Incidence Of Rotavirus Gastroenteritis Research Articles

Long-term surveillance of rotavirus vaccination after implementation of a national immunization program in Finland (2008–2018)

BackgroundRotavirus (RV) vaccination was included in the Finnish National immunization Program (NIP) in 2009. RotaTeq (RV5) has been used exclusively with a national average vaccination coverage rate (VCR) of > 90%. While previous studies have demonstrated that inpatient rotavirus gastroenteritis (RVGE) admissions declined by as much as 96% in Finnish children ≤ 5 years old following RV vaccination introduction, no study has evaluated long-term protection after vaccination in Finland. In this study, we analyze incidence of hospital outpatient visits and inpatient admissions of gastroenteritis in children up to 7 years of age. MethodsWe first describe the incidence of RVGE, viral gastroenteritis (VGE), and acute gastroenteritis (AGE) for all Finnish children born during 2008–2011. Children were stratified by the year of birth into not-eligible, partially eligible and rotavirus vaccine-eligible (born in 2008, 2009, 2010 and 2011, respectively). Hospital inpatient and outpatient data was collected from the National Care Register for all children from birth until December 31st, 2018. We also studied RVGE incidence during 2014–2017 for children<3 years of age in municipalities with VCRs of 90% and above and municipalities with VCRs below 90%. ResultsRVGE incidence decreased significantly soon after implementation of RV vaccination in the NIP. In vaccine-eligible cohorts, no clear peak incidence in the youngest age groups could be observed, and no RVGE cases were observed beyond 6 years after vaccination, in contrast to vaccine ineligible and partially eligible cohorts. Despite an overall high VCR in Finland, regions with high VCR had lower incidence of RVGE than regions with lower VCR. ConclusionIncidence of RVGE has remained low in all age groups during the 10 years following introduction of RV vaccine in the Finnish NIP. Differences in RVGE incidence were observed in regions with high as compared with lower VCR, highlighting the importance of maintaining high vaccination coverage.

Incidence of Rota Virus Gastroenteritis among Vaccinated and Non-vaccinated Children Less Than Two Years Old in Ramadi City, Iraq

Incidence of Rota Virus Gastroenteritis among Vaccinated and Non-vaccinated Children Less Than Two Years Old in Ramadi City, Iraq

Incidence of Rota Virus Gastroenteritis among Vaccinated and Non-vaccinated Children Less Than Two Years Old in Ramadi City, Iraq.

Incidence of Rota Virus Gastroenteritis among Vaccinated and Non-vaccinated Children Less Than Two Years Old in Ramadi City, Iraq.

THE IMMUNOPROPHYLAXIS OF ROTAVIRUS INFECTIONS IN KRASNODAR

Aim. This research was performed to study the specific immunoprophylaxis of rotavirus infection among child population in Krasnodar.Materials and methods. There was conducted the analysis of 2386 medical records of patients who were immunized against the rotavirus infection by the pentavalent reassortant vaccine "Rotatec" for the period of 2013-2017, the assessment of the incidence of acute intestinal infections (AII) and rotavirus infection among vaccinated and unvaccinated children of the first two years of life as well as a comparative analysis of primary prophylaxis of rotavirus infection with the incidence of rotavirus infection according to data of Rospotrebnadzor for the study period.Results. Coverage of the vaccination against rotavirus infection among children in Krasnodar for the period of 2013−2017 was 5,6 % of the target cohort which is not enough to reduce the incidence of rotavirus gastroenteritis. There was demonstrated the efficacy and safety of rotavirus vaccine. During the study period vaccinated children were 2.5 times less likely to suffer from AII. No cases of rotavirus infection were reported among the vaccinated respondents.Conclusion. The leading role of rotavirus infection in severe forms of acute gastroenteritis in children of the first 5 years of life as well as the high efficiency of vaccine prophylaxis gives hope that vaccination against rotavirus infection will be included in the Russian national calendar of preventive vaccinations everywhere in the nearest future.

Pentavalent rotavirus vaccine (RotaTeq®) in the prevention of rotavirus gastroenteritis: a profile of its use in the EU

RotaTeq® is a three-dose, pentavalent, human-bovine reassortment vaccine, indicated for the prevention of rotavirus gastroenteritis (RVGE) in infants aged 6–32 weeks in the EU. The vaccine solution is given orally and can be administered with a number of common childhood vaccines. In the pivotal REST study, RotaTeq® showed high protective efficacy with respect to reductions in the RVGE incidence and associated hospitalizations or emergency department visits. The effectiveness and impact of the vaccine against RVGE-related healthcare use were demonstrated in several real-world studies. RotaTeq® was generally well tolerated, with no or minimal risk of intussusception.

Decline of rotavirus-coded hospitalizations in children under 5 years: A report from Japan where rotavirus vaccines are self-financed

ObjectivesTo estimate the trend in incidence of rotavirus gastroenteritis (RVGE) hospitalization among children aged <5 years in Japan during pre- and post-vaccine periods (2009–2011 and 2012–2015). Study designThis retrospective observational study used a health insurance claims database (constructed by Japan Medical Data Center Co., Ltd.). Rotavirus vaccine became commercially available in 2011. We analyzed data of all children aged <5 years between January 2009 and December 2015. We estimated the incidence rate (IR) of RVGE hospitalization per 1000 person-years from 2009 to 2015 and incidence rate ratio (IRR) of post-vaccine years compared with the averaged pre-vaccine years. IRs and IRRs were also estimated by age group. Primary analysis was limited to the rotavirus season (January to June) of each year. ResultsThe IR was 6.3–9.3 in pre-vaccine years, 2.3 in 2014, and 3.0 in 2015; the decline was estimated to be 71% in 2014 and 61% in 2015 (p<0.01). By age group, reduction in hospitalizations began in 2013 among children <1 year old, followed by children aged 1 to <5 years in 2014. In the 2014 season, a 65% reduction in RVGE hospitalization was observed in children aged 36 to <60 months, although this age group was unlikely to be vaccinated. ConclusionsA substantial decline of RVGE hospitalization in 2014 and its persistence was observed among children aged <5 years in Japan after introduction of rotavirus vaccine, although not included in the national immunization program. Indirect effects of rotavirus vaccination were suggested in the 2014 season.

ADAPTATION OF HUMAN ROTAVIRUS STRAINS OF GROUP A TO THE REPRODUCTION IN PASSAGED CELL CULTURES.

The incidence of rotavirus gastroenteritis in the world still has no tendency to reduction. The development of an effective vaccine would reduce or, in the future, even defeat this highly contagious dangerous disease. However, both in Russia and abroad there is still no developed technique for adapting and cultivating strains of the human rotavirus A that would stably produce a high "yield" of virus progeny in transplanted culture cells. The phenomenon of gene exchange for the segmented genome of rotavirus was used by foreign researchers to create the rotavirus vaccine using reassortant strains which are the result of joint cultivation of low-titer (1-2·106 virions per ml) human rotavirus strains and rotavirus strains of animals, such as monkey rotavirus SA-11 or Nebraska calf rotavirus diarrhea providing a relatively high "yield" of virus progeny (1·107-1·108). It is clear that such vaccine compositions will not be able to replace a full-fledged vaccine of human rotavirus strains of different serotypes, but they can be used for the time being as a solution to the problem. Ideally, a rotavirus vaccine is needed that includes the full set of G and P serotypes of rotaviruses circulating in the territory of their application. The paper describes an original technique for adaptation and cultivation of human rotaviruses of group A on the culture of transplantable cells developed by the authors. This technique allows 5·108 virions to be obtained per 1 ml of culture fluid. High-titer cultivated strains of human rotavirus that can be used as vaccine strains were obtained, as well as highly-active antigens for the construction of diagnostic test-systems.

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.

Incidence of rotavirus gastroenteritis by age in African, Asian and European children: Relevance for timing of rotavirus vaccination

ABSTRACTVariability in rotavirus gastroenteritis (RVGE) epidemiology can influence the optimal vaccination schedule. We evaluated regional trends in the age of RVGE episodes in low- to middle- versus high-income countries in three continents. We undertook a post-hoc analysis based on efficacy trials of a human rotavirus vaccine (HRV; Rotarix™, GSK Vaccines), in which 1348, 1641, and 5250 healthy infants received a placebo in Europe (NCT00140686), Africa (NCT00241644), and Asia (NCT00197210, NCT00329745). Incidence of any/severe RVGE by age at onset was evaluated by active surveillance over the first two years of life. Severity of RVGE episodes was assessed using the Vesikari-scale. The incidence of any RVGE in Africa was higher than in Europe during the first year of life (≤2.78% vs. ≤2.03% per month), but much lower during the second one (≤0.86% versus ≤2.00% per month). The incidence of severe RVGE in Africa was slightly lower than in Europe during the first year of life. Nevertheless, temporal profiles for the incidence of severe RVGE in Africa and Europe during the first (≤1.00% and ≤1.23% per month) and second (≤0.53% and ≤1.13% per month) years of life were similar to those of any RVGE. Any/severe RVGE incidences peaked at younger ages in Africa vs. Europe. In high-income Asian regions, severe RVGE incidence (≤0.31% per month) remained low during the study. The burden of any RVGE was higher earlier in life in children from low- to middle- compared with high-income countries. Differing rotavirus vaccine schedules are likely warranted to maximize protection in different settings.

Did Large-Scale Vaccination Drive Changes in the Circulating Rotavirus Population in Belgium?

Vaccination can place selective pressures on viral populations, leading to changes in the distribution of strains as viruses evolve to escape immunity from the vaccine. Vaccine-driven strain replacement is a major concern after nationwide rotavirus vaccine introductions. However, the distribution of the predominant rotavirus genotypes varies from year to year in the absence of vaccination, making it difficult to determine what changes can be attributed to the vaccines. To gain insight in the underlying dynamics driving changes in the rotavirus population, we fitted a hierarchy of mathematical models to national and local genotype-specific hospitalization data from Belgium, where large-scale vaccination was introduced in 2006. We estimated that natural- and vaccine-derived immunity was strongest against completely homotypic strains and weakest against fully heterotypic strains, with an intermediate immunity amongst partially heterotypic strains. The predominance of G2P[4] infections in Belgium after vaccine introduction can be explained by a combination of natural genotype fluctuations and weaker natural and vaccine-induced immunity against infection with strains heterotypic to the vaccine, in the absence of significant variation in strain-specific vaccine effectiveness against disease. However, the incidence of rotavirus gastroenteritis is predicted to remain low despite vaccine-driven changes in the distribution of genotypes.

Retrospective Evaluation of the Incidence of Acute Gastroenteritis and Rotavirus Gastroenteritis in Italy

Introduction Acute gastroenteritis (AGE) is one of the most important causes of morbidity and mortality in childhood. Among all the causative agents of AGE, rotavirus (RV) is the most common pathogen. The aim of this study is to estimate the incidence by age group of rotavirus gastroenteritis (RVGE) in children Materials and Methods This was an observational, retrospective, cohort study using the Pedianet database that included all children aged ˂12 years with a diagnosis of AGE or acute diarrhea, and registered on the network during the period from January 2002 to December 2008. Since development of the model was specifically based on data collected during the Rotavirus gastroenteritis Epidemiology and Viral types in Europe Accounting for Losses in Public Health and Society Study (REVEAL study), RVGE estimation was restricted to children aged Results A total of 128,154 children Conclusions The Pedianet database was found to be a useful instrument for collecting information about the number and main features of AGE episodes at the primary care level in Italy. The statistical model presented in this study has proved reliable to predict RV-positive cases. Epidemiological results showed a consistent RVGE incidence from year to year in children less than 5 years old at the primary care level and underlined the persistent contribution of RV infections to the winter workload of Italian FPs.

Budget impact analysis of universal rotavirus vaccination in the Local Health Unit 11 Empoli, Tuscany, Italy.

Rotavirus (RV) infection is the first cause of acute viral gastroenteritis in children under five years of age all over the world; it mainly affects children between six and 24 months of age and can cause serious acute diarrhoea and dehydration. The aim of this study is to perform the budget impact analysis of universal rotavirus vaccination in the Local Health Unit (LHU) 11 Empoli, Tuscany, Italy. An ad hoc mathematical simulation model was developed to evaluate the budget impact analysis of 5-years universal rotavirus vaccination. Particularly, incidence of rotavirus gastroenteritis (RVGE), hospitalizations, nosocomial diarrhoea, medical consultations, prescriptions and accesses to emergency department were taken into account in the analysis. The direct medical costs due to RV diarrhoea and the costs of vaccination campaign were considered as the main outcome measures in the study. The adoption of universal rotavirus vaccination campaign for five years in the LHU 11 Empoli would result in relevant savings due to the health cares avoided. These savings would overlapped the costs of vaccination yet from the second year after the introduction of vaccination. The saving for the Health Service would be 1.5 million Euro after five years of campaign. Universal vaccination against rotavirus results clinically and economically favourable for both the Health Service and the Society perspectives.

Effect of monovalent rotavirus vaccine on rotavirus disease burden and circulating rotavirus strains among children in Morocco.

Rotarix(TM) vaccine was introduced into the National Program of Immunization of Morocco in October 2010, reaching quickly 87% of the target population of children nationally. The incidence of rotavirus gastroenteritis and the prevalence of circulating rotavirus strains has been monitored in three sentinel hospitals since June 2006. The average percentage of rotavirus positive cases among all children under 5 years old hospitalized for gastroenteritis during the pre-vaccine period (2006-2010) was 44%. This percentage dropped to 29%, 15% and 24% in the 3 years post vaccine introduction (2011, 2012 and 2013), which is a decline of 34%, 66%, and 45%, respectively. Declines in prevalence were greatest among children 0-1 years of age (53%) and were most prominent during the winter and autumn rotavirus season. The prevalence of the G2P[4] and G9P[8] genotype sharply increased in the post vaccine period (2011-2013) compared to the previous seasons (2006-2010). Rotavirus vaccines have reduced greatly the number of children hospitalized due to rotavirus infection at the three sentinel hospitals; it is however unclear if the predominance of G2P[4] and G9P[8] genotypes is related to the vaccine introduction, or if this is attributable to normal genotype fluctuations. Continued surveillance will be pivotal to answer this question in the future.

Is there a relationship between rotavirus positive gastroenteritis and ABO blood groups?: a retrospective cohort study.

Rotavirus is the most common cause of severe diarrhea in children. There is only a few clinical studies about the relationship between rotavirus gastroenteritis and ABO blood groups. The aim of this study was to investigate the role of blood groups, if any present, in the incidence of rotavirus gastroenteritis, and the severity of the gastroenteritis. The file records of babies born in our hospital and diagnosed with acute gastroenteritis in their follow up were investigated retrospectively. The study was conducted with 219 (36.3%) rotavirus positive and 383 (63.6%) rotavirus negative patients. The A blood group was detected more commonly in the rotavirus positive group compared to the rotavirus negative group (50.6 vs. 42.2%, p= 0.047). Hospitalization rates of the cases with rotavirus gastroenteritis among children with the A blood group (30.6 vs. 8%, p= 0.001) were significantly higher. Rotavirus gastroenteritis was determined to be more common in children with A blood group. The hospitalization rates of such patients were detected to be higher. Therefore, rotavirus gastroenteritis among children with blood group A should be monitored closely.

¿Existe una relación entre la gastroenteritis rotavirus positivo y los grupos sanguíneos ABO? Estudio retrospectivo de cohorte

Rotavirus is the most common cause of severe diarrhea in children. There is only a few clinical studies about the relationship between rotavirus gastroenteritis and ABO blood groups. The aim of this study was to investigate the role of blood groups, if any present, in the incidence of rotavirus gastroenteritis, and the severity of the gastroenteritis. The file records of babies born in our hospital and diagnosed with acute gastroenteritis in their follow up were investigated retrospectively. The study was conducted with 219 (36.3%) rotavirus positive and 383 (63.6%) rotavirus negative patients. The A blood group was detected more commonly in the rotavirus positive group compared to the rotavirus negative group (50.6 vs. 42.2%, p= 0.047). Hospitalization rates of the cases with rotavirus gastroenteritis among children with the A blood group (30.6 vs. 8%, p= 0.001) were significantly higher. Rotavirus gastroenteritis was determined to be more common in children with A blood group. The hospitalization rates of such patients were detected to be higher. Therefore, rotavirus gastroenteritis among children with blood group A should be monitored closely.

Evaluating the potential risks and benefits of infant rotavirus vaccination in England

Rotarix®, a vaccine for the prevention of gastroenteritis in young children, was introduced in England in July 2013. At around this time, an elevated risk of intussusception (a cause of bowel obstruction) was reported among infants vaccinated in Australia and the USA. A risk-benefit analysis compared potential vaccine-related risks (additional intussusception admissions and deaths) with estimated vaccine benefits (prevented rotavirus general practitioner visits, emergency visits, admissions and deaths) in the 2012 birth cohort. Detailed data from England included the incidence of intussusception events aged <2 years by week of age, the coverage of vaccination aged <2 years by week of age, and the incidence of rotavirus gastroenteritis (RVGE) events aged <5 years by week of age. Recent estimates of vaccine-related risk from Australia were applied during the 1–21 day period after the first and second dose of vaccination. Rotarix® is estimated to cause one additional intussusception admission in every 18,551 vaccinated English infants (5th and 95th percentiles, 6728–93,952), equivalent to 35 (7-98) additional intussusception admissions each year. The vaccine is estimated to prevent three rotavirus deaths, 13,000 rotavirus admissions, 27,000 rotavirus emergency visits and 74,000 rotavirus GP consultations in children aged <5 years, and lead to annual savings of over £11 million, each year. We estimate 375 (136-1900) fewer RVGE admissions for every additional intussusception admission, and 88 (18-852) fewer RVGE deaths for every additional intussusception death. The estimated benefits of Rotarix® vaccination would greatly exceed the potential risk in England.

Efficacy and safety of pentavalent rotavirus vaccine in Japan

Rotavirus is the most common cause of severe gastroenteritis in children under 5 y of age. Estimates of disease burden in Japan suggest that between 26,500 and 78,000 children in this age group need hospitalization each year, resulting in a direct medical cost of 10 to 24 billion Yen. Since being introduced in routine infant immunization schedules in the United States in 2006, the oral live pentavalent rotavirus vaccine RV5 (RotaTeq™) has contributed to dramatic reductions in the incidence of rotavirus gastroenteritis (RVGE) and in health care resource utilization. This was a multicenter, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy and safety of a 3-dose regimen of RV5 in healthy infants, age 6 to 12 weeks, at 32 sites across Japan. The results indicate that RV5 was significantly efficacious in preventing any severity [74.5% (95% confidence interval [CI]: 39.9%, 90.6%; p < 0.001)], moderate-to-severe [80.2% (95% CI: 47.4%, 94.1%)], and severe [100% (95% CI: 55.4%, 100%)] RVGE caused by viruses with serotypes contained in the vaccine. The observed cases of RVGE included rotavirus types G1 (n = 19), G3 (n = 9), G9 (n = 5) and one unspecified G serotype with P1A[8]. No G2 or G4 RVGE cases were observed, and this study was not powered to evaluate efficacy against individual serotypes. RV5 was generally safe and well tolerated in Japanese infants. These results are comparable to those observed in clinical studies conducted in other developed countries. Introduction of the vaccine in Japan may reduce disease burden and associated health care costs.

Vaccination programme: Reducing rotavirus gastroenteritis in children

Rotavirus is the leading cause of gastroenteritis in children living in the UK ( Public Health England (PHE), 2013 ). On 1 July 2013, a live oral rotavirus vaccine, Rotarix (made by GlaxoSmithKline), was introduced into the national routine childhood immunization schedule for all children born on or after 1 May 2013. The programme is expected to reduce the incidence of rotavirus gastroenteritis in young children. This article provides a background to the introduction of the new vaccination programme, discussing the epidemiology and clinical features of rotavirus infection. As a major influence on vaccine uptake is the way in which health professionals communicate with parents and carers, this article highlights key vaccine and programme information for practitioners who promote and advise parents and carers about immunizations.

Descriptive epidemiology of rotavirus infection in a community in North India

In India, rotavirus infections cause the death of 98621 children each year. In urban neighbourhoods in Delhi, children were followed up for 1 year to estimate the incidence of rotavirus gastroenteritis and common genotypes. Infants aged f1 week were enrolled in cohort 1 and infants aged 12 months (up to +14 days) in cohort 2. Fourteen percent (30/210) gastroenteritis episodes were positive for rotavirus. Incidence rates of rotavirus gastroenteritis episodes in the first and second year were 0.18 [95% confidence interval (CI) 0.10–0.27] and 0.14 (95% CI 0.07–0.21) episodes/child-year, respectively. The incidence rate of severe rotavirus gastroenteritis in the first year of life was 0.05 (95% CI 0.01–0.10) episodes/child-year. There were no cases in the second year. The common genotypes detected were G1P[8] (27%) and G9P[4] (23%). That severe rotavirus gastroenteritis is common in the first year of life is relevant for planning efficacy trials.

Our results for five years of rotavirus vaccination

We aimed to evaluate the results of 5 years of rotavirus vaccination experience and compare the effects of monovalent and pentavalent vaccines. This retrospective study included 2345 children vaccinated in a trial that was held between January 2007 and January 2012. Information was obtained on whether the patient was administered the monovalent or pentavalent vaccine, whether he/she had rotavirus gastroenteritis after the vaccination, and whether he/she was treated as an outpatient or an inpatient. This information was obtained from the computer records and, in cases where information was lacking, the families were called to obtain missing details. In all patients with complaints of diarrhea, rotavirus antigen analysis was done with a rapid immunochromatographic stool test. The age range of the children was 3–60 months. Of the patients included in the study, 1270 (54%) were female and 1075 (46%) male. The monovalent vaccine was administered to 1700 (72.5%) children, while the pentavalent vaccine was administered to 645 (27.5%) children. After administration of the vaccine, no major complications were reported. Symptomatic rotavirus gastroenteritis was detected in 4 % of vaccinated children. No patients died due to rotavirus infection. There was no statistically significant difference between the vaccines in terms of the incidence of rotavirus gastroenteritis and the number of children who were hospitalized or received outpatient treatment (P > 0.05). Symptomatic rotavirus gastroenteritis was detected in only 4 % of the vaccinated children in our study. Moreover, there is no significant difference in the protection offered by the monovalent and pentavalent vaccines.