Epidemiologic and Clinical Features of Other Enteric Viruses Associated with Acute Gastroenteritis in American Indian Infants

ObjectiveTo investigate the viral etiology, through the use of molecular methods, of acute gastroenteritis (AGE), which is a considerable public health burden in Native American infants.Study designFrom March 2002 through February 2004, AGE and non-diarrheal stools were collected from Navajo and White Mountain Apache infants who received placebo during a rotavirus vaccine trial. Case (n = 247) and control (n = 344) specimens were tested for enteric adenovirus, astrovirus, norovirus, rotavirus, and sapovirus with real-time polymerase chain reaction. The odds of AGE were compared with population-averaged logistic regression models.ResultsIn 65% of the cases of AGE (161/247), at least one virus was detected; norovirus (n = 80, 32%) and rotavirus (n = 70, 28%) were the most common. A virus was detected in 38% of control specimens (132/344). Detection of “any virus” was associated with AGE (OR = 3.22; 95% CI, 2.11-4.91), as was detection of norovirus (OR = 2.00; 95% CI, 1.22-3.26) and rotavirus (OR = 2.69; 95% CI, 1.52-4.79).ConclusionThis study highlights the significant burden of viral AGE in American Indian infants and identifies pathogen targets for future prevention efforts in this population.