Abstract
Rotaviruses are a major cause of acute gastroenteritis in infants and young children worldwide and in many other mammalian and avian host species. Since 2006, two live-attenuated rotavirus vaccines, Rotarix® and RotaTeq®, have been licensed in >100 countries and are applied as part of extended program of vaccination (EPI) schemes of childhood vaccinations. Whereas the vaccines have been highly effective in high-income countries, they were shown to be considerably less potent in low- and middle-income countries. Rotavirus-associated disease was still the cause of death in >200,000 children of <5 years of age worldwide in 2013, and the mortality is concentrated in countries of sub-Saharan Africa and S.E. Asia. Various factors that have been identified or suggested as being involved in the differences of rotavirus vaccine effectiveness are reviewed here. Recognition of these factors will help to achieve gradual worldwide improvement of rotavirus vaccine effectiveness.
Highlights
Rotaviruses (RVs) were discovered as a major cause of acute gastroenteritis (AGE) in infants and young children worldwide more than 40 years ago [1,2] and were recognized as pathogenic agents in many mammalian and avian species [3]
The viral genome, the RNA-dependent RNA polymerase (VP1) and the capping enzyme (VP3) are surrounded by an inner protein layer (VP2), forming a core. This in turn is surrounded by an intermediate layer (VP6), to form a dual-layered particle (DLP), and the DLP gains an outer layer, consisting of the VP7 protein and the spike-forming VP4, to become a triple-layered particle (TLP), the infectious virion [3,4] (Figure 1)
NSP4, which is inserted into the endoplasmic reticulum (ER), where it serves as an intracellular receptor as an intracellular receptor mediating of acts
Summary
Rotaviruses (RVs) were discovered as a major cause of acute gastroenteritis (AGE) in infants and young children worldwide more than 40 years ago [1,2] and were recognized as pathogenic agents in many mammalian and avian species [3]. While UMV against RV disease has been highly effective (80–90%—preventing severe RV-associated disease) in high income countries [3,4], their efficacy and effectiveness is much lower (40–60%) in low- and middle-income countries [5,6,7]. RV-associated disease still caused the death of over 200,000 children of
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