What is the most common viral cause of diarrhea with its ICD-10 (International Classification of Diseases, 10th Revision) code?

Most Common Viral Cause of Diarrhea with ICD-10 Code

Rotavirus is the most common viral cause of severe diarrhea among children with ICD-10 code A08.0, while norovirus (ICD-10 code A08.1) is the most common viral cause of gastroenteritis outbreaks among adults. 1, 2

Viral Causes of Diarrhea by Population

Children

• Rotavirus remains the leading cause of severe diarrhea in children under 5 years of age, causing approximately 3.5 million cases annually in the United States 1
• Peak incidence of rotavirus occurs among children 6 months to 2 years of age 1, 2
• By age 4, most children have been infected with rotavirus and developed immunity to severe disease 1
• Since the introduction of rotavirus vaccines, norovirus has emerged as a leading cause of viral gastroenteritis in children in the United States 1, 3

Adults

• Norovirus is the most common viral cause of gastroenteritis outbreaks among adults 1, 2
• Norovirus accounts for 58% of foodborne illness in the United States, exceeding Salmonella (11%) 1
• While norovirus causes more illness, Salmonella exceeds norovirus as a cause of hospitalization (35% vs 28%) and death (28% vs 11%) 1

Clinical Characteristics of Major Viral Causes

Rotavirus (ICD-10: A08.0)

• Incubation period: approximately 2 days 1
• Clinical presentation: vomiting for 3 days followed by watery diarrhea for 3-8 days 1
• Associated symptoms: fever and abdominal pain 1
• Seasonality: concentrated in cooler months (October-April) in the United States 1
• Transmission: primarily person-to-person; highly infectious with as few as 10 viral particles needed for infection in children 1

Norovirus (ICD-10: A08.1)

• Incubation period: 24-48 hours 2
• Clinical presentation: acute onset of vomiting, watery diarrhea, abdominal cramps 2, 4
• Duration: 12-60 hours 2
• Transmission: highly contagious through person-to-person contact, contaminated food/water, aerosols from vomitus, and environmental surfaces 2, 4

Other Important Viral Causes

• Enteric adenoviruses (ICD-10: A08.2): primarily serotypes 40 and 41, contributing to 5-20% of hospitalizations for childhood diarrhea 1, 2
• Astrovirus (ICD-10: A08.3): accounts for approximately 3-5% of hospitalizations for diarrhea in children 1, 5
• Calicivirus (ICD-10: A08.4): affects approximately 3% of children hospitalized for diarrhea 1

Diagnostic Considerations

• Molecular techniques have transformed understanding of viral gastroenteritis burden 4, 3
• Multiplex reverse transcriptase PCR allows simultaneous detection of multiple viral pathogens 6
• Most acute diarrhea episodes in previously healthy, immunocompetent people are self-resolving and of viral or unknown etiology 1

Clinical Pearls and Pitfalls

• Laboratory investigation is generally not warranted for most cases of acute diarrhea in healthy individuals as most are self-limiting 1
• The burden of rotavirus has been significantly reduced since implementation of rotavirus vaccines, but it remains an important pathogen globally 1, 3
• Both symptomatic and asymptomatic norovirus infections are common, complicating control efforts 4
• Viral gastroenteritis in immunocompromised patients may be more severe, prolonged, or relapsing 1

Prevention

• Proper handwashing with soap and water for at least 20 seconds is essential 2
• Disinfection of contaminated surfaces with chlorine bleach solution is necessary 2
• Exclusion of ill food handlers until 48-72 hours after symptom resolution 2
• Rotavirus vaccination has significantly reduced the burden of rotavirus disease 1