Rotavirus Disease and Prevention Through Vaccination

Division of Pediatric Infectious Diseases, University of Louisville School of Medicine, Louisville, KY, USA.
The Pediatric Infectious Disease Journal (Impact Factor: 2.72). 05/2009; 28(4):355-62, quiz 363-4. DOI: 10.1097/INF.0b013e318199494a
Source: PubMed


Rotavirus is the most common cause of acute infectious gastroenteritis in children and is associated with substantial morbidity in the United States and morbidity and mortality in the developing world. Two orally administered vaccines, a live bovine reassortant vaccine (RV5; licensed in 2006) and a live attenuated human vaccine (RV1; licensed in 2008), are now being used in a universal infant vaccination program in the United States. There is already ecologic evidence and data from post-licensure effectiveness studies that this program will be an unequivocal success in reducing the impact of rotavirus disease. This overview presents the structure, pathogenesis, and mechanisms of natural immunity to rotavirus, key concepts in understanding the rationale behind vaccine-induced protection. The history of rotavirus vaccine development is also included, along with a discussion of the safety, efficacy, and recommended use of the approved vaccines.

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    • "Rotavirus has been recognized as one of the most common causes of acute infectious gastroenteritis (Marshall 2009) and the leading cause of severe, dehydrating diarrhea in children (WHO 2007). Outbreaks of viral gastroenteritis caused by rotaviruses have been reported in both infants and adults (Craun et al. 2010; Anderson and Weber 2004; Siqueira et al. 2010), and rotaviruses might be responsible for more than 50% of enteritis among infants worldwide (Fenner and White 1976). "
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    ABSTRACT: This paper reviews the state of knowledge regarding human viruses in water systems from an environmental engineer's perspective. The authors describe (1) viruses of concern and potential human diseases; (2) waterborne outbreaks related to viruses; (3) the sources, reservoirs, and fate of viruses in the environment; (4) the use of viruses as microbial source tracking tools; (5) virus survival and virus transport; (6) virus concentration and detection methods; (7) the fate of viruses in water treatment; (8) the removal of viruses in full-scale, bench, and pilot-scale conventional and membrane bioreactor (MBR) wastewater systems; and (9) other issues related to viruses in water systems such as the role of bacterial viruses (phages) and viral risk assessment. Occurrence of human pathogenic viruses in environmental waters (i.e., surface waters, groundwater, drinking water, recreational water, and wastewater) raises concerns regarding the possibility of human exposure and waterborne infections. Commonly observed waterborne viruses include adenoviruses, enteroviruses, noroviruses, and rotaviruses. Viruses are the smallest of all microorganisms, and their size facilitates transport in environmental media. In addition, viruses have very low die-off rates and low infectivity doses, increasing concern over outbreaks of disease related to waterborne or sludge-related virus exposures. Overall, virus presence in water and wastewater is a difficult problem for environmental engineers because of prevalence, infectivity, and resistance of viruses to disinfection. Environmental engineers should be aware that even state-of-the-art wastewater treatment plants may not be able to eliminate viruses from wastewater, and viruses potentially escaping from drinking water treatment plants because of technical and management deficiencies may lead to human exposure and disease. The knowledge and tools summarized in this paper provide basic information needed to make decisions for efficient water and wastewater management and reduction of risk of human exposure. (C) 2014 American Society of Civil Engineers.
    Full-text · Article · Jul 2014 · Journal of Environmental Engineering
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    ABSTRACT: The association between rotavirus gastroenteritis (RVGE)-associated hospitalization and rotavirus vaccine receipt was examined, and vaccine effectiveness was estimated in a case-control study conducted between 11/2007 and 12/2009 among Israeli children age eligible for rotavirus vaccination. Cases (n=111) were hospitalized children with diarrhea testing positive for rotavirus by immunochromatography. Controls (n=216) were hospitalized children with diarrhea testing negative for rotavirus. Among controls 36 (16.7%) children were vaccinated against rotavirus compared with two children (1.8%) among cases (p < 0.001). Rotavirus immunization was associated with lower risk of RVGE-associated hospitalization; adjusted OR 0.106 (95% CI 0.024, 0.481), yielding a vaccine effectiveness of 89.4% (95% CI 51.9%, 97.6%) in preventing hospitalization. These data demonstrate high effectiveness of rotavirus vaccines in a high income country.
    Full-text · Article · Jun 2010 · Human vaccines
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    Preview · Article · Dec 2010 · The Pediatric Infectious Disease Journal
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