The Burden of Rotavirus Gastroenteritis among Japanese Children during Its Peak Months: an Internet Survey
Department of Molecular Microbiology and Immunology, Graduate School of Biomedical Sciences, and the Global Center of Excellence, Nagasaki University.Japanese journal of infectious diseases 07/2013; 66(4):269-75. DOI: 10.7883/yoken.66.269
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 · 3.02 Impact Factor
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ABSTRACT: Objectives Rotavirus vaccination has been reimbursed in Belgium since November 2006 with a high uptake (>85%). Economic analyses of the vaccine have been reported, including estimates of indirect cost gain related to the reduction in work absenteeism. The objective of this study was to evaluate the latter parameter using real-life data. Design and setting A simple model estimated the reduction in absent workdays per working mother with a firstborn baby after the introduction of the rotavirus vaccine. Next, data on work absences were retrospectively analysed (from 2003 to 2012) using a database of administrative employees (n=11 600 working women per year) in the City of Antwerp. Observed reductions in absenteeism after the introduction of the vaccine were compared with the results from the model. These reductions would most likely be observed during the epidemic periods of rotavirus (from January to the end of May) for short-duration absences of ≤5 days. We compared data from outside epidemic periods (from June to December), expecting no changes over time prevaccine and postvaccine introduction, as well as with a control group of women aged 30–35 years with no first child. Results Model estimates were 0.73 working days gained per working mother. In the database of the City of Antwerp, we identified a gain of 0.88 working days during the epidemic period, and an accumulated gain of 2.24 days over a 3-year follow-up period. In the control group, no decrease in absenteeism was measured. Giving vaccine access to working mothers resulted in an estimated accumulated net cost gain of €187 per mother. Conclusions Reduction in absenteeism among working mothers was observed during periods of the epidemic after the introduction of the rotavirus vaccine in Belgium. This reduction is in line with estimates of indirect cost gains used in economic evaluations of the rotavirus vaccine. Trial registration number HO-12-12768.BMJ Open 06/2015; 5(6):e007453. DOI:10.1136/bmjopen-2014-007453 · 2.27 Impact Factor
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