Impact of rotavirus vaccination on hospital-acquired rotavirus gastroenteritis in children.
ABSTRACT Data show that after the implementation of routine rotavirus vaccination for infants in the United States, community-acquired (CA) rotavirus cases declined substantially in the 2007-2008 season. The impact of community-based rotavirus vaccination on the substantial burden of hospital-acquired (HA) rotavirus has not been documented.
We assessed CA and HA rotavirus, respiratory syncytial virus, and influenza infections at Children's Memorial Hospital for 5 winter seasons (defined as occurring from September through May) from 2003 to 2008. We also report rotavirus data from the 2008-2009 season.
A similar dramatic decline (>60% compared with the median of previous seasons) occurred in the rates of cases of both CA (P < .0001) rotavirus hospitalizations and HA (P < .01) rotavirus infections in the 2007-2008 season compared with previous seasons, whereas the rates of CA and HA influenza and respiratory syncytial virus, respectively, remained stable. Improvements in hand-hygiene compliance did not correlate with a reduction in the transmission rate of rotavirus in the hospital. Both CA and HA rotavirus rates remained much lower in the 2008-2009 than in the 2003-2007 seasons.
Community-based rotavirus vaccination is associated with a substantial reduction in the number of children who are admitted with rotavirus. These data also indicate that routine community-based rotavirus infant vaccination protects hospitalized children from acquiring rotavirus. Vaccination efforts should be encouraged as a strategy to affect the substantial burden of HA rotavirus.
- SourceAvailable from: Venkata Raghava Mohan[Show abstract] [Hide abstract]
ABSTRACT: Rotavirus vaccines are being introduced in several low- and middle-income countries across the world with and without support from the GAVI Alliance. India has the highest disease burden of rotavirus based on morbidity and mortality estimates and several indigenous vaccine manufacturers are developing rotavirus vaccines. One candidate has undergone phase III testing and others have completed evaluation in phase II. Global data on licensed vaccine performance in terms of impact on disease, strain diversity, safety and cost-effectiveness has been reviewed to provide a framework for decision making in India.Vaccine 08/2014; 32:A171–A178. · 3.49 Impact Factor
Article: Rotaviruses.[Show abstract] [Hide abstract]
ABSTRACT: Recent advances of rotavirus (RV) basic and applied research are reviewed. They consist of: determination of the RV particle structure and functions of structural proteins, classification into genotypes based on whole genome analyses, description of the RV genome and gene protein assignments, description of the viral replication cycle and of functions of RV-encoded non-structural proteins as well as cellular proteins and cellular organelles involved, the present status of RV genetics and reverse genetics, molecular determinants of pathogenesis and pathophysiology, the RV-specific humoral and cell-mediated immune responses, innate immune responses and correlates of protection, laboratory diagnosis, differential diagnosis and present status of treatment, the molecular epidemiology and mechanisms of evolution of RVs, the development and universal application of RV vaccines as well as issues arising from present universal RV vaccination programmes and work on alternative vaccines. The review concludes by presenting problems requiring further exploration and perspectives of future basic and translational research.Virus Research 07/2014; · 2.83 Impact Factor
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ABSTRACT: Background Group-A Rotavirus (RV) is the main causative agent of acute gastroenteritis in children < 5 years of age. Its role as a pathogen in adults needs to be monitored. The aim of this study was to characterise the group-A RV strains that cause infections of acute gastroenteritis in adolescents and adults and determine the temporal variations in the circulating strains during 2008–2012 in continuation of an earlier study conducted in 2004–2007, in Pune, India. Methods A total of 371 stool samples were tested by RV antigen capture ELISA. VP4, VP6, VP7 and NSP4 genes of all of the RV strains detected in the study were analysed using reverse transcription PCR, multiplex PCR and sequencing. Results Group-A RV was detected in 9.4% (35/371) of the stool samples examined in the study period. The frequency of detection of RV was found to decline from 18.0% (16/90) in 2008 to 3.8% (2/52) in 2012. Of the 6 strains typed for both VP7 and VP4 genes, G2P, G1P and G9P were detected in 3, 1 and 2 samples, respectively. Sequencing and phylogenetic analysis of the VP4, VP6, VP7 and NSP4 genes revealed an infrequently reported NSP4-E6 genotype and circulation of heterogenous [G2 (lineage IIC and IID), G9 (lineage 3), P (lineage P-5), P (lineage P-3), VP6 I1 / I2 and NSP4 E2] genotypes/lineages in the RV strains. Analysis of linkage within these genes showed concordance (G2-P-I2-E2) and discordance (G9-P-I2-E6), equally. The sequences of amplified VP6 (n = 20) and NSP4 (n = 2) genes from G and P nontypeable RV strains (80.0%, 28/35) were most homologous to human group-A RV strains. Conclusion The study underscores the significant temporal variations in RV strains, identifies circulation of intergenogroup reassortants among adolescent and adult patients with acute gastroenteritis and emphasizes the need for continued surveillance and whole genome analysis of emerging rotavirus strains.Vaccine 08/2014; 32:A68–A74. · 3.49 Impact Factor