Epidemiology of diarrheal disease among children enrolled in four west coast health maintenance organizations

Umesh D. Parashar, Robert C. Holman, Joseph S. Bresee, Matthew J. Clarke, Philip H. Rhodes, Robert Davis, Robert S. Thompson, John P. Mullooly, Steven B. Black, Henry R. Shinefield, S. Michael Marcy, Connie M. Vadheim, Joel I. Ward, Robert T. Chen, Roger I. Glass

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Background. We used information from the Vaccine Safety Datalink (VSD) about ~1 million children enrolled in four health maintenance organizations to assess the morbidity from diarrhea and estimate the disease burden of rotavirus. Methods. We examined trends of diarrhea-associated hospitalizations and emergency room (ER) visits among VSD children ages 1 month through 4 years during October, 1992, through September, 1994 (two rotavirus seasons) and estimated the morbidity from rotavirus on the basis of characteristics patterns of age and seasonality. Results. Overall diarrhea was associated with 6.3% of hospitalizations and 4% of ER visits. During a child's first 5 years of life, we estimated that 1 in 57 was hospitalized and 1 in 21 required an ER visit because of diarrhea. Each year the number of diarrhea-associated hospitalizations and ER visits was greatest in winter among children ages 4 to 23 months and peaked in November in California and during February in Oregon and Washington. The winter seasonality of diarrhea- associated hospitalizations reflected the trends for diarrhea of presumed noninfectious and viral etiologies, which together accounted for most (92.9%) hospitalizations. Conclusions. Diarrhea is an important cause of morbidity among VSD children. The epidemiologic patterns of diarrhea-associated hospitalizations and ER visits resembled those reported previously for rotavirus diarrhea, suggesting that rotavirus may be a major contributor to the overall morbidity from diarrhea. Enhanced surveillance by screening for rotavirus in a sample of children with diarrhea will permit a more accurate assessment of the disease burden of this pathogen and the cost effectiveness of a rotavirus immunization program.

Original languageEnglish (US)
Pages (from-to)605-611
Number of pages7
JournalPediatric Infectious Disease Journal
Volume17
Issue number7
DOIs
StatePublished - Jul 1 1998
Externally publishedYes

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Health Maintenance Organizations
Diarrhea
Epidemiology
Rotavirus
Hospitalization
Hospital Emergency Service
Morbidity
Vaccines
Safety
Immunization Programs
Cost-Benefit Analysis

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Epidemiology of diarrheal disease among children enrolled in four west coast health maintenance organizations. / Parashar, Umesh D.; Holman, Robert C.; Bresee, Joseph S.; Clarke, Matthew J.; Rhodes, Philip H.; Davis, Robert; Thompson, Robert S.; Mullooly, John P.; Black, Steven B.; Shinefield, Henry R.; Marcy, S. Michael; Vadheim, Connie M.; Ward, Joel I.; Chen, Robert T.; Glass, Roger I.

In: Pediatric Infectious Disease Journal, Vol. 17, No. 7, 01.07.1998, p. 605-611.

Research output: Contribution to journalArticle

Parashar, UD, Holman, RC, Bresee, JS, Clarke, MJ, Rhodes, PH, Davis, R, Thompson, RS, Mullooly, JP, Black, SB, Shinefield, HR, Marcy, SM, Vadheim, CM, Ward, JI, Chen, RT & Glass, RI 1998, 'Epidemiology of diarrheal disease among children enrolled in four west coast health maintenance organizations', Pediatric Infectious Disease Journal, vol. 17, no. 7, pp. 605-611. https://doi.org/10.1097/00006454-199807000-00006
Parashar, Umesh D. ; Holman, Robert C. ; Bresee, Joseph S. ; Clarke, Matthew J. ; Rhodes, Philip H. ; Davis, Robert ; Thompson, Robert S. ; Mullooly, John P. ; Black, Steven B. ; Shinefield, Henry R. ; Marcy, S. Michael ; Vadheim, Connie M. ; Ward, Joel I. ; Chen, Robert T. ; Glass, Roger I. / Epidemiology of diarrheal disease among children enrolled in four west coast health maintenance organizations. In: Pediatric Infectious Disease Journal. 1998 ; Vol. 17, No. 7. pp. 605-611.
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abstract = "Background. We used information from the Vaccine Safety Datalink (VSD) about ~1 million children enrolled in four health maintenance organizations to assess the morbidity from diarrhea and estimate the disease burden of rotavirus. Methods. We examined trends of diarrhea-associated hospitalizations and emergency room (ER) visits among VSD children ages 1 month through 4 years during October, 1992, through September, 1994 (two rotavirus seasons) and estimated the morbidity from rotavirus on the basis of characteristics patterns of age and seasonality. Results. Overall diarrhea was associated with 6.3{\%} of hospitalizations and 4{\%} of ER visits. During a child's first 5 years of life, we estimated that 1 in 57 was hospitalized and 1 in 21 required an ER visit because of diarrhea. Each year the number of diarrhea-associated hospitalizations and ER visits was greatest in winter among children ages 4 to 23 months and peaked in November in California and during February in Oregon and Washington. The winter seasonality of diarrhea- associated hospitalizations reflected the trends for diarrhea of presumed noninfectious and viral etiologies, which together accounted for most (92.9{\%}) hospitalizations. Conclusions. Diarrhea is an important cause of morbidity among VSD children. The epidemiologic patterns of diarrhea-associated hospitalizations and ER visits resembled those reported previously for rotavirus diarrhea, suggesting that rotavirus may be a major contributor to the overall morbidity from diarrhea. Enhanced surveillance by screening for rotavirus in a sample of children with diarrhea will permit a more accurate assessment of the disease burden of this pathogen and the cost effectiveness of a rotavirus immunization program.",
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AU - Holman, Robert C.

AU - Bresee, Joseph S.

AU - Clarke, Matthew J.

AU - Rhodes, Philip H.

AU - Davis, Robert

AU - Thompson, Robert S.

AU - Mullooly, John P.

AU - Black, Steven B.

AU - Shinefield, Henry R.

AU - Marcy, S. Michael

AU - Vadheim, Connie M.

AU - Ward, Joel I.

AU - Chen, Robert T.

AU - Glass, Roger I.

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N2 - Background. We used information from the Vaccine Safety Datalink (VSD) about ~1 million children enrolled in four health maintenance organizations to assess the morbidity from diarrhea and estimate the disease burden of rotavirus. Methods. We examined trends of diarrhea-associated hospitalizations and emergency room (ER) visits among VSD children ages 1 month through 4 years during October, 1992, through September, 1994 (two rotavirus seasons) and estimated the morbidity from rotavirus on the basis of characteristics patterns of age and seasonality. Results. Overall diarrhea was associated with 6.3% of hospitalizations and 4% of ER visits. During a child's first 5 years of life, we estimated that 1 in 57 was hospitalized and 1 in 21 required an ER visit because of diarrhea. Each year the number of diarrhea-associated hospitalizations and ER visits was greatest in winter among children ages 4 to 23 months and peaked in November in California and during February in Oregon and Washington. The winter seasonality of diarrhea- associated hospitalizations reflected the trends for diarrhea of presumed noninfectious and viral etiologies, which together accounted for most (92.9%) hospitalizations. Conclusions. Diarrhea is an important cause of morbidity among VSD children. The epidemiologic patterns of diarrhea-associated hospitalizations and ER visits resembled those reported previously for rotavirus diarrhea, suggesting that rotavirus may be a major contributor to the overall morbidity from diarrhea. Enhanced surveillance by screening for rotavirus in a sample of children with diarrhea will permit a more accurate assessment of the disease burden of this pathogen and the cost effectiveness of a rotavirus immunization program.

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