Objective  To examine the distribution of viral pathogens among child outpatients with acute diarrhea and to provide evidences for developing targeted strategies on the prevention and management of viral diarrhea.

  Methods  We collected fecal specimens among children visiting the internal medicine outpatient of Shanghai Children′s Hospital for medication of acute diarrhea successively for one of every 15 attendees from May 2015 to December 2018. Nucleic acid of norovirus (NoV) and rotavirus (RV), enteric adenovirus (EAdV), Sapovirus (SaV), and astrovirus (AstV) were detected with real-time reverse transcriptase PCR (RT-PCR) for all the specimens.

  Results  A total of 1 041 fecal specimens of children with diarrhea were detected. The total detection rate of the viral nucleic acid was 26.0%. The detection rate of NoV was the highest (11.0%), followed by RV (6.7%), and the detection rates of EAdV, SaV, and AstV were 3.7%, 3.7%, and 2.9%, respectively. The detection rate of NoV was the highest among the diarrheic children aged 1 – 4 years; the detection rate of RV did not differ significantly by the age of the diarrheic children but the detection rate of AstV tended to increase with age. The detection rate of EAdV was higher among the children in kindergartens and schools than among those living scattered. The detection rate of viral pathogens was higher among the diarrheic children visiting the outpatient clinic during January – March and October – December than during other seasons in a year.

  Conclusion  Among child outpatients with acute diarrhea, Nov is the most frequently detected virus; the detection rates of NoV, EAdV, SaV, and AstV differ significantly by age and the detection rates of NoV, RV, and AstV vary in different seasons.