Epidemiological, clinical and laboratorial features of rotavirus infection in older children and adults: a multicenter hospital-based study in east China

BACKGROUND: Rotavirus (RV) is a leading cause of infectious gastroenteritis and associated deaths worldwide, imposing a substantial disease burden in China. This study aimed to describe the epidemiological characteristics, clinical manifestations and dominant genotypes of rotavirus infection in Zhejiang Province and evaluated risk factors for severe RV-associated diarrhea. METHODS: A prospective study was conducted on patients with acute gastroenteritis (AGE) from multicenter hospitals in Zhejiang Province between 2023 and 2024. Relevant information was collected through epidemiological questionnaires and electronic medical records. Fecal samples were collected to detect pathogens and G/P serotypes. RESULTS: A total of 4,810 RV-infected patients were enrolled, including 75.95% aged 0–59 months, 22.56% aged 5–14 years, 0.95% aged 15–64 years and 0.54% aged ≥ 65 years. The gender distribution showed a slight male predominance. Regionally, Hangzhou had the highest number of cases (60.35%), while seasonally, spring was the peak period (65.09%), followed by winter (22.41%). Epidemiologically, the 5–14 years group had the highest per capita gross domestic product (GDP) in their residential areas, while the ≥ 65 years group had the highest average air temperature and the lowest relative humidity (P0.05). Regarding the severe rotavirus diarrhea analysis, 39.23% had severe diarrhea and 60.77% had non-severe diarrhea. Severe cases were characterized by longer durations of diarrhea and vomiting, higher frequencies of diarrhea and vomiting within 24 hours, and a higher proportion of high fever compared to non-severe cases (P