Outbreak of acute gastroenteritis in young children with death due to rotavirus genotype G9 in Rio Branco, Brazilian Amazon region, 2005

This study was supported by federal funds from the National Council for Scientific and Technological Development (CNPq; grants 303539/2004–6 and 303475/2005–6), Oswaldo Cruz Institute– FIOCRUZ.Ministry of Health. Secretariat of Health Surveillance. Field Epidemiology Training Program. Brasília, DF, Brazil.Ministry of Health. Secretariat of Health Surveillance. Field Epidemiology Training Program. Brasília, DF, Brazil.Ministry of Health. Secretariat of Health Surveillance. Field Epidemiology Training Program. Brasília, DF, Brazil.Ministry of Health. Secretariat of Health Surveillance. Field Epidemiology Training Program. Brasília, DF, Brazil.Ministry of Health. Secretariat of Health Surveillance. Field Epidemiology Training Program. Brasília, DF, Brazil / Ministry of Health. Secretariat of Health Surveillance. Waterborne and Foodborne Infectious Diseases Coordination. Brasília, DF, Brazil.Ministry of Health. Secretariat of Health Surveillance. Field Epidemiology Training Program. Brasília, DF, Brazil / Ministry of Health. Secretariat of Health Surveillance. Waterborne and Foodborne Infectious Diseases Coordination. Brasília, DF, Brazil.Ministry of Health. Secretariat of Health Surveillance. Field Epidemiology Training Program. Brasília, DF, Brazil.Ministry of Health. Secretariat of Health Surveillance. Waterborne and Foodborne Infectious Diseases Coordination. Brasília, DF, Brazil.Acre State Secretariat of Health. Department of Epidemiological Surveillance. Rio Branco, AC, Brazil.Acre State Secretariat of Health. Department of Epidemiological Surveillance. Rio Branco, AC, Brazil.Ministry of Health. Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Comparative Virology. Rio de Janeiro, RJ, Brazil.Ministry of Health. Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Comparative Virology. Rio de Janeiro, RJ, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministry of Health. Secretariat of Health Surveillance. Public Health Laboratory Network. Brasília, DF, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministry of Health. Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Comparative Virology. Rio de Janeiro, RJ, Brazil.Ministry of Health. Secretariat of Health Surveillance. Field Epidemiology Training Program. Brasília, DF, Brazil / Ministry of Health. Oswaldo Cruz Foundation. Gonçalo Moniz Institute. Salvador, BA, Brazil.Ministry of Health. Secretariat of Health Surveillance. Field Epidemiology Training Program. Brasília, DF, Brazil / Centers for Disease Control and Prevention. Coordinating Office for Global Health. Division of Global Public Health Capacity Development. Atlanta, Georgia, USA.An epidemic of acute gastroenteritis occurred in Rio Branco City, Acre State, in Brazil's Amazon region in 2005. An investigation was conducted to confirm the etiology and identify possible risk factors for death. Methods: Rio Branco municipality surveillance data for the period May to October 2005 were reviewed. In a caseûcontrol study, children who died following acute gastroenteritis were compared to age-matched controls with acute gastroenteritis who survived. Rotavirus A (RV-A) was investigated in 799 stool samples and genotyped by reverse transcription polymerase chain reaction (RT-PCR). Results: The cumulative incidence of diarrhea in children aged 5 years was 21 percent. A fatal outcome was significantly associated with uncovered household water storage containers. RV-A was identified in 88 percent of samples and G9 was the prevalent genotype (71 percent). Conclusions: Oral rehydration solution and boiling or chlorinating drinking water likely limited mortality. This epidemic was caused by RV-A genotype G9. After the outbreak, a rotavirus vaccine was introduced into the official childhood immunization schedule in Brazil