Abstract
BackgroundAcute gastroenteritis (AGE) is a major reason for presentation to pediatric primary emergency medical centers. Because rotavirus vaccines were introduced in November 2011 for voluntary vaccination in Japan, we analyzed the changes in the numbers of AGE patients.MethodsThe number and proportion of patients visiting Kobe children’s primary emergency medical center from January 2011 to February 2015 due to AGE, out of all visiting children, were investigated retrospectively. The rotavirus and norovirus epidemic periods were defined as the periods from March to June and from November to February, respectively, based on their disease prevalence.ResultsIn patients ≤2 years of age, the numbers and proportions of patients with AGE were significantly decreased from 2464/14098 (17%) in 2011 to 1888/12321 (15%) in 2014 (p < 0.01). In patients ≤2 and 3–5 years of age, significant decreases in AGE patients between 2011 and 2014 were observed during the rotavirus season (from 20% [1090/5329] to 14% [642/4482] in patients aged ≤2 years and from 23% [704/3047] to 20% [572/2807] in patients aged 3–5 years, p < 0.01 and p < 0.05, respectively), but not during the norovirus season (from 19% [834/4436] to 19% [797/4160] in patients aged ≤2 years and from 20% [679/3334] to 25% [710/2852] in patients aged 3–5 years).ConclusionsThe estimated rotavirus vaccine coverage in our area increased from 1% in 2011 to 49% in 2014; this coverage may have resulted in a reduction in AGE patients, both directly and indirectly, in our Japanese children’s primary emergency medical center.
Highlights
Acute gastroenteritis (AGE) is a major reason for presentation to pediatric primary emergency medical centers
The AGE patients were identified from the medical database based on the diagnosis of AGE, and the numbers of AGE patients in the full season, rotavirus season, and norovirus season were calculated from 2011 to 2014
The proportion of AGE patients was significantly decreased from 17.4% in 2011 to 15.3% in 2014 (p < 0.01), but not in 2012 (20.3%) or 2013 (16.9%)
Summary
Acute gastroenteritis (AGE) is a major reason for presentation to pediatric primary emergency medical centers. From many countries where the rotavirus vaccine has already been introduced, the direct effects thereof have been reported, including reduced numbers of pediatric AGE patients requiring hospitalization, outpatient visits, and emergency department visits [6,7,8,9,10,11,12,13,14]. A live attenuated monovalent human rotavirus vaccine (RotarixTM: GlaxoSmithKline Biologicals, Rixensart, Belgium) and a pentavalent human-bovine reassortant rotavirus vaccine (RotaTeqTM: Merck & Co., Inc., New Jerzy, USA) were introduced for voluntary vaccination in Japan in November 2011 and July 2012, respectively. The direct and indirect effects of this vaccine have not yet been studied in a children’s primary emergency medical center, which is a unique Japanese medical service system
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