Hydroelectrolytic imbalances in children’s norovirus infection

Abstract

Worldwide, after rotavirus, norovirus (NoV) is the second most important virus that induce diarrheal disease in children and is estimated to be responsible for 17% of acute diarrhea in people of low socioeconomic status. The aim of this study was to establish the prevalence of NoV infection in children admitted to the Emergency Clinical Hospital for Children ,,St. Ioan”. During August to December 2021, NoV isolated from feces, as well as the association of NoV with other viral or bacterial digestive infections was retrospectively evaluated. The paraclinical diagnosis was made with the help of immunochromatographic tests, being supported by the haematological and biochemical tests, as well as with clinical data. For a number of 328 patients hospitalized in the Emergency Clinical Hospital for Children ,,St. Ioan”, 30 patients were positive to NoV, from which 3% also associated infection with Clostridium difficile for GDH-antigen and Toxin A, and 9% presented co-infection with Campylobacter spp. This study highlights the local situation regarding the incidence of Norovirus species, co-infections with Rotavirus and Adenovirus, as well as bacterial co-infections. For children infected with NoV included in the study, changes were found regarding the hydro-electrolytic and acid-base balance, observing losses of electrolytes and bicarbonates (43% of the patients showed decreases in the alkaline reserve, as well as 12% decreases in sodium and 10% had elevated levels of potassium) being associated with water losses suffered depending on the duration and frequency of diarrheal stools, vomiting. Acute diarrheal disease surveillance is an important tool for updating local protocols
and the local strategy for managing these infections.