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ABSTRACT: INTRODUCTION: Two rotavirus vaccines have been licensed globally since 2006. In China, only a lamb rotavirus vaccine is licensed and several new rotavirus vaccines are in development. Data regarding the projected health impact and cost-effectiveness of vaccination of children in China against rotavirus will assist policy makers in developing recommendations for vaccination. METHODS: Using a Microsoft Excel model, we compared the national health and economic burden of rotavirus disease in China with and without a vaccination program. Model inputs included 2007 data on burden and cost of rotavirus outcomes (deaths, hospitalizations, outpatient visits), projected vaccine efficacy, coverage, and cost. Cost-effectiveness was measured in US dollars per disability-adjusted life-year (DALY) and US dollars per life saved. RESULTS: A 2-dose rotavirus vaccination program could annually avert 3013 (62%) deaths, 194,794 (59%) hospitalizations and 1,333,356 (51%) outpatient visits associated with rotavirus disease in China. The medical break-even price of the vaccine is $1.19 per dose. From a societal perspective, a vaccination program would be highly cost-effective in China at the vaccine price of $2.50 to $5 per dose, and be cost-effective at the price of $10 to $20 per dose. CONCLUSIONS: A national rotavirus vaccination program could be a cost-effective measure to effectively reduce deaths, hospitalizations, and outpatient visits due to rotavirus disease in China.
Vaccine 06/2012; · 3.77 Impact Factor
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Yan Liu,
Zi-qian Xu,
Qing Zhang,
Miao Jin,
Jie-mei Yu,
Jin-song Li, Na Liu,
Shu-xian Cui,
Xiang-yu Kong,
Hong Wang,
Hui-ying Li,
Wei-xia Cheng,
Xue-jun Ma,
Zhao-jun Duan
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ABSTRACT: Rapid and broad diagnostic methods are needed for the identification of viral agents of gastroenteritis. In this study, we used Luminex xMAP technology to develop a multiplexed assay for the simultaneous identification of major enteric viral pathogens, including rotavirus A (RVA), noroviruses (NoVs) (including genogroups GI and GII), sapoviruses (SaV), human astrovirus (HAstV), enteric adenoviruses (EAds), and human bocavirus 2 (HBoV2). The analytical sensitivity allowed detection of 10(3) (EAds, HBoV2, and RVA) and 10(4) (NoV GI and GII, SaV, and HAstV) copies per reaction mixture. Compared to conventional PCR, the Luminex-based assay yielded greater than 75% sensitivity and 97% specificity for each virus, and the kappa correlation for detection of all viruses ranged from 0.75 to 1.00. In conclusion, this multiplexed Luminex-based assay provides a potentially rapid, high-throughput, and maneuverable diagnostic tool for major viral pathogens associated with gastroenteritis.
Journal of clinical microbiology 04/2012; 50(7):2384-9. · 4.16 Impact Factor
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ABSTRACT: To investigate the molecular epidemiologic characteristics and genotypes of norovirus in children less than 5 years of age in Lulong area from 2008 to 2009.
325 stool specimens and epidemiological data from hospitalized children with diarrhea less than 5 years of age were collected. Rotavirus was detected by using the ELISA kit. Norovirus, adenovirus and astrovirus were detected by multiple reverse transcription-polymerase chain reaction (RT-PCR). Partial norovirus strains were sequenced and the tree was conducted by using the phylogenetic analyses.
Norovirus was detected in 37 out of 325 (11.3%) specimens,ranked only second to rotavirus (48.6%), and higher than adenovirus (6.5%) and astrovirus (4.3%). Norovirus predominantly infected children less than 2 years of age and the season peak of norovirus occurred in November. Phylogenetic analysis showed that the predominant strain was the GII. 4/2006b variant. Interestingly, a novel unreported GII-4 variant was found in this study.
Norovirus was one of the most important pathogens causing acute gastroenteritis from 2008 to 2009 in Lulong area. The GII. 4/2006b vairant was still the predominant strain. It is important to keep on monitoring the novel GII. 4 variant.
Zhonghua shi yan he lin chuang bing du xue za zhi = Zhonghua shiyan he linchuang bingduxue zazhi = Chinese journal of experimental and clinical virology 02/2012; 26(1):11-3.
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ABSTRACT: Acute gastroenteritis (AGE) is one of the leading causes of death in children worldwide. Human bocavirus 2 (HBoV2) was recently identified in stool samples and is involved in the pathogenesis of AGE, but the current data were too limited to clarify this issue.
We conducted a case-control study on 632 children with diarrhea and 162 healthy controls in Lanzhou, China, to assess the role of HBoV2 in gastroenteritis.
Viruses known or suspected to be agents of AGE, including RV, HucV, AdV, AstV, and HBoVs, were detected. Viral loads of HBoV2 were quantified by Real-time PCR.
HBoV2 was detected in 129 (20.4%) and 20 (12.3%) of the gastroenteritis and control samples, respectively. The association between HBoV2 and gastroenteritis was weaker (OR = 1.269, CI= 0.704-2.288) than that between gastroenteritis and RV, HucV, AdV, or AstV, as determined by multivariate logistic regression analysis. The data also suggested that infection with HBoV2 did not exacerbate the clinical symptoms of gastroenteritis. Mean HBoV2 viral load in the case and control groups was fewer than 55 copies/ml extract.
HBoV2 exhibit different epidemiological features from HBoV1 and HBoV3. The data presented herein do not support a causative role for HBoV2 in AGE, despite its high prevalence in stool samples.
Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 09/2011; 52(3):251-3. · 3.12 Impact Factor
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ABSTRACT: Little is known about the role of noroviruses (NVs) in sporadic cases of acute gastroenteritis in adults. The GII-4 NVs are currently the globally dominant genotype with diverse genetic makeups. The mechanism(s) underlying the persistence and rapid evolution of the viruses are not yet clear. In this study we collected 547 specimens from adult of >14 years of age with acute gastroenteritis in Beijing, China from September 2007 to Febraury 2008. NVs were screened and sequenced to determine their genotypes. Bioinformatics methods were used to detect NV recombination and their breakpoints. The residue variations of the capsid proteins between GII-4/Den Haag and previous predominant variants of GII-4 were compared to identify mutations that are likely important for current epidemic wave. Putative epitopes were predicted based upon the crystal structure. 106 (19.4%) NVs were identified among 547 specimens. While GII-4 remains predominant, at least six other genotypes were observed. Two recombinant types were identified with both predicted breakpoints locating within the 24-27 bp region upstream the start codon of ORF2. We found the emergent mutations H414P/Q of the capsid protein are specific for GII-4/Den Haag and this site lies within a predicted antibody-binding epitope. Our data demonstrated that NVs were an important cause of acute gastroenteritis in Chinese adults. The shared breakpoints identified in the GI and GII recombinants imply the presence of recombination hotspots in NVs. The mutations at residue 414 and its location within a putative antigenic epitope suggested a possible mechanism that may allow GII-4 NVs to escape from herd immunity.
Infection, genetics and evolution: journal of molecular epidemiology and evolutionary genetics in infectious diseases 07/2011; 11(7):1716-26. · 3.22 Impact Factor
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Hong-wen Ji,
Li Ma,
Xu-rong Gao, Na Liu,
Ying Zhang,
Yang Wang,
Zu-xuan Ma,
Yue Wang,
Jing Wang,
Xin Fu,
Qian Xiong,
Hong-Mei Qi
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ABSTRACT: To determine the normal values for thromboelastography (TEG) in Chinese healthy adult volunteers residing in Beijing for over three years and compare them with those of the manufacturer's.
A total of 137 healthy adult volunteers were enrolled from June 2010 to August 2010. The technique was standardized with citrated blood and kaolin activator. And a Haemoscope 5000 device was employed. The TEG parameters analyzed were R, K, α, maximal amplitude (MA), LY30 and coagulation index (CI). All volunteers underwent the tests of prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and plasma fibrinogen level with the same blood sample.
The reference ranges of 95% for 137 volunteers were R: 3.8 - 8.4 min, K: 0.8 - 3.3 min, α-Angle: 46.2 - 76.2°, MA: 50.0 - 70.8 mm, LY30: -3.3% - 4.0% and CI: -3.8 - 2.9. Overall, 24.1% (33/137) of the volunteers had at least one abnormal parameter while 7.3% (10/137) would have been considered coagulopathy had the manufacturer's reference values been used, resulting in a test specificity of 76.0%. As compared with the western ethnicity (the manufacturer's reference values), Chinese healthy volunteers were associated with lower fibrinogen functions. There were significantly different in R, K, α-Angle, MA and CI between men and women groups (all P < 0.01).
This study supports the manufacturer's recommendation that each institute should determine its own normal reference values.
Zhonghua yi xue za zhi 04/2011; 91(14):980-3.
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Jie Li,
Qing Zhang,
Zi-qian Xu,
Wei-xia Cheng,
Dan-di Li,
Hui-ying Li,
Jin-xin Xie,
Shu-xian Cui, Na Liu,
Jing-bo Zhao,
Zhao-jun Duan
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ABSTRACT: To study HPeV from stool samples of children with acute gastroenteritis under 5 years old.
We conducted a real-time PCR to detect HPeV from stool samples and to amply VP1 sequence by nested RT-PCR to identify HPeV type.
The results showed that 27 of 306 (8.82%) children with acute gastroenteritis were infected HPeV. 11 strains were typed. 9 strains HPeV1, both HPeV2 and HPeV4 was 1 strain. HPeV was mostly identified in autumn season with a peak in July. HPeV seemed relevant in children >2 years old. The range of nucleotide identity between all isolated strains with reference strains was 79%-92%.
Epidemiology characteristic of HPeV in Jilin was concordance with that of reports. HPeV3 wasnt detected. It's significant to conduct the large scale and long-term surveillance of HPeV.
Zhonghua shi yan he lin chuang bing du xue za zhi = Zhonghua shiyan he linchuang bingduxue zazhi = Chinese journal of experimental and clinical virology 02/2011; 25(1):46-8.
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Chun-ying Li, Na Liu,
Wei-dong Guo,
Qiong Yu,
Wen-rui Wang,
Zhuang-zhi Song,
Hai Yan,
Yun Luo,
Ai-tao Lu,
Hui-ying Li,
Lin Zhu,
Zhao-jun Duan
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ABSTRACT: This report describes for the first time an outbreak of acute gastroenteritis among neonates associated with human astrovirus (HAstV) serotype 1b at a maternity hospital in Inner Mongolia, China. Of 40 specimens, 28 were astrovirus positive and rotavirus, calicivirus, and adenovirus negative. Poor hygiene likely contributed to the spread and persistence of HAstV in the neonatal care room.
Journal of clinical microbiology 11/2010; 48(11):4306-9. · 4.16 Impact Factor
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Rong-Fang Zhang,
Yu Jin,
Zhi-Ping Xie, Na Liu,
Kun-Long Yan,
Han-Chun Gao,
Jing-Rong Song,
Xin-Hui Yuan,
Ni-Guang Xiao,
Ming-Wei Guo,
Qiong-Hua Zhou,
Yun-De Hou,
Zhaojun Duan
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ABSTRACT: There are limited data on the prevalence and clinical and molecular characterization of human respiratory syncytial virus (HRSV) in children with acute respiratory tract infections (ARTIs) in China. From December 2006 to March 2009, 894 nasopharyngeal aspirates (NPAs) were collected from children under 14 years of age with ARTIs. Samples were screened for HRSV and genotyped by reverse transcription-PCR (RT-PCR) and sequencing. Demographic and clinical information was recorded. A total of 38.14% (341/894) of samples were positive for HRSV. Phylogenetic analysis revealed that 60.4% of the selected 227 RSV strains were GA2, 34.4% were BA, 4.8% were GB2, and 0.4% were GB3. A total of 40.47% of all of the RSV-positive samples were coinfected with other respiratory viruses, and adenovirus was the most common additional respiratory virus. No statistical differences were found in the frequency of diagnosis and symptoms between the coinfection group and monoinfection group. Additionally, no statistical differences were found in epidemiological characterizations or disease severity between genotype BA- and GA2-positive patients, except for a greater frequency of lower respiratory tract infections (LRTIs) (mostly bronchitis)with BA. HRSV is the most important viral pathogen in Chinese children with ARTIs. Four genotypes (i.e., GA2, BA, GB2, and GB3) circulate locally, and the predominant genotype may shift between seasons. Coinfection with other viruses does not affect disease severity. HRSV genotypes were not associated with different epidemiological characterizations or disease severity.
Journal of clinical microbiology 11/2010; 48(11):4193-9. · 4.16 Impact Factor
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D-L Zhang,
Y Jin,
D-D Li,
W-X Cheng,
Z-Q Xu,
J-M Yu,
M Jin,
S-H Yang,
Q Zhang,
S-X Cui, N Liu,
Z-J Duan
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ABSTRACT: Human parechoviruses (HPeVs) are widespread pathogens causing a wide spectrum of diseases. HPeVs belong to the family Picornaviridae, and 14 genotypes are known. We conducted a case-control study to investigate the role of HPeV in acute gastroenteritis. HPeV was detected and quantified using real-time RT-PCR, and then genotyped by sequencing of the nested RT-PCR product of the VP3/VP1 partial gene. HPeV was found in both the case and control groups (29.4% and 15.3% respectively, p 0.006). Six HPeV genotypes (HPeV1, HPeV3, HPeV4, HPeV5, HPeV6, and HPeV8) were detected. Nine positive samples could not be sequenced with negative genotyped RT-PCR. HPeV1 and HPeV3 were the most prevalent genotypes, and co-infection was common in the case group. No statistically significant differences in either viral load or the rate of HPeV1 and HPeV3 infection were found between the two groups. Additionally, no significant differences were found in fever rates, vomiting rates or mean duration and frequency of diarrhoea and vomiting between the positive and negative case groups with HPeV1 or HPeV3. Multivariate logistic regression analysis indicated that there was no association between the HPeV1 or HPeV3 infection and acute gastroenteritis. Multiple genotypes of HPeVs were highly prevalent in Chinese children. One potential new HPeV genotype was identified, but needs to be confirmed further by the picoma study group. However, the present study does not support a causative role of HPeV1 and HPeV3 in acute gastroenteritis.
Clinical Microbiology and Infection 10/2010; 17(10):1563-9. · 4.54 Impact Factor
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ABSTRACT: To acknowledge the epidemiology of gastroenteritis outbreaks caused by norobiruses and their genotypes.
Epidemiologic data and specimens were collected from 19 gastroenteritis outbreaks. 201 specimens were detected for norovirus, rotavirus, astrovirus, adenovirus and sapovirus by RT-PCR methods and PCR products were sequenced. Sequence alignment and phylogenetic analysis were performed by Clustal X 1.83 and MEGA 4.0 programs.
Noroviruses were one of the most predominant pathogens causing viral gastroenteritis outbreaks (12 of 19 outbreaks, accounting for 63.2%). Variant GII-4/2006b was the predominant strain responsible for 11 of the 12 NV-associated outbreaks. Other genotypes would include GII-17, GII-6 and GII-3. The NV-associated gastroenteritis outbreaks occurred mainly in winter and spring between December 2006 and April 2007. These gastroenteritis outbreaks caused by noroviruses would involve all age groups in various locations. Meantime, 2 out of 12 outbreaks were caused by norovirus or other viruses. In addition, multiple viruses and multiple genotypes of noroviruses were found in the same outbreak.
Noroviruses were one of the most major pathogens causing gastroenteritis outbreaks while GII-4/2006b variant was identified as the predominant strain in China.
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 05/2010; 31(5):549-53.
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ABSTRACT: From November 2008 to January 2009, a sharp increase of diarrhea in children in Guangdong province appeared, we randomly collected 53 stool specimens from out-patient children with dirrhea in 3 major hospitals (Guangzhou City Children's Hospital, Shenzhen Baoan District Maternal and Child Health Hospital, First Affiliated Hospital of Shantou University). Rotavirus and calicivirus were screened by ELISA and RT-PCR. We found 29 cases of rotavirus infection with diverse serotypes. Only four cases were identified as calicivirus infection. The result indicated that rotavirus was a major pathogen of this high incidence of diarrhea from November 2008 to January 2009 in Guangdong Province.
Bing du xue bao = Chinese journal of virology / [bian ji, Bing du xue bao bian ji wei yuan hui] 03/2010; 26(2):150-2.
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ABSTRACT: The genus bocavirus includes bovine parvovirus (BPV), minute virus of canines (MVC), and a group of human bocaviruses (HBoV1-4). Using sequence-independent single primer amplification (SISPA), a novel bocavirus group was discovered with high prevalence (12.59%) in piglet stool samples. Two nearly full-length genome sequences were obtained, which were approximately 5,100 nucleotides in length. Multiple alignments revealed that they share 28.7-56.8% DNA sequence identity with other members of Parvovirinae. Phylogenetic analyses indicated their closest neighbors were members of the genus bocavirus. The new viruses had a putative non-structural NP1 protein, which was unique to bocaviruses. They were provisionally named porcine bocavirus 1 and 2 (PBoV1, PBoV2). PBoV1 and PBoV2 shared 94.2% nucleotide identity in NS1 gene sequence, suggesting that they represented two different bocavirus species. Two additional samples (6V, 7V) were amplified for 2,407 bp and 2,434 bp products, respectively, including a partial NP1 gene and the complete VP1 gene; Phylogenetic analysis indicated that 6Vand 7V grouped with PBoV1 and PBoV2 in the genus of bocavirus, but were in the separate clusters. Like other parvoviruses, PBoV1, PBoV2, 6Vand 7V also contained a putative secretory phospholipase A(2) (sPLA(2)) motif in the VP1 unique region, with a conserved HDXXY motif in the catalytic center. The conserved motif YXGXF of the Ca(2+)-binding loop of sPLA2 identified in human bocavirus was also found in porcine bocavirus, which differs from the YXGXG motif carried by most other parvoviruses. The observation of PBoV and potentially other new bocavirus genus members may aid in molecular and functional characterization of the genus bocavirus.
PLoS ONE 01/2010; 5(10):e13583. · 4.09 Impact Factor
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ABSTRACT: Rotavirus was detected in 52% of 2328 stool specimens collected from children with acute gastroenteritis admitted to three sentinel hospitals in Mainland China from January 2006 to December 2007. G3P[8] (42%) was the most common strain. Despite being common globally, only 18 (2%) G9-positive samples were identified. The VP7, VP4, VP6, and NSP4 genes were sequences for 13 of the G9 strains with G9P[8] being most common and showing the same origin as G9 strains reported in other countries. One G9P[6] strain was possibly derived by reassortment between earlier Chinese G9 strains and more recent local P[6] strains.
Vaccine 11/2009; 27 Suppl 5:F40-5. · 3.77 Impact Factor
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Eileen L Yee,
Zhao-Yin Fang, Na Liu,
Stephen C Hadler,
Xiaofeng Liang,
Huaqing Wang,
Xu Zhu,
Baoming Jiang,
Umesh Parashar,
Marc-Alain Widdowson,
Roger I Glass
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ABSTRACT: Rotavirus mortality is an important component of the total burden of rotavirus disease for children under 5 years old, but accurate estimation is difficult for many developing countries. Here we applied a more direct method to improve estimates of rotavirus mortality in China using 2002 Chinese-specific data. Results indicate that in 2002, approximately 13,400 children under 5 years old in China died from rotavirus and 70% of these deaths occur in rural areas. Thus, a national rotavirus immunization program targeting rural areas with high mortality from diarrhoea could dramatically reduce these deaths and urban areas could reduce childhood hospitalizations attributed to rotavirus by 43%.
Vaccine 11/2009; 27 Suppl 5:F46-9. · 3.77 Impact Factor
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Zhao-Jun Duan, Na Liu,
Su-Hua Yang,
Jing Zhang,
Li-Wei Sun,
Jing-Yu Tang,
Yu Jin,
Zeng-Qing Du,
Jin Xu,
Qing-Bin Wu,
Zhi-Li Tong,
Si-Tang Gong,
Yuan Qian,
Jian-Min Ma,
Xu-Chun Liao,
Marc-Alain Widdowson,
Baoming Jiang,
Zhao-Yin Fang
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ABSTRACT: Rotaviruses cause acute diarrhea worldwide. Previous studies of rotavirus diarrhea in China found that rotavirus infection is the most common cause of severe diarrhea in young children. In the present study, surveillance of rotavirus diarrhea was conducted involving 9549 children aged <5 years who were admitted for treatment of diarrhea at 11 sentinel hospitals in China from August 2003 through July 2007. Group A rotavirus was detected in 3749 (47.8%) of the 7846 fecal specimens by using enzyme-linked immunosorbent assay. Rotavirus isolates were characterized by reverse-transcriptase polymerase chain reaction to determine G and P genotypes. All the strains that are common worldwide were detected; G3P[8] was the most common. An unusual G5 strain was detected in 2 specimens. Of all episodes of rotavirus diarrhea, 94% occurred during the first 2 years of life, peaking at 6-23 months of age. Our findings indicate that globally common rotavirus strains continue to be a major cause of severe childhood diarrhea in China. Introduction of routine immunization with effective rotavirus vaccines would substantially reduce this burden.
The Journal of Infectious Diseases 11/2009; 200 Suppl 1:S167-73. · 6.41 Impact Factor
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The Journal of infection 08/2009; 59(3):215-8. · 4.13 Impact Factor
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ABSTRACT: To study molecular epidemiology of Rotavirus among children under 5 years of age in china.
Stool specimens were collected from 4047 inpatients under 5 years of age with diarrhea in our 9 hospital-based surveillance sites from January 2006 to December 2007 following the WHO Rotavirus surveillance protocol. Rotavirus were detected by ELISA, Further strain characterization of rotavirus was carried out with RT-PCR.
A total of 4047 stool samples were collected and 3862 of total stools were tested among which 1700 was positive. The Rotavirus positive rate is 44.0%. A peak admission of rotavirus diarrhea was observed from November to next January. More than 95.4% of viral diarrhea patients occurred in their first 2 years. The incidence rates of rotavirus diarrhea were highest in 12-17 months of age. The most common rotavirus strain was P[8]G3(58.3%); followed by P[8] G1(22.1%), P[4]G1 (3.0%), P[8]G9 (2.4%). G4 was not detected in this study. The four common strains were 80.8% in the world.
Rotavirus diarrhea was an important infectious disease among children under 5 years of age in China. Safe and effective rotavirus vaccines for the prevention of rotavirus diarrhea and reduction of treatment costs are of significant importance to China.
Zhonghua shi yan he lin chuang bing du xue za zhi = Zhonghua shiyan he linchuang bingduxue zazhi = Chinese journal of experimental and clinical virology 06/2009; 23(3):168-70.
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ABSTRACT: Effects of RIDASCREEN Norovirus (C 1401) 3rd Generation kit (R-biopham AG, darmstadt, Germany) and IDEIA NLV kit (DAKOCytomation., Ely, UK) were compared for detecting human norovirus (HuNV) in fecal sample.
The performance of the ELISA was compared with that of the reverse transcription polymerase chain reaction (RT-PCR) by testing a panel of 308 fecal samples collected from patients involved in outbreaks of gastroenteritis in Chang Chun and Guang Zhou. Gene sequencing was performed to positive samples tested by RT-PCR to determine genotype compared with standard sequences.
RT-PCR is gold standard, RIDASCREEN Norovirus (C 1401) 3rd Generation kit had a high sensitivity of 96.10% but a specificity of 93.51%, and Dako kit had a low sensitivity of 95.83% but a high specificity of 95.76%.
RIDASCREEN Norovirus (C 1401) 3rd Generation kit is more Satisfactory for a preliminary screening.
Zhonghua shi yan he lin chuang bing du xue za zhi = Zhonghua shiyan he linchuang bingduxue zazhi = Chinese journal of experimental and clinical virology 06/2009; 23(3):227-8.
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Jie-mei Yu,
Miao Jin,
Qing Zhang,
Hui-ying Li,
Dan-di Li,
Zi-qian Xu,
Jin-song Li,
Shu-xian Cui,
Su-hua Yang, Na Liu,
Zhao-jun Duan
Emerging Infectious Diseases 06/2009; 15(5):823-5. · 6.79 Impact Factor
