand J In-fect Dis 2009; 41: 685-88. 18.Walter JE, Mitchell DK. Astrovirus infection in children. CurrOpin Infect Dis 2003; 16: 247-53. 19.Ozdemir S, Delialioğlu N, Emekdaş G. Investigation of rota-virus, adenovirus and astrovirus frequencies in childrenwith acute gastroenteritis and evaluation of epidemiologicalfeatures. Mikrobiyol Bul 2010; 44: 571-78. 20.Wilhelmi I, Roman E, Sánchez-Fauquier A. Viruses causinggastroenteritis. Clin Microbiol Infect 2003; 9: 247-62. 21.King CK, Glass R, Bresee JS, Duggan C; Centers for Disea-se Control and Prevention. Managing acute gastroenteritisamong children: oral rehydration, maintenance, and nutritio-nal therapy. MMWR Recomm Rep 2003; 52: 1-16. 22.Duggan C, Lasche J, McCarty M, et al. Oral rehydration so-lution for acute diarrhea prevents subsequent unscheduled fol-low-up visits. Pediatrics 1999; 104: e29. 23.Sandhu BK. Practical guidelines for the management of gas-troenteritis in children. J Pediatr Gastroenterol Nutr 2001;33: 36–39. 24.Hossain S, Biswas R, Kabir I, et al. Single dose vitamin A tre-atment in acute shigellosis in Bangladeshi children: rando-mized double blind controlled trial. BMJ 1998; 316: 422–26. 25.WHO/UNICEF Joint Statement:Clinical Managemet of Acu-te Diarrhae, May 2004. 26.Piescik-Lech M, Shamir R, Guarino A, Szajewska H. Reviewarticle: the management of acute gastroenteritis in children.Aliment Pharmacol Ther 2013; 37: 289-303. 27.Guarino A, Albano F, Ashkenazi S, et al. European Society forPaediatric Gastroenterology, Hepatology, and Nutrition/European Society for Paediatric Infectious Diseases eviden-ce based guidelines for the management of acute gastroente-ritis in children in Europe: executive summary. J Pediatr Gas-troenterol Nutr 2008; 46: 619-21. 28.Keddy K, Goldsmid JM, Frean J. Tropical GastrointestinalInfections. Australasian College of Tropical Medicine. Primerof tropical medicine 6.1-6.24 (Erişim Tarihi: 25.08.2015).