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Congenital infections 

Congenital infections
Chapter:
Congenital infections
DOI:
10.1093/med/9780198729228.003.0011
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date: 17 November 2019

Acute gastroenteritis remains a major cause of morbidity and mortality in children under the age of 5 years, with an overwhelming burden of mortality in developing settings. Rotavirus remains the single most important cause of severe diarrhoea and dehydration, with norovirus recognized as the next commonest pathogen. Clostridium difficile has emerged as an important nosocomial pathogen in childhood. Molecular assays are helping to identify roles for a wider range of viral pathogens in diarrhoea, helping to reduce the proportion of cases where no pathogen is identified. Hygiene and sanitation interventions have some efficacy in reducing faecal–oral transmission but appear less effective in reducing viral gastroenteritis. Oral rehydration therapy is highly effective in treating acute gastroenteritis. Rotavirus vaccines have proven effective in reducing mortality due to acute diarrhoeal dehydration in developing settings, but further improvements are needed to improve access to vaccination and efficacy in developing settings. A small increased risk of intussusception has been associated with rotavirus vaccination;however, the benefits of rotavirus vaccination heavily outweigh this risk in all settings tested.

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