Influenza virus detection in the stool of children with acute gastroenteritis

Jianling Xie, Xiao Li Pang, Gillian A.M. Tarr, Yuan Mu, Ran Zhuo, Linda Chui, Bonita E. Lee, Otto G. Vanderkooi, Phillip I. Tarr, Samina Ali, Shannon E. MacDonald, Stephen B. Freedman

Research output: Contribution to journalArticlepeer-review


Objectives: To determine if the clinical characteristics of children with gastroenteritis and influenza identified in their stool differ from those whose stool was influenza-negative. Methods: Children <18-years with gastroenteritis whose stool tested negative for enteropathogen were tested for influenza in stool. The clinical features between influenza-positive and influenza-negative gastroenteritis cases were compared. Stools from controls without infection were also tested for influenza. Results: Among the 440 gastroenteritis cases, those who were influenza test-positive were older [median age 4.0 (IQR: 2.3, 5.5) vs. 1.5 (IQR: 0.5, 4.0) years; P = 0.008], more likely to present in fall or winter (92.3 % vs. 48.0 %; P = 0.001), be febrile (84.6 % vs. 30.6 %; P < 0.001), have respiratory symptoms (91.7 % vs. 44.8 %; P = 0.002), have dehydration [median Clinical Dehydration Scale score: 4 (IQR: 1.5, 4.5) vs. 2 (IQR: 0, 3); P = 0.034], and have higher Modified Vesikari Scale scores [median: 13 (IQR: 10.5, 14.0) vs. 10 (IQR: 9.0, 13.0); P = 0.044], than those who tested negative. Thirteen gastroenteritis cases (13/440; 3.0 %) including one child without respiratory symptoms vs. one control (1/250; 0.4 %) were influenza stool positive. Conclusions: Fever, respiratory symptoms, more severe illness, and older age were more common in children with gastroenteritis with influenza detected in stool, compared to those tested negative

Original languageEnglish (US)
Article number104565
JournalJournal of Clinical Virology
StatePublished - Oct 2020
Externally publishedYes

Bibliographical note

Funding Information:
This research was supported by APPETITE , which is funded by a grant from the Alberta Innovates–Health Solutions Team Collaborative Research Innovation Opportunity . APPETITE is also supported by the Alberta Children’s Hospital Research Institute (Calgary, AB, Canada) and the Women and Children’s Health Research Institute (Edmonton, AB, Canada) , through a Partnership Award. S.B.F was supported by the Alberta Children’s Hospital Foundation Professorship in Child Health and Wellness . P.I.T was supported by grant number NIH P30DK052574 (Digestive Diseases Research Core Center). G.A.M.T. was supported by a Canadian Institutes of Health Research Banting Postdoctoral Fellowship , Alberta Innovates Health Programs Postgraduate Fellowship , and University of Calgary Eyes High Postdoctoral Fellowship . The Pediatric Emergency Medicine Research Associate Program (PEMRAP) is supported by a grant from the Alberta Children’s Hospital Foundation .


  • Enteropathogens
  • Gastroenteritis
  • Influenza
  • Pediatrics
  • Reverse transcriptase- quantitative polymerase chain reaction

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

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