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Viral Diarrhea

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Textbook of Pediatric Gastroenterology, Hepatology and Nutrition

Abstract

Diarrhea is the second leading cause of death in children below 5 years of age worldwide. In developing countries, the mortality rate due to acute gastroenteritis is very high with 1 out of 40 children dying because of diarrhea. In industrialized countries, the mortality rate is much lower but acute gastroenteritis accounts for 4 % of hospitalization in children below 5 years of age. Viruses are the most common etiologic agents, with rotavirus and norovirus being the most frequent pathogens. Acute gastroenteritis is generally a self-limiting disease characterized by diarrhea, vomiting, and fever, generally lasting no more than 5 days. Microbiological examination is not helpful in the majority of cases, and it is indicated only in specific circumstances. The severity of acute gastroenteritis is reflected by the degree of dehydration. The first-line treatment is oral rehydration solution. Feeding should be continued if possible. Intravenous rehydration is recommended in case of severe dehydration, failure of oral rehydration, and in the presence of complications. Active treatment of acute gastroenteritis with selected probiotics in adjunct to rehydration is effective in reducing the intensity and duration of symptoms. The incidence of viral diarrhea is very high but could be consistently reduced by rotavirus immunization.

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References

  1. Walker CL, Aryee MJ, Boschi-Pinto C, Black RE. Estimating diarrhea mortality among young children in low and middle income countries. PLoS One. 2012;7:e29151.

    Article  PubMed  Google Scholar 

  2. Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Rudan I, et al. Child Health Epidemiology Reference Group of WHO and UNICEF. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379:2151–61.

    Article  PubMed  Google Scholar 

  3. Fischer-Walker CL, Rudan I, Liu L, Nair H, Theodoratou E, et al. Child Health Epidemiology Reference Group (CHERG). Global burden of childhood pneumonia and diarrhea. Lancet. 2013;381:1405–16.

    Article  Google Scholar 

  4. Kosek M, Bern C, Guerrant RL. The magnitude of the global burden of diarrheal disease, as estimated from studies published between 1992 and 2000. Bull World Health Organ. 2003;81:197–204.

    PubMed Central  PubMed  Google Scholar 

  5. Guarino A, Winter H, Bhupinder S, Quak SH, Lanata C. Acute gastroenteritis disease: report of the FISPGHAN Working Group. J Pediatr Gastroenterol Nutr. 2012;55:621–626.

    Article  PubMed  Google Scholar 

  6. Lanata CF, Fischer-Walker CL, Olascoaga AC, Torres CX, Aryee MJ, Black RE. Child Health Epidemiology Reference Group of the World Health Organization and UNICEF. Global causes of diarrheal disease mortality in children < 5 years of age: a systematic review. PLoS One. 2013;8:e72788.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Parashar UD, Hummelman EG, Bresee JS, Miller MA, Glass RI. Global illness and deaths caused by rotavirus disease in children. Emerg Infect Dis. 2003;9:565–72.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Velázquez FR, Matson DO, Calva JJ Guerrero L, Morrow AL, Carter-Campbell S, et al. Rotavirus infections in infants as protection against subsequent infections. N Engl J Med. 1996;335:1022–8.

    Article  PubMed  Google Scholar 

  9. Centers for Disease Control and Prevention. Rotavirus surveillance—worldwide, 2009. MMWR Morb Mortal Wkly Rep. 2011;60:514–6.

    Google Scholar 

  10. Forster J, Guarino A, Parez N, Moraga F, Román E, Mory O, et al. Rotavirus Study Group. Hospital-based surveillance to estimate the burden of rotavirus gastroenteritis among European children younger than 5 years of age. Pediatrics. 2009;123:393–400.

    Article  Google Scholar 

  11. Tate JE, Burton AH, Tate JE, Burton AH, Boschi-Pinto C, Steele AD, et al. WHO-coordinated global rotavirus surveillance network. 2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12:136–41.

    Article  PubMed  Google Scholar 

  12. Fischer TK, Viboud C, Parashar U, et al. Hospitalizations and deaths from diarrhea and rotavirus among children < 5 years of age in the United States, 1993–2003. J Infect Dis. 2007;195:1117–25.

    Article  PubMed  Google Scholar 

  13. Coffin SE, Elser J, Marchant C, Sawyer M, Pollara B, Fayorsey R, et al. Impact of acute rotavirus gastroenteritis on pediatric outpatient practices in the United States. Pediatr Infect Dis J. 2006;25:584–9.

    Article  PubMed  Google Scholar 

  14. Widdowson MA, Meltzer MI, Zhang X, Bresee JS, Parashar UD, Glass RI. Cost-effectiveness and potential impact of rotavirus vaccination in the United States. Pediatrics. 2007;119:684–97.

    Article  PubMed  Google Scholar 

  15. Denno DM, Shaikh N, Stapp JR, Qin X, Hutter CM, Hoffman V, et al. Diarrhea etiology in a pediatric emergency department: a case control study. Clin Infect Dis. 2012;55:897–904.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Pediatric Rotavirus European Committee (PROTECT). The paediatric burden of rotavirus disease in Europe. Epidemiol Infect. 2006;134:908–16.

    Article  Google Scholar 

  17. Van Damme P, Giaquinto C, Huet F, Gothefors L, Maxwell M, Van der Wielen M, REVEAL Study Group. Multicenter prospective study of the burden of rotavirus acute gastroenteritis in Europe, 2004–2005: the REVEAL study. J Infect Dis. 2007;195:S4–16.

    Article  Google Scholar 

  18. Avendano P, Matson DO, Long J, Whitney S, Matson CC, Pickering LK. Costs associated with office visits for diarrhea in infants and toddlers. Pediatr Infect Dis J. 1993;12:897–902.

    Article  CAS  PubMed  Google Scholar 

  19. Guarino A, Albano F. Viral diarrhea. In: Guandalini S, editor. Textbook of pediatric gastroenterology and nutrition. London: Taylor & Francis; 2004. p. 126–144.

    Google Scholar 

  20. Greenberg HB, Estes MK. Rotaviruses: from pathogenesis to vaccination. Gastroenterology. 2009;136:1939–51.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Hodges K, Gill R. Infectious diarrhea: cellular and molecular mechanisms. Gut Microbes. 2010;1:4–21.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Camilleri, M, Nullens S, Nelsen T. Neuroendocrine and neuronal mechanisms in pathophysiology of acute infectious diarrhea. Dig Dis Sci. 2012;57:19–27.

    Article  CAS  PubMed  Google Scholar 

  23. Istrate C, Hagbom M, Vikström E, Magnusson KE, Svensson L. Rotavirus infection increases intestinal motility but not permeability at the onset of diarrhoea. J Virol. 2014;88(6):3161–9.

    Article  PubMed Central  PubMed  Google Scholar 

  24. De Marco G, Bracale I, Buccigrossi V, Bruzzese E, Canani RB, Polito G, et al. Rotavirus induces a biphasic enterotoxic and cytotoxic response in human-derived intestinal enterocytes, which is inhibited by human immunoglobulins. J Infect Dis. 2009;200:813–19.

    Article  CAS  PubMed  Google Scholar 

  25. Guarino A, Albano F, Ashkenazi S, Gendrel D, Hoekstra JH, Shamir R, et al. ESPGHAN/ESPID evidence-based guidelines for the management of acute gastroenteritis in children in Europe Expert Working Group. European Society for paediatric gastroenterology, hepatology and nutrition/European Society for paediatric infectious disease evidence-based guidelines for the management of acute gastroenteritis in children in Europe. J Pediatr Gastroenterol Nutr. 2008;46:S81–184.

    Article  PubMed  Google Scholar 

  26. Fontana M, Zuin G, Paccagnini S, Ceriani R, Quaranta S, Villa M, et al. Simple clinical score and laboratory-based method to predict bacterial etiology of acute diarrhea in childhood. Pediatr Infect Dis J. 1987;6:1088–91.

    Article  CAS  PubMed  Google Scholar 

  27. Finkelstein JA, Schwartz JS, Torrey S, Fleisher GR. Common clinical features as predictors of bacterial diarrhea in infants. Am J Emerg Med. 1989;7:469–73.

    Article  CAS  PubMed  Google Scholar 

  28. Patteau G, Stheneur C, Chevallier B, Parez N. Benign afebrile seizures in rotavirus gastroenteritis. Arch Pediatr. 2010;17:1527–30.

    Article  CAS  PubMed  Google Scholar 

  29. Chan CM, Chan CW, Ma CK, Chan HB. Norovirus as cause of benign convulsion associated with gastro-enteritis. J Paediatr Child Health. 2011;47:373–7.

    Article  PubMed  Google Scholar 

  30. Shai S, Perez-Becker R, von König CH, von Kries R, Heininger U, Forster J, et al. Rotavirus disease in Germany—a prospective survey of very severe cases. Pediatr Infect Dis J. 2013;32:e62–7.

    Article  PubMed  Google Scholar 

  31. Ansaldi F, Lai P, Valle L, Riente R, Durando P, Sticchi L, et al. Paediatric Leghorn Group. Burden of rotavirus-associated and non-rotavirus-associated diarrhea among nonhospitalized individuals in central Italy: a 1-year sentinel-based epidemiological and virological surveillance. Clin Infect Dis. 2008;46:e5155.

    Article  Google Scholar 

  32. Kaiser P, Borte M, Zimmer KP, Huppertz HI. Complications in hospitalized children with acute gastroenteritis caused by rotavirus: a retrospective analysis. Eur J Pediatr. 2012;171:337–45.

    Article  PubMed  Google Scholar 

  33. Wiegering V, Kaiser J, Tappe D, Weissbrich B, Morbach H, Girschick HJ. Gastroenteritis in childhood: a retrospective study of 650 hospitalized pediatric patients. Int J Infet Dis. 2011;15:e401–7.

    Article  Google Scholar 

  34. Narkeviciute I, Tamusauskaite I. Peculiarities of norovirus and rotavirus infections in hospitalized young children. J Ped Gastroenterol Nutr. 2008;46:289–92

    Article  Google Scholar 

  35. Payne DC, Staat MA, Edwards KM, Szilagyi PG, Gentsch JR, Stockman LJ, et al. Active, population-based surveillance for severe rotavirus gastroenteritis in children in the United States. Pediatrics. 2008;122:1235–43.

    Article  PubMed  Google Scholar 

  36. Santos N, Hoshino Y. Global distribution of rotavirus serotypes/genotypes and its implication for the development and implementation of an effective rotavirus vaccine. Rev Med Virol. 2005;15:29–56.

    Article  PubMed  Google Scholar 

  37. Guarino A, Lo Vecchio A, Berni Canani R. Chronic diarrhoea in children. Best Pract Res Clin Gastroenterol. 2012;26:649–61.

    Article  PubMed  Google Scholar 

  38. Linhares AC, Verstraeten T, Wolleswinkel-van den Bosch J, Clemens R, Breuer T. Rotavirus serotype G9 is associated with more-severe disease in Latin America. Clin Infect Dis. 2006;43:312–4.

    Article  CAS  PubMed  Google Scholar 

  39. Page N, Esona M, Armah G, Nyangao J, Mwenda J, Sebunya T, et al. Emergence and characterization of serotype G9 rotavirus strains from Africa. J Infect Dis. 2010;202:S55–63.

    Article  PubMed  Google Scholar 

  40. Seheri M, Nemarude L, Peenze I, Netshifhefhe L, Nyaga MM, Ngobeni HG, et al. Update of rotavirus strains circulating in Africa from 2007 through 2011. Pediatr Infect Dis J. 2014;33:S76–84.

    Article  PubMed  Google Scholar 

  41. Mwenda JM, Tate JE, Steele AD, Parashar UD. Preparing for the scale-up of rotavirus vaccine introduction in Africa: establishing surveillance platforms to monitor disease burden and vaccine impact. Pediatr Infect Dis J. 2014;33:S1–5.

    Article  PubMed  Google Scholar 

  42. Bruijning-Verhagen P, Quach C, Bonten M. Nosocomial rotavirus infections: a meta-analysis. Pediatrics. 2012;129:e1011–9.

    Article  PubMed  Google Scholar 

  43. Festini F, Cocchi P, Mambretti D, Tagliabue B, Carotti M, Ciofi D, Biermann KP, et al. Nosocomial rotavirus gastroenteritis in pediatric patients: a multi-center prospective cohort study. BMC Infect Dis. 2010;10:235.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Staat MA, Azimi PH, Berke T, Roberts N, Bernstein DI, Ward RL, et al. Clinical presentations of rotavirus infection among hospitalized children. Pediatr Infect Dis J. 2002;21:221–7.

    Article  PubMed  Google Scholar 

  45. Lopman B. Noroviruses: simple detection for complex epidemiology. Clin Infect Dis. 2006;42:970–1.

    Article  PubMed  Google Scholar 

  46. Glass RI, Noel J, Ando T, Fankhauser R, Belliot G, Mounts A, et al. The epidemiology of enteric caliciviruses from humans: a reassessment using new diagnostics. J Infect Dis. 2000;181:S254–61.

    Article  PubMed  Google Scholar 

  47. Widdowson MA, Monroe SS, Glass RI. Are noroviruses emerging? Emerg Infect Dis. 2005;11:735–7.

    Article  PubMed Central  PubMed  Google Scholar 

  48. Amar CF, East CL, Gray J, Iturriza-Gomara M, Maclure EA, McLauchlin J. Detection by PCR of eight groups of enteric pathogens in 4627 faecal samples: re-examination of the English case control Infectious Intestinal Disease Study (1993–1996). Eur J Clin Microbiol Infect Dis. 2007;26:311–23.

    Article  CAS  PubMed  Google Scholar 

  49. Lopman BA, Reacher MH, Vipond IB, Hill D, Perry C, Halladay T, Brown DW, et al. Epidemiology and cost of nosocomial gastroenteritis, Avon, England, 2002–2003. Emerg Infect Dis. 2004;10:1827–34.

    Article  PubMed Central  PubMed  Google Scholar 

  50. Lopman BA, Reacher MH, Vipond IB, Sarangi J, Brown DW. Clinical manifestation of norovirus gastroenteritis in health care settings. Clin Infect Dis. 2004;39:318–24.

    Article  PubMed  Google Scholar 

  51. Zheng D-P, Ando T, Fankhauser RL, Beard RS, Glass RI, Monroe SS. Norovirus classification and proposed strain nomenclature. Virology 2006;346:312–23.

    Article  CAS  PubMed  Google Scholar 

  52. Cheetham S, Souza M, Meulia T, Grimes S, Han MG, Saif LJ. Pathogenesis of a genogroup II human norovirus in gnotobiotic pigs. J Virol. 2006;80:10372–81.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  53. Troeger H, Loddenkemper C, Schneider T, Schreier E, Epple HJ, Zeitz M, et al. Structural and functional changes of the duodenum in human norovirus infection. Gut. 2009;58:1070–7.

    Article  CAS  PubMed  Google Scholar 

  54. Ettayebi K, Hardy ME. Norwalk virus nonstructural protein p48 forms a complex with the SNARE regulator VAP-A and prevents cell surface expression of vesicular stomatitis virus G protein. J Virol. 2003;7:11790–7.

    Article  Google Scholar 

  55. Hillenbrand B, Günzel D, Richter JF, Höhne M, Schreier E, Schulzke JD, et al. Norovirus non-structural protein p20 leads to impaired restitution of epithelial defects by inhibition of actin cytoskeleton remodelling. Scand J Gastroenterol. 2010;45:1307–19.

    Article  CAS  PubMed  Google Scholar 

  56. Elftman MD, Gonzalez-Hernandez MB, Kamada N, Perkins C, Henderson KS, Núñez G, et al. Multiple effects of dendritic cell depletion on murine norovirus infection. J Gen Virol. 2013;94:1761–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  57. Kim YG, Park JH, Reimer T, Baker DP, Kawai T, Kumar H, et al. Viral infection augments Nod1/2 signaling to potentiate lethality associated with secondary bacterial infections. Cell Host Microbe. 2011;9:496–507.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  58. McFadden N, Bailey D, Carrara G, Benson A, Chaudhry Y, Shortland A, Heeney J, et al. Norovirus regulation of the innate immune response and apoptosis occurs via the product of the alternative open reading frame 4. PLoS Pathog. 2011;7:e1002413.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  59. Nelson AM, Walk ST, Taube S, Taniuchi M, Houpt ER, Wobus CE, et al. Disruption of the human gut microbiota following Norovirus infection. PLoS One. 2012;7:e48224.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  60. Buccigrossi V, Nicastro E, Guarino A. Functions of intestinal microflora in children. Curr Opin Gastroenterol. 2013;29:31–8.

    Article  PubMed  Google Scholar 

  61. Baert L, Uyttendaele M, Stals A, VAN Coillie E, Dierick K, Debevere J, Botteldoorn N, et al. Reported foodborne outbreaks due to noroviruses in Belgium: the link between food and patient investigations in an international context. Epidemiol Infect. 2009;137:316–25.

    Article  CAS  PubMed  Google Scholar 

  62. Harris JP, Edmunds WJ, Pebody R, Brown DW, Lopman BA. Deaths from norovirus among the elderly, England and Wales. Emerg Infect Dis. 2008;14:1546–5.

    Article  PubMed Central  PubMed  Google Scholar 

  63. Abugalia M, Cuevas L, Kirby A, Dove W, Nakagomi O, Nakagomi T, Kara M, et al. Clinical features and molecular epidemiology of rotavirus and norovirus infections in Libyan children. J Med Virol. 2011;83:1849–56.

    Article  PubMed  Google Scholar 

  64. Kawada J, Arai N, Nishimura N, Suzuki M, Ohta R, Ozaki T, et al. Clinical characteristics of norovirus gastroenteritis among hospitalized children in Japan. Microbiol Immunol. 2012;56:756–9.

    Article  CAS  PubMed  Google Scholar 

  65. Junquera CG, de Baranda CS, Mialdea OG, Serrano EB, Sánchez-Fauquier A. Prevalence and clinical characteristics of norovirus gastroenteritis among hospitalized children in Spain. Pediatr Infect Dis J. 2009;28:604–7.

    Article  PubMed  Google Scholar 

  66. Gonzalez-Galan V, Sa´nchez-Fauqier A, Obando I, Montero V, Fernandez M, Torres MJ, et al. High prevalence of community-acquired norovirus gastroenteritis among hospitalized children: a prospective study. Clin Microbiol Infect. 2011;17:1895–99.

    Article  CAS  PubMed  Google Scholar 

  67. Bailey B, Gravel J, Goldman RD, Friedman JN, Parkin PC. External validation of the clinical dehydration scale for children with acute gastroenteritis. Acad Emerg Med. 2010;17(6):583–8. doi:10.1111/j.1553–2712.2010.00767.x.

    Article  PubMed  Google Scholar 

  68. MacGillivray S, Fahey T, McGuire W. Lactose avoidance for young children with acute diarrhoea. Cochrane Database Syst Rev. 2013;10:CD005433.

    PubMed  Google Scholar 

  69. Bruzzese E, Lo Vecchio A, Guarino A. Hospital management of children with acute gastroenteritis. Curr Opin Gastroenterol. 2013;29:23–30.

    Article  PubMed  Google Scholar 

  70. Szajewska H, Skórka A, Ruszczyński M, Gieruszczak-Białek D. Meta-analysis: Lactobacillus GG for treating acute gastroenteritis in children—updated analysis of randomised controlled trials. Aliment Pharmacol Ther. 2013;38:467–76.

    Article  CAS  PubMed  Google Scholar 

  71. Szajewska H, Skórka A, Dylag M. Meta-analysis: Saccharomyces boulardii for treating acute diarrhoea in children. Aliment Pharmacol Ther. 2007;25:257–64.

    Article  CAS  PubMed  Google Scholar 

  72. Guarino A, Lo Vecchio A, Canani RB. Probiotics as prevention and treatment for diarrhea. Curr Opin Gastroenterol. 2009;25:18–23.

    Article  PubMed  Google Scholar 

  73. Guandalini S. Probiotics for prevention and treatment of diarrhea. J Clin Gastroenterol. 2011;45:S149–53.

    Article  PubMed  Google Scholar 

  74. Lehert P, Cheron G, Calatayud GA, Cézard JP, Castrellón PG, Garcia JM, et al. Racecadotril for childhood gastroenteritis: an individual patient data meta-analysis. Dig Liver Dis. 2011;43:707–13.

    Article  CAS  PubMed  Google Scholar 

  75. Ruiz-Palacios GM, Perez-Schael I, Velazquez FR, Abate H, Breuer T, Clemens SC, et al. Human rotavirus vaccine study group. Safety and efficacy of an attenuated vaccine against severe rotavirus gastroenteritis. N Engl J Med. 2006;354:11–22.

    Article  CAS  PubMed  Google Scholar 

  76. Vesikari T, Matson DO, Dennehy P, Van Damme P, Santosham M, Rodriguez Z, et al. Rotavirus Efficacy and Safety Trial (REST) Study Team. Safety and efficacy of a pentavalent human–bovine (WC3) reassortant rotavirus vaccine. N Engl J Med. 2006;354:23–33.

    Article  CAS  PubMed  Google Scholar 

  77. Phua KB, Lim FS, Lau YL, Nelson EA, Huang LM, Quak SH, et al. Safety and efficacy of human rotavirus vaccine during the first 2 years of life in Asian infants: randomised, double-blind, controlled study. Vaccine 2009;27:5936–41.

    Article  CAS  PubMed  Google Scholar 

  78. Armah GE, Sow SO, Breiman RF, Dallas MJ, Tapia MD, Feikin DR, et al. Efficacy of pentavalent rotavirus vaccine against severe rotavirus gastroenteritis in infants in developing countries in sub-Saharan Africa: a randomised, double-blind, placebo-controlled trial. Lancet. 2010;376:606–14.

    Article  CAS  PubMed  Google Scholar 

  79. Zaman K, Dang DA, Victor JC, Shin S, Yunus M, Dallas MJ, et al. Efficacy of pentavalent rotavirus vaccine against severe rotavirus gastroenteritis in infants in developing countries in Asia: a randomised, double-blind, placebo-controlled trial. Lancet. 2010;376:615–23.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Translation Medical Science, Section of Pediatrics, University of Naples “Federico II”, Via S. Pansini 5, 80131, Naples, Italy

    Alfredo Guarino & Eugenia Bruzzese

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  1. Alfredo Guarino
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  2. Eugenia Bruzzese
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Correspondence to Alfredo Guarino .

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Editors and Affiliations

  1. Department of Pediatrics, University of Chicago, Chicago, Illinois, USA

    Stefano Guandalini

  2. Clinical Director Child Health King’s College Hospital, Professor and Director Pediatric Liver, GI and Nutrition Center, London, United Kingdom

    Anil Dhawan

  3. Department of Pediatrics, Hebrew University Hadassah Hospital, Jerusalem, Israel

    David Branski

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Guarino, A., Bruzzese, E. (2016). Viral Diarrhea. In: Guandalini, S., Dhawan, A., Branski, D. (eds) Textbook of Pediatric Gastroenterology, Hepatology and Nutrition. Springer, Cham. https://doi.org/10.1007/978-3-319-17169-2_14

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