Burden Of Rotavirus Gastroenteritis Research Articles

Acute Gastroenteritis in Children Below 5Years of Age at Tirupati, Andhra Pradesh, India Post Introduction of Rotavirus Vaccine into National Immunization Programme.

To identify the burden of rotavirus acute gastroenteritis (AGE) and the genotypes presenting in the authors' area in the period after introduction of rotavirus vaccine in Universal Immunization Programme (UIP). Children aged less than 5 y and presenting to hospital for the treatment of AGE were enrolled into the study from January 2016 to June 2019. Clinical details including age, gender, extent of illness, number of stools, concomitant vomiting and fever, grade of dehydration, and associated illness were recorded. Stool samples were tested for rotavirus using a commercially available ELISA Kit. Genotyping was performed for the rotavirus antigen-positive samples. Rotavirus positive AGE was seen in 14.2% of the children. High burden of rotavirus gastroenteritis was seen in the age group of 6-23 mo and more cases were observed from December to February months. In our region the prevalent rotavirus genotypes in positive samples are G3 and G1 in G-typing, P[8] and P[4] in P-typing, respectively. G3P[8] and G1P[8] are the most prevalent genotypes identified in our area with a frequency of 35.1% and 25.9%, respectively. Almost all the cases (97.7%) got discharged and only one patient has died. The findings conclude a declining trend in the rotavirus positive AGE cases in the authors' area after introduction of Rotavac vaccine in the UIP.

Detection and characterization of rotavirus G and P types from children with acute gastroenteritis in Qom, central Iran.

The aim of the study is to estimate the burden of Rotavirus gastroenteritis as well as predominant genotypes of Rotavirus among children less than 5 years of age referring to Pediatric University Hospital in Qom, Iran. Gastroenteritis is the fourth most common cause of death and accounts for 16% of all deaths in children <5 years of age worldwide. During two years, 130 patients referring to a pediatric hospital were enrolled in this study. After RNA extraction, Rotaviruses were detected by the VP6 gene. Then, G-typing (G1, G2, G3, G4, G8, G9, and G12) and P-typing (P4, P6, and P8) were performed using RT-PCR and specific primers. The results of the PCR revealed that from a total of 130 patients, 22 cases (16.9%) showed positive VP6 by RT-PCR. G1was mostly thepredominant serotype (27%),accounting for 22% of all VP7-positive isolates, followed by G9 (18%), G2 (9%), G3 (9%), and G4 (9%). None of the strains revealed the presence of G8 genotype (0%), and 5 specimens (23%)were non-typable. The frequency of P typing was P8 (50%), P6 (23%), P4 (14%), and 3 samples were P-non-typable (13%), respectively. The dominant G-P combination was G1 [8] (32%). Such studies based on typing methods assists in the Rotavirus vaccine introduction by policymakers and design of new effective vaccines.

Knowledge of rotavirus gastroenteritis and its current preventive strategies in children, among healthcare providers in Ilorin, North-Central Nigeria

Context: Rotavirus is a leading cause of severe gastroenteritis in children aged less than 5 years. Healthcare providers are responsible for implementing strategies for control of rotavirus gastroenteritis. Aims: To determine knowledge of healthcare providers regarding rotavirus gastroenteritis, its burden, management, and prevention. Materials and Methods: The study was a crosssectional descriptive survey of healthcare providers working in facilities caring for children. A selfadministered questionnaire was given to subjects containing questions on demographics and knowledge covering burden of rotavirus gastroenteritis, modes of transmission, age of occurrence, prevention, and rotavirus vaccines. Statistical analysis used: Data analysis was carried out with SPSS version 20. Results: Questionnaires were issued to 75 participants of which 65 (response rate = 86.7%) returned filled questionnaires. Majority (70.8%) of the subjects were females. Subjects included medical doctors (33.8%), nurses (32.3%), community health extension workers (27.7%), and laboratory scientists (4.6%). Most [39, 60.0%] subjects identified rotavirus as the commonest cause of diarrhea and only 21 (32.3%) indicated rotavirus contributed over 30% to the burden of diarrhea in these children. Fecooral route was recognized as a route of transmission by most subjects (95.4%) and 67.7% identified vaccination as a modality for prevention. Only six (9.2%) respondents could name any rotavirus vaccine. None of the demographic or occupational characteristics of the subjects was significantly related to awareness of effective rotavirus vaccines (all P > 0.05). Conclusions: Healthcare providers were aware of rotavirus as a cause of gastroenteritis in underfive children but most had poor understanding regarding its burden, prevention, and existing vaccines.

Epidemiology and economic losses of rotavirus infection associated with hospitalization of Armenian children.

Rotavirus (RV) is the leading cause of severe diarrhea-associated morbidity and mortality among children worldwide. Limited data exist on the epidemiology and burden of rotavirus gastroenteritis in Armenia. The purpose of this study is to estimate the economic losses and describe the epidemiological characteristics of rotavirus infections in hospitalized children in Armenia. A retrospective chart review was performed of all children (aged < 5 years) with Rotavirus infection admitted to the "Nork" Republican Infection Clinical Hospital in Yerevan, the capital of Armenia, between January and July 2014. Criteria of inclusion were age under 5 years old and presence of RV antigen in stool by enzyme linked immunosorbent assay. The total number of patients was 126; average age was 28.7 ± 13.3 months; 54.8% were male. The highest number of cases (31.8%) was observed in April. Most of the patients (71.4%) were hospitalized in the first three days, demonstrating an acute onset of the disease. In total 19% of the patients had received RV vaccine and, despite this, were infected with RV. Based on bacteriological examination of stool, 18.3% of patients had RV infection combined with pathogenic or conditional pathogenic microflora. All patients spent 817 days in total in the hospital. Economic losses associated with hospitalization were 16340000 AMD (≈ 33346 USD). Rotavirus carries significant morbidity and economic losses. Comprehensive estimates of the disease characteristics and introduction of a national immunization program against RV initiated in 2012 may decrease this burden. Further studies to evaluate the feasibility and cost-effectiveness of such a program are warranted.

The effectiveness of rotavirus vaccine and its impact on demographic characteristics for children in Babylon city, Iraq

Gastroenteritis caused by rotavirus infection is one of the major healthcare problem affecting millions of children all over the world. WHO has recommended vaccine against rotavirus to be involved in the national immunisation programmes. In Iraq, rotavirus vaccine has been started since 2012 and in the current study, we aimed to estimate the effectiveness of rotavirus vaccine in Babylon city, Iraq. Faecal samples were obtained from children presented with diarrhoea during the period beginning in October 2016 until August 2017. The age range was 6-60 months and history of rotavirus vaccine was checked. Latex test for detection of Rotavirus analysed specimens. We examined 349 children with diarrhoea; the rotavirus antigen was detected in 169 faecal specimens from children with diarrhoea (48%). For those who are infected with rotavirus antigen, 44 (26%) were previously vaccinated against rotavirus and 125 (74%) were not. These results indicated that children who did not receive rotavirus vaccination have 4.679 folds increased the risk of having positive rotavirus antigen infected diarrhoea. Furthermore, low percentages of vaccinated children with positive rotavirus antigens detected in their stool were seen in most age groups except for those between 25–36 months with no gender differences. Additionally, more percentages were in the urban area and artificial feedings. The effectiveness of rotavirus vaccine, in the present study, has been confirmed in reducing the burden of rotavirus gastroenteritis in young children in Babylon city, Iraq. However, huge effort needs to be done in order to have more children received rotavirus vaccine.

Economic assessment of rotavirus vaccination in Saudi Arabia.

In the Kingdom of Saudi Arabia (KSA), rotavirus universal mass vaccination has been introduced in 2013, however, there is limited information available on the economic benefit and the epidemiological impact of the programme to date. We used a Markov cohort model to evaluate and compare the economic value of rotavirus vaccination with no vaccination in a birth cohort of 562,428 infants. This lifetime analysis considered the societal perspective. Model input was obtained through consensus of local experts after two rounds of evaluation of the proposed estimates. The primary outcome measure was to assess cost-effectiveness and to define the cost-neutrality level reached by comparing vaccination with no vaccination as a function of the price adjustment of the vaccination course. With an assumed vaccine coverage rate of 96%, the already started rotavirus vaccination is expected to reduce the overall burden of rotavirus gastroenteritis by 65% with model exercise, over lifetime. The maximum impact will be seen in rotavirus gastroenteritis-related hospitalizations (93%). Outpatient and emergency visits are shown to decline by 87% each while the occurrence of nosocomial infections, by 78%. Cost neutrality is reached if the vaccine price per course is less than SAR 178.20 at steady state. Rotavirus vaccination should be recommended in KSA given the important clinical impact the vaccine can have and the good value for money it can obtain.

Predominance of unusual rotavirus G1P[6] strain in North India: An evidence from hospitalized children and adult diarrheal patients

Group A Rotavirus remains the leading cause of gastroenteritis in children and accounts for 0.2 million fatalities each year; out of which, approximately 47,100 deaths occur in India. In adults also, rotavirus is reported to be responsible for diarrhea severe enough to require hospitalizations. India has recently introduced rotavirus vaccine in the Universal Immunization Programme and Himachal Pradesh became the first Indian state to implement this project. This study is an attempt to provide the pre-vaccination data on rotavirus gastroenteritis burden and circulating genotypes in Himachal Pradesh, India. A total of 607 faecal specimens (247 children ≤5years, 50 older children and 310 adults) from hospitalized diarrheal patients from Himachal Pradesh, India were screened for rotavirus using ELISA and RT-PCR. The positive samples were further G/P genotyped using semi-nested PCR. Rotavirus was detected in 25.2% and 28.3% of samples with ELISA and RT-PCR, respectively. In children, rotavirus frequency was significantly high with positivity in 49.0% cases whereas 14.0% adult samples have rotavirus in them. Genotyping of the positive samples revealed predominance of G1 (66.0%) and P[6] (66.7%) genotypes. The most common G and P combination was G1P[6] (62.8%) followed by G1P[8] (16.5%), G9P[6] (7.4%) and G12P[6] (5.0%). Molecular analysis reveals the belonging of P[6] strains in Lineage 1a. This pre-vaccination data on rotavirus prevalence and diversity would be helpful for assessing the affect of vaccination on the disease burden and its comparison with post-vaccination data of circulating genotypes would help in studying the effect on diversity of rotavirus strains possibly due to vaccine selection pressure.

Multicenter prospective study on the burden of rotavirus gastroenteritis in children less than 3years of age in Spain.

BackgroundRotavirus is acknowledged as an important cause of paediatric gastroenteritis worldwide. In Spain, comprehensive data on the burden of rotavirus disease was lacking.MethodsA prospective, multicenter, observational study was carried out, during the winter season, from October to April 2014 in selected areas of Spain (Catalonia, Basque Country, Andalusia) to estimate the frequency and characteristics of acute gastroenteritis (AGE) and rotavirus gastroenteritis (RVGE) in children ≤3 years of age seeking medical care in primary care and emergency department centres.ResultsOf the 1087 episodes of AGE registered, 33.89 % were RVGE positive. The estimated incidence of RVGE, was 40.3 (95 % CI 36.1–44.8) episodes per 10,000 child-months in children ≤ 3 years of age and the 5-month (December-April) seasonal RVGE incidence rate was 2.01 [1.81–2.24] per 100 children. No vaccination and attending a day care centre were the main risk factors for RV infection. RVGE infected children presented more frequently with fever (63.9 % vs. 45.1 %, p = 0.009), vomiting (61.2 % vs. 44.3 %, p = 0.015), suffered more dehydration, and were hospitalised and went to the emergency room more often (41.7 % vs. 15.7 %, p <0.001) than non-RVGE infected ones. Children were usually more tired (77.5 % vs. 54.2 %, p <0.001), tearful, (47.2 % vs. 34.8 %, p <0.001), and easily irritated (76.5 % vs. 59.8 %, p <0.001), and parents were more concerned (41.7 % vs. 15.7 %, p <0.001) and suffered more working rhythm disturbances (39.0 % vs. 22.9 %, p <0.001). The cost for families of RVGE cases was significantly higher than the cost of non-RVGE infected ones (47.3 vs 36.7 euros, p = 0.011). Vaccinated children suffered less clinical symptoms and no hospitalization. Therefore, vaccination decreases the psychosocial stressors caused by the disease in the family.ConclusionsRotavirus infections are responsible for a substantial proportion of AGE cases in children ≤3 years of age in Spain attended at primary care visits. RVGE episodes are associated with greater clinical severity, greater alterations in the child´s behaviour, and higher parental distress. The outcomes of the present study recommend that routine rotavirus vaccination in infants ≤3 years of age could considerably reduce the serious burden of this potentially serious childhood disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1890-7) contains supplementary material, which is available to authorized users.

Burden of Rotavirus Gastroenteritis in the Pediatric Emergency Service

Burden of Rotavirus Gastroenteritis in the Pediatric Emergency Service

Çocuk Acil Servisinde Rotavirus Gastroenteritlerinin Yükü

Çocuk Acil Servisinde Rotavirus Gastroenteritlerinin Yükü

Hospital bed occupancy for rotavirus and all cause acute gastroenteritis in two Finnish hospitals before and after the implementation of the national rotavirus vaccination program with RotaTeq®.

BackgroundVaccination-impact studies of the live-attenuated pentavalent oral vaccine Rotateq® have demonstrated that the burden of rotavirus gastroenteritis has been reduced significantly after the introduction of RotaTeq® vaccination, but less is known about the benefit of this vaccination on hospital overcrowding.MethodsAs part of an observational surveillance conducted during the RV seasons 2000/2001 to 2011/2012, we analysed hospital discharge data collected retrospectively from two Finnish hospitals (Oulu and Tampere), concerning ICD 10 codes A00-09 (acute gastroenteritis, AGE) and A08.0 (rotaviral acute gastroenteritis RV AGE). We estimated the reduction in the number of beds occupied and analysed the bed occupancy rate, for RV AGE and all cause AGE, among 0–16 year-old children, before and after the implementation of the RV immunisation program.ResultsThe rate of bed days occupied for RV AGE was reduced by 86% (95% CI 66%-94%) in Tampere and 79% (95% CI 47%-92%) in Oulu after RV vaccination implementation. For all cause AGE, reduction was 50% (95% CI 29% to 65%) in Tampere and 70% (95% CI 58% to 79%) in Oulu. Results were similar among 0–2 year-old children. This effect was also observed on overcrowding in both hospitals, with a bed occupancy rate for all cause AGE >25% in only 1% of the time in Tampere and 9% in Oulu after the implementation of the immunisation program, compared to 13% and 48% in the pre-vaccination period respectively. After extrapolation to the whole country, the annual number of prevented hospitalizations for all cause AGE in the post-vaccination period in Finland was estimated at 1,646 and 2,303 admissions for 0–2 and 0–16 year-old children respectively.ConclusionsThis study demonstrated that universal RV vaccination is associated with a clear decrease in the number of bed days and occupancy rates for RV AGE and all cause AGE. Positive consequences include increase in quality of care and a better healthcare management during winter epidemics.

Cost Analysis of Rotaviral Treatment in Libyan Public Hospitals

Limited data exist on economics burden of rotavirus gastroenteritis in Libya. Aim of this study is to perform cost analysis of rotavirus diseasein Libya. Cost analysis of rotavirus disease in Libya. A prospective cross sectional study was conducted among rotavirus children aged below five years from August 2012to April 2013 at three public hospitals in Libya. The cost of rotavirus treatment from the hospital and patients perspective for hospatalized and ambulatory case. A total of 311 patients were enrolled in this study of these 239 cases were inpatients while 72 cases were outpatient.The average treatment cost of a hospitalized rotavirus episode was US$66.7.76 and out of this US$480.36(72%) was by the hospital,while US$187.40 (28%) by the patient. The average cost of treatment for ambulatory rotavirus case was US$166.34, of which US$120.02(72%) was from hospital cost and US$46.32(28%) from patient's cost. These costs for inpatient and outpatient were during the whole treatment period. Hospital and patient's cost of rotavirus treatment showed the disease posed a considerable economic burden on Libyan government and facilities. Applying preventive measures would be more appropriate such as introducing rotavirus immunization to reduce the disease.

Çocuk Acil Servisinde Rotavirus Gastroenteritlerinin Yükü

Çocuk Acil Servisinde Rotavirus Gastroenteritlerinin Yükü

Rotavirus gastroenteritis among children less than 5 years of age in private outpatient setting in urban India

Burden of rotavirus gastroenteritis (RVGE) in outpatient setting in India is not fully understood. A prospective study was undertaken to describe RVGE among Indian children less than 5 years of age presenting in outpatient departments with acute gastroenteritis (AGE). This study was conducted at 11 outpatient departments (OPDs) of private pediatric clinics in urban areas of India. A total of 605 eligible children were enrolled at OPDs. Stool samples of the subjects were collected and tested for presence of rotavirus antigen by enzyme immune assay (EIA) and were typed by reverse-transcriptase polymerase chain reaction (RT-PCR). Physician examined the children and documented the disease particulars. In addition, parents/guardians were interviewed for AGE related symptoms, health care utilization and cost incurred due to AGE, and parental stress associated with AGE. After OPD, parents/guardians completed diary cards and questionnaires to capture the information for 14 days following the enrollment.Complete data for analysis including stool sample results was available from 552 subjects. 23% (127/552; [CI 19.5, 26.5]) of stool samples were rotavirus (RV) positive. RT-PCR was done for 85.8% (109/127) of RV positive samples. G1, G2, G9, and G12 types were identified in 34.9% (38/109), 37.6% (41/109), 8.3% (9/109), and 6.4% (7/109) stool samples, respectively. P[4] and P[8] were identified in 36.7% (40/109) stool samples each, followed by P[6] identified in 15.6% (17/109) stool samples.At the time of enrollment, all three symptoms (vomiting, diarrhea, and fever) were observed concurrently in higher proportion of RV positive subjects compared to RV negative subjects (60.6% [77/127] vs. 42.8% [182/425], p=0.0004). Healthcare resource utilization, costs incurred due to disease, and parental stress were higher for RV positive subjects compared to RV negative subjects.In conclusion, RVGE was found to be a definite burden in AGE cases attending pediatric outpatient clinics in urban areas and it was associated with substantial economic and psychological burden. Introduction of rotavirus vaccine in India may help in reducing this disease burden.

Burden of rotavirus gastroenteritis in children

ObjectivesThis study describes the epidemiology of rotavirus (RV) gastroenteritis (GE) disease following the introduction of RV vaccination in Greece in 2006.DesignA prospective hospital-based surveillance.SettingA multicentre study was conducted at six...

RE: The burden of Rotavirus gastroenteritis among hospitalized pediatric patients in a tertiary referral hospital in Jeddah

lettersRE: The burden of Rotavirus gastroenteritis among hospitalized pediatric patients in a tertiary referral hospital in Jeddah Mahmood Dhahir Al-Mendalawi Mahmood Dhahir Al-Mendalawi Search for more papers by this author Published Online:5 Dec 2013https://doi.org/10.5144/0256-4947.2013.634SectionsPDF ToolsAdd to favoritesDownload citationTrack citations ShareShare onFacebookTwitterLinked InRedditEmail AboutIntroductionTo the Editor: I have 2 comments on the interesting paper by Afifi and Nabiha.1First, despite the implementation of Rotavirus (RV) vaccine in Saudi Arabia in 2006, the prevalence of RV gastroenteritis (RVGE) (42.9%) reported by Afifi and Nabiha1 is still worrisome. I presume that that the worrying prevalence can be attributed to the following 2 points: (1) Saudi pediatric population is not yet completely covered with RV vaccine. This is obvious on noticing that only 2.3% of the studied RV positive GE and 6.1% of the studied RV negative GE received RV vaccine (Table 1).1 (2) It is obvious that temporal and spatial fluctuations in the genotype distribution of human RV are continuously observed worldwide in surveillance studies. New genotypes, such as G9 and G12, have emerged and spread worldwide in a very short time span. In addition, reassortment events have the potential to contribute substantially to genetic diversity among human and animal RV.2 Recent data on the molecular epidemiology of RVGE in Saudi children are scarce. Kheyami3 addressed the distribution of G and P types of RV circulating in the population of Saudi Arabia and demonstrated the presence of serotypes G1-G4, G9, G12, P [4], P [6], and P [8]. However, Obeid4 in his study found that subgroup I (serotype 2) constituted 5.4% of the isolates in comparison to 56.7% for subgroup II (serotypes 1, 3, and 4), whereas 37.8% were nontypeable. Regular surveillance and characterization of RV are, therefore, warranted to confirm RV genotype fluctuations. This, in turn, might partly explain the prevalence of RVGE in Saudi children compared to other viruses. It also helps identify unusual types that could be incorporated into future RV vaccines.Second, Norovirus (NV) is currently recognized as one of the emerging viruses causing infection in humans. It is the leading cause of the outbreaks of viral GE worldwide. In children, NV plays an increasing and important role in enteric infection, apart from RV, especially in the post-RV vaccine era.5 Afifi and Nabiha1 categorized their studied GE cases into 4 groups: RV infection alone (33.6%), adenovirus (AV) infection alone (7%), combined RV and AV infection (9.3%), and other causes of GE (50.2%). I wonder whether they detected the cases of NVGE in their studied cohort and probably included them within the latter group. This is critical to comment that NVGE shares many characteristics of RVGE, namely similar clinical presentation, significant morbidity, mortality and economic burden, and the need for regular molecular and genetic surveillance of the circulating virus.ARTICLE REFERENCES:1. Afifi R, Nabiha M. "The burden of Rotavirus gastroenteritis among hospitalized pediatric patients in a tertiary referral hospital in Jeddah" . Ann Saudi Med. 2013; 33:241-6. Google Scholar2. Matthijnssens J, Bilcke J, Ciarlet M, Martella V, Bányai K, Rahman M, et al. "Rotavirus disease and vaccination: impact on genotype diversity" . Future Microbiol. 2009; 4:1303-16. Google Scholar3. Kheyami AM. "Rotavirus gastroenteritis and strain diversity in Saudi Arabia. Current status and future prospects" . Saudi Med J. 2010; 31:276-9. Google Scholar4. Obeid OE. "Characterization of human rotavirus subgroups and serotypes in children under five with acute gastroenteritis in a Saudi Hospital" . Family Community Med. 2011; 18:22-5. Google Scholar5. Chen SY, Chiu CH. "Worldwide molecular epidemiology of norovirus infection" . Paediatr Int Child Health. 2012; 32:128-31. Google Scholar Previous article Next article FiguresReferencesRelatedDetails Volume 33, Issue 6November-December 2013 Metrics History Published online5 December 2013 InformationCopyright © 2013, Annals of Saudi MedicineThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.PDF download

RE: The burden of Rotavirus gastroenteritis among hospitalized pediatric patients in a tertiary referral hospital in Jeddah.

RE: The burden of Rotavirus gastroenteritis among hospitalized pediatric patients in a tertiary referral hospital in Jeddah.

Rotavirus Vaccination in Central Europe

Each year, rotavirus (RV) infection is the leading cause of acute gastroenteritis requiring hospitalisation and of nosocomially transmitted diseases in children younger than 5 years across Central European Vaccination Awareness Group (CEVAG) countries; however, inadequate surveillance systems and lack of routine RV testing still exist in most CEVAG countries, making it difficult to accurately assess the present burden of acute RV gastroenteritis in the younger population. Furthermore, routine immunisation of infants with RV vaccines has not been implemented, and no official and uniform recommendations exist in most of the countries in these territories. The present study provides CEVAG country-specific estimates of the disease burden of RV gastroenteritis among the youngest population and presents evidence-based advice on the use of RV vaccines in the region, while providing a framework for vaccination at the national level.

The Burden of Rotavirus Gastroenteritis among Japanese Children during Its Peak Months: an Internet Survey

Rotavirus gastroenteritis (RVGE) is one of the most common early childhood diseases; however, little information exists on the frequency of RVGE attacks during peak epidemic months and the subsequent clinical consequences in Japanese children. Therefore, we conducted a nationwide internet survey that targeted mothers whose children recently experienced an episode of RVGE or influenza from January 2011 to April 2011. Data concerning the incidence and clinical consequences of RVGE and influenza among 15,137 children aged <3 years were collected. Of these, 1,286 children who experienced an RVGE episode and 1,487 children who experienced an influenza episode visited a physician or required hospital admission. Data analysis of 867 RVGE episodes and 897 influenza episodes found that 25% of children with RVGE required 8-14 days for recovery, 28% received intravenous rehydration, 7% were hospitalized, 15% visited an emergency department, 70% sought medical interventions ≥2 times, and 32% sought medical intervention ≥3 times. Compared with influenza, RVGE required a longer recovery period, and was associated with more frequent episodes of intravenous rehydration, hospitalization, and emergency department and physician visits. Our results indicate that, like influenza, RVGE occurring during peak epidemic months in children aged <3 years imposes a substantial burden on families and medical institutions in Japan.

Epidemiology and prospects for prevention of rotavirus disease in India

With rotavirus vaccines now available globally, it will be useful to assemble the available evidence on the epidemiology and burden of rotavirus gastroenteritis in India, in order to weigh the urgency of introducing a vaccine to help control rotavirus disease. We reviewed published studies on rotavirus infection and genotype distribution in India, as well as safety and immunogenicity studies of currently available vaccines. PubMed was searched for papers published after 1990, and several authors who are experts in the field recommended papers of known significance. Rotavirus accounts for close to 40% of hospitalizations for diarrhea in India, with more recent studies showing an increased proportion compared with older studies. There is substantial serotype diversity in India, although there is less intra-country variation than previously thought. Two genotypes, G1P[8] and G2P[4], account for roughly 50% of symptomatic infections in non-neonates. Currently licensed vaccines are safe, and although the efficacy appears lower in developing countries, given the extremely high incidence of diarrhea these could still be cost-effective interventions. The epidemiology and burden of rotavirus diarrhea is fairly well characterized in India. Introducing rotavirus vaccine into the UIP, along with adequate surveillance, should be an important part of efforts to reduce diarrhea mortality, the third leading cause of death among Indian children, and achieve the country's MDG goals.