Rotavirus vaccines: viral shedding and risk of transmission. Lancet Infect Dis 8:642-649

Department of Pediatrics, Northwestern University Feinberg School of Medicine, Division of Infectious Diseases at Children's Memorial and Northwestern Memorial Hospitals, Chicago, IL 60614, USA.
The Lancet Infectious Diseases (Impact Factor: 22.43). 11/2008; 8(10):642-9. DOI: 10.1016/S1473-3099(08)70231-7
Source: PubMed


Rotavirus causes gastroenteritis in almost all children by 5 years of age. Immunity to rotavirus is incomplete, with potential for recurrent infections occurring throughout life. Live rotavirus vaccines have been developed for the protection of children from severe wildtype rotavirus infections. Transmission of vaccine virus strains from vaccinated children to unvaccinated contacts harbours the potential for herd immunity, but also the risk of vaccine-derived disease in immunocompromised contacts. A review of rotavirus vaccine prelicensure studies shows that viral shedding and transmission were higher with the old tetravalent rhesus rotavirus vaccine than with the current human attenuated monovalent rotavirus vaccine and the pentavalent bovine-human reassortant vaccine. Immunocompromised contacts should be advised to avoid contact with stool from the immunised child if possible, particularly after the first vaccine dose for at least 14 days. Since the risk of vaccine transmission and subsequent vaccine-derived disease with the current vaccines is much less than the risk of wildtype rotavirus disease in immunocompromised contacts, vaccination should be encouraged.

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    • "Rotavirus shedding in feces has been detected in human infants following rotavirus vaccination at all doses [Anderson, 2008]. Recently, new reassortant strains have been identified and were found to have arisen through culture adaptation [Hemming and Vesikari, 2012]. "
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    ABSTRACT: Genotyping of human rotaviruses was performed in 191 rotavirus-positive fecal samples collected from infants with acute gastroenteritis, 3 years after the introduction of two rotavirus vaccines in South Korea. Among these samples, the most prevalent rotavirus genotype was G3P[8] (30.9%), followed by G1P[8] (27.7%), G4P[6] (15.2%), and G9P[8] (5.8%). Sequence analysis identified RotaTeq® vaccine-derived strains in 12 samples (6.3%), comprising 11 G1P[8] human–bovine double reassortant rotaviruses and 1 G1P[5] human–bovine single reassortant rotavirus. It is of note that cross-reactivity between the current G4-specific typing primer and RotaTeq®-specific G1 genotypes was found. A trace of the clinical and environmental routes of the rotavirus vaccine strains revealed unexpected complexity, and the diagnostic protocol for rotaviruses may require modification by using either another typing primer set or nucleotide sequence analysis. J. Med. Virol. © 2014 Wiley Periodicals, Inc.
    No preview · Article · Jan 2015 · Journal of Medical Virology
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    • "Currently, monovalent and pentavalent human vaccines have been approved in the United States and other countries (Anderson, 2008). "
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    ABSTRACT: Anti-rotaviral activities of Sophora flavescens extract (SFE) and stevioside (SV) from Stevia rebaudiana Bertoni either singly or in various combinations were examined in vitro and in vivo using a porcine rotavirus G5[P7] strain. Combination of SFE and SV inhibited in vitro virus replication more efficiently than each single treatment. In the piglet model, SV had no effect on rotavirus enteritis, whereas SFE improved but did not completely cure rotaviral enteritis. Interestingly, combination therapy of SFE and SV alleviated diarrhea, and markedly improved small intestinal lesion score and fecal virus shedding. Acute toxicity tests including the piglet lethal dose 50, and body weight, organ weight and pathological changes for the combination therapy did not show any adverse effect on the piglets. These preliminary data suggest that the combination therapy of SV and SFE is a potential curative medication for rotaviral diarrhea in pigs. Determination of the efficacy of this combination therapy in other species including humans needs to be addressed in the future.
    Full-text · Article · Apr 2014 · Research in Veterinary Science
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    • "However, the immunogenicity and efficacy of these vaccines was shown to be lower in certain low-income countries of Africa [9] [10], Asia [11] and Central America [12], where the vaccines would be most critical to saving lives. Moreover, the transmission of the vaccine virus strains from vaccinated children to unvaccinated contacts was observed [13] [14]. This form of transmission would cause vaccine-derived disease in immuno-compromised infants [15]. "
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    ABSTRACT: Live rotavirus vaccines that are effective in middle- and high-income countries have been found to be less immunogenic and effective in infants in resource-limited settings. The virus-like particle (VLP) approach is promising for rotavirus vaccine development, but challenges remain for VLP production at large scale. In this study, rotavirus capsid VP2 and VP6 proteins were expressed in Escherichia coli and were assembled with high efficiency into homogeneous single-layered VP6-VLPs or double-layered VP2/6-VLPs (dl2/6-VLPs) through a post-purification assembly process. The dl2/6-VLPs were observed to have better thermal stability and antigenicity. Although the immunogenicity of VP6 trimers, VP6-VLPs and dl2/6-VLPs was comparable, the efficacy of the dl2/6-VLPs to protect against rotavirus-induced diarrhea in pups was significantly higher than that of the trimeric VP6 or the VP6-VLPs when assessed using a mouse maternal antibody model. Taken together, the recombinant dl2/6-VLP antigen, which is highly analogous to rotavirus virion-derived double-layered particles, is a viable candidate for vaccine development and has the potential to be a parenterally administered safe and efficacious rotavirus vaccine.
    Full-text · Article · Feb 2014 · Vaccine
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