The Burden of Rotavirus Gastroenteritis among Japanese Children during Its Peak Months: an Internet Survey.
ABSTRACT 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.
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ABSTRACT: Rotavirus is a major cause of severe gastroenteritis in children <5 years of age worldwide, and two, live attenuated rotavirus vaccines are globally available. As rotavirus vaccines are introduced into national immunization programs, there is an increasing need to monitor circulating wild-type strains. However, few studies have systematically examined their full genotype constellation. This study was therefore undertaken to characterize the whole genotype constellation of circulating rotavirus strains in three widely-separated locations in Japan during the 2012 rotavirus season when rotavirus vaccines became available in the country for the first time. Of 107 rotavirus-positive specimens, 50 (46.7%) strains collected from all three locations possessed an unusual G1-P-I2-R2-C2-M2-A2-N2-T2-E2-H2 constellation in which a typical G2P strain appeared to have acquired its two surface protein genes from the most common G1P strain. These G1P double-reassortant strains were shown to possess the 11 genome segments virtually indistinguishable from each other in their nucleotide sequences and phylogenetic lineages except for two strains that underwent further intra-genotype reassortment. Successful spread to and predominance in broad locations across Japan of novel rotavirus strains possessing a genotype constellation that was previously thought not to be preferred suggests unexpected genomic flexibility of the genotype constellation.Infection, genetics and evolution: journal of molecular epidemiology and evolutionary genetics in infectious diseases 08/2014; 28. DOI:10.1016/j.meegid.2014.08.001 · 3.26 Impact Factor