Abstract
The EuroRotaNet surveillance network has conducted rotavirus genotype surveillance since 2007 in 16 European countries. Using epidemiological and microbiological data from 39,786 genotyped rotavirus-positive specimens collected between September 2007 and August 2013, we assessed genotype distribution and age distribution of rotavirus gastroenteritis (RVGE) cases in and out of peak season in 12 countries which were yet to implement routine rotavirus vaccination. In multinomial multivariate logistic regression, adjusting for year, country and age, the odds of infection caused by genotype-constellation 2 DS-1-like stains (adjusted multinomial odds ratio (aM-OR) = 1.25; 95% confidence interval (CI): 1.13-1.37; p < 0.001), mixed or untypable genotypes (aM-OR = 1.55; 95% CI: 1.40-1.72; p < 0.001) and less common genotypes (aM-OR = 2.11; 95% CI:1.78-2.51; p < 0.001) increased out of season relative to G1P[8]. Age varied significantly between seasons; the proportion of RVGE cases younger than 12 months in the United Kingdom increased from 34% in season to 39% out of season (aM-OR = 1.66; 95% CI: 1.20-2.30), and the proportion five years and older increased from 9% in season to 17% out of season (aM-OR = 2.53; 95% CI: 1.67-3.82). This study provides further understanding of the rotavirus ecology before vaccine introduction, which will help interpret epidemiological changes in countries introducing or expanding rotavirus vaccination programmes.
Highlights
Rotavirus is the most common cause of acute gastroenteritis in children under five years of age, causing an estimated 450,000 deaths per year worldwide, with over 90% of deaths occurring in developing countries [1]
There are eight groups of rotaviruses defined by the middle capsid antigen [4]; the majority of rotavirus gastroenteritis (RVGE) in humans is caused by group A rotaviruses
This study shows that rotavirus genotype distribution in Europe is variable and that most countries included in this study experience variation in genotypes typed from specimens collected during the peak rotavirus season compared with the out-of-season periods
Summary
Rotavirus is the most common cause of acute gastroenteritis in children under five years of age, causing an estimated 450,000 deaths per year worldwide, with over 90% of deaths occurring in developing countries [1]. There are eight groups of rotaviruses defined by the middle capsid antigen [4]; the majority of rotavirus gastroenteritis (RVGE) in humans is caused by group A rotaviruses. Group A rotavirus genotypes are typically further classified into G and P types, based on sequence diversity of the genes encoding the outer viral proteins VP7 (glycoprotein) and VP4 (protease-sensitive protein), respectively [5]. Whole genome sequencing has allowed rotavirus strains to be classified into genotype constellations based on a common genomic backbone in which the genotypes of nine of the 11 genes are conserved, while G and P types may vary. Human rotaviruses typically belong to the Wa-like or the DS-1-like genotype constellations [6]
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