An Outbreak of Acute Gastroenteritis Presenting with Metabolic Acidosis in Many Nurseries in Gyeonggi Province, Korea.

Shin,  Dong Han; Kim,  Soo Young; Seo,  Won Hee; Choi,  Byung Min; Lee,  Jung Hwa; Shin,  Young Kyu; Lee,  Kee Hyung; Eun,  Baik Lin; Hong,  Young Suk

Original Article

Journal of the Korean Society of Neonatology 2003;10(2):218-225.
Published online November 1, 2003.

An Outbreak of Acute Gastroenteritis Presenting with Metabolic Acidosis in Many Nurseries in Gyeonggi Province, Korea.

Dong Han Shin, Soo Young Kim, Won Hee Seo, Byung Min Choi, Jung Hwa Lee, Young Kyu Shin, Kee Hyung Lee, Baik Lin Eun, Young Suk Hong

Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea. cbmin@korea.ac.kr

경기도 지역의 신생아실에서 유행한 대사성 산증을 동반한 급성 위장관염

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Abstract

PURPOSE
The hospital-acquired outbreak of acute gastroenteritis caused by a virus is currently one of major health problems among newbron nurseries in Korea. We report an outbreak of acute gastroenteritis with metabolic acidosis over a eight-month period in many nurseries in Gyeonggi-do, Korea. METHODS: We retrospectively evaluated 73 neonates who were admitted in Ansan Hospital, Korea University Medical Center, presenting with symptoms of acute viral gastroenteritis from March, 2001 to September, 2003. Epidemiologic, clinical and laboratory data for these neonates were reviewed. Enzyme-linked immunosorbent assay (ELISA) for rotavirus and enzyme immunoassay (EIA) for astrovirus, norwalk virus and enteric adenovirus were performed in 54 and 16 neonates, respectively. RESULTS: The mean age at admission was 9.5 +/- 3.9 days. The mean body weight was significantly decreased, compared with mean birth weight. The numbers of severe dehydration were 37 (50.7%) and severe metabolic acidosis (pH < 7.2) were 40 (54.8%). Although the symptoms and laboratory findings were all compatible with acute gastroenteritis caused by a virus, the positive results for ELISA for rotavirus and EIA for astrovirus, norwalk virus and enteric adenovirus were 8 (14.8%) for 54 neonates and none for 16 neonates, respectively. CONCLUSION: Recognizing an outbreak of viral gastroenteritis necessitates notification of local health officials, collection of appropriate specimen for diagnosis and prompt institution of infection control measures.

Key Words: Gastroenteritis; Metabolic acidosis; Severe dehydration; Hospital infection; Rotavirus; Neonate; Nursery