• The severity of rotavirus infection ranges from asymptomatic infection to severe dehydrating gastroenteritis, which can lead to hospitalization in some cases.⁸
• Dehydration of at least mild severity occurs in 80% of patients.⁸
• There are no reliable predictors to determine whether any given child is at risk for serious disease.⁸
• The disease can lead to serious complications in some cases, even for healthy infants.¹¹

While Canadian deaths due to rotavirus are uncommon, the virus remains a major cause of severe dehydration, often necessitating hospitalization due to rapid deterioration. It is estimated that it accounts for up to 56,000 physician visits (95% Credibility Interval: 27,000-56,000), up to 27,000 emergency room (ER) visits (95% Credibility Interval: 9,000-27,000), of which up to 7,000 children (Credibility Interval: 4,200-7,000) younger than 5 years of age are admitted to the hospital.^10,*

*The epidemiological and economic burden of rotavirus in Canada was estimated using a mathematical model that consolidated information from various sources. Estimated outcomes included rotavirus gastroenteritis related physician consultations, ER visits, hospitalizations, as well as parent/caregiver work loss and out-of-pocket expenses.

A surveillance program for gastroenteritis in children <5 years of age conducted at the Cincinnati Children’s Hospital Medical Center found that there may be more infant deaths due to rotavirus gastroenteritis than have been previously estimated, because of a lack of identification of gastroenteritis and the lack of testing for rotavirus²²

• The surveillance program revealed 2 deaths that were initially diagnosed as sudden infant death syndrome, but upon further review were determined to be caused by rotavirus gastroenteritis.²²

Rotavirus: Nosocomial Burden

Rotavirus is an important cause of nosocomial infection; in addition to the asymptomatic infections associated with rotavirus endemics in newborn nurseries, rotavirus causes symptomatic hospital-acquired outbreaks associated with circulation of rotavirus in the community.³

A review of the burden of nosocomially-acquired rotavirus infections found that approximately one-quarter to one-third of all patients discharged for rotavirus infection may have contracted the disease nosocomially.^13,*

Seasonal peaks place a significant burden on physicians.^10,18,19

* Based on a literature review of 13 studies investigating nosocomial rotavirus infections. The number of nosocomial rotavirus patients was calculated as a percentage of the total number of patients discharged with a diagnosis of rotavirus diarrhea. Among the 13 studies, this percentage ranged from 14-51% (median 32%).

Worldwide Statistics

Worldwide, rotavirus mortality is significant, particularly in developing countries. It may be implicated in as many as 600,000 deaths each year.²³

In a country like Canada, rotavirus is a major cause of hospitalizations, responsible for up to an estimated 7,000 hospitalizations (Credibility Interval: 4,200-7,000), up to 56,000 physician visits (95% Credibility Interval: 27,000-56,000), and up to 27,000 emergency room visits (95% Credibility Interval: 9,000-27,000), but relatively few deaths.

It was responsible for up to 78% of hospitalized cases of gastroenteritis among children in two studies conducted in Canada.^1,16,**,***

** This study tested stool samples from 565 children <5 years of age hospitalized for gastroenteritis between December 1999 and May 2000 in seven community and specialized hospitals in Quebec.

*** Data from the Pediatric Rotavirus Epidemiology Study for Immunization (PRESI) study, a prospective, multisite cohort study. Data were collected between November 1997 and June 1998 in 18 hospitals serving the Toronto region. Hospitalization data obtained from 1638 children <5 years of age who were hospitalized for diarrhea, and prospective, centralized testing of their stools was performed.