Burden of rotavirus disease in European Union countries. Pediatr Infect Dis J 25:S7-S11

GlaxoSmithKline Biologicals, Rixensart, Belgium.
The Pediatric Infectious Disease Journal (Impact Factor: 2.72). 01/2006; 25(1 Suppl):S7-S11. DOI: 10.1097/01.inf.0000197622.98559.01
Source: PubMed


Two new rotavirus vaccines are expected to be introduced in the European Union (EU) in coming years. A human rotavirus vaccine has already been licensed in several countries worldwide, and a pentavalent bovine vaccine has been submitted for licensure in the United States and the EU. Few data exist on the burden of rotavirus disease and its associated costs within the EU. To estimate the burden of rotavirus disease in the EU, we adapted a model based on the approach developed by the Centers for Disease Control and Prevention to the European situation and applied it to recent population and mortality data from European countries. Country-specific estimates were added to obtain a global estimate of rotavirus episodes treated at home, clinic visits, hospitalization and death. We estimate that 3.6 million episodes of rotavirus disease occur annually among the 23.6 million children younger than 5 years of age in the EU. Every year, rotavirus accounts for 231 deaths, >87,000 hospitalizations and almost 700,000 outpatient visits. Rotavirus disease constitutes a large public health burden in the EU. Except for deaths, the burden of disease is not dissimilar to that in the developing world. Country-specific studies are required to more accurately understand the burden of disease caused by rotavirus. With the introduction of new rotavirus vaccines in sight, rotavirus gastroenteritis may be regarded as the single most frequent vaccine-preventable disease among children in the EU.

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    • "Most RV infections are community-acquired and transmitted by the fecal-oral route [12] and peak in the winter season between November and February in temperate climates [4] [13] [14]. RVGE imposes a heavy economic burden by incurring not only direct (consultation, emergency, hospitalisation, and medication) costs, but also indirect costs (parent workdays lost, childcare, etc.) [12] [15] [16]. In Europe, it has been associated with direct medical costs per patient ranging from $1942 to $2389. "
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    ABSTRACT: . Rotavirus (RV) is the commonest pathogen in the hospital and primary care settings, followed by Adenovirus (AV) and Norovirus (NV). Only few studies that assess the burden of RV gastroenteritis at the community level have been carried out. Objectives . To estimate incidence, disease characteristics, seasonal distribution, and working days lost by parents of RV, AV, and NV gastroenteritis leading to a family pediatrician (FP) visit among children < 5 years. Methods . 12-month, observational, prospective, FP-based study has been carried out using Pedianet database. Results . RVGE incidence was 1.04 per 100 person-years with the highest incidence in the first 2 years of life. Incidences of AVGEs (1.74) and NVGEs (1.51) were slightly higher with similar characteristics regarding age distribution and symptoms. Risk of hospitalisation, access to emergency room (ER), and workdays lost from parents were not significantly different in RVGEs compared to the other viral infections. Conclusions . Features of RVGE in terms of hospitalisation length and indirect cost are lower than those reported in previous studies. Results of the present study reflect the large variability of data present in the literature. This observation underlines the utility of primary care networks for AGE surveillance and further studies on community-acquired gastroenteritis in children.
    Full-text · Article · Jan 2016 · International Journal of Pediatrics
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    • "Prior to the introduction of rotavirus vaccines in Europe in 2006, it was estimated that 3.6 million episodes of rotavirus disease occurred annually among the 23.6 million children younger than 5 years of age [2]. Every year, rotavirus accounted for 231 deaths, over 87,000 hospitalisations and almost 700,000 outpatient visits in Europe [2]. "
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    ABSTRACT: Prior to the introduction of rotavirus vaccines in 2006, rotavirus was the leading cause of severe gastroenteritis among European children <5 years of age. We conducted a systematic review of the published literature to examine the effectiveness and impact of rotavirus vaccines in Europe following the first eight years of routine use. Four publication databases were searched, yielding 276 unique citations from February 1st, 2006 to July 31st, 2014. Twenty four studies on effectiveness (n=9) and impact (n=15) met the inclusion criteria. Across Europe, vaccine effectiveness against rotavirus-related healthcare utilisation ranged from 68% to 98%, consistent with efficacy data from clinical trials. Reductions in rotavirus hospitalisations ranged from 65% to 84%, consistent with findings from post-marketing studies from the US and Latin America. We confirm the significant public health benefit of rotavirus vaccination in Europe and provide further evidence to support implementation of universal rotavirus vaccination in all European countries. Copyright © 2015. Published by Elsevier Ltd.
    Full-text · Article · Mar 2015 · Vaccine
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    • "However, this estimation awaits confirmation after initiation of mass vaccination . Rotavirus vaccine (in this case RV1) has been assessed to prevent deaths also in Western European countries such as England [18] where RVGE associated mortality is very low [19]. A review summarizing RV5 vaccine-effectiveness studies and vaccination impact studies in the USA, Australia and Europe described an effectiveness of RV5 between 79% and 100% depending on the study setting and coverage [12]. "
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    ABSTRACT: By January 2015, rotavirus vaccination has been implemented in national vaccination programs in 75 countries worldwide. Two live oral rotavirus vaccines are internationally available: human, monovalent vaccine and human-bovine pentavalent reassortant vaccine. Since January 2014, another live, oral human-bovine monovalent vaccine has been available in India. After implementation of rotavirus vaccines in childhood immunization programs, over 90% reduction of rotavirus hospitalizations has been observed in industrialized and resource deprived countries. Additionally, in Latin America, significant reduction of rotavirus-associated deaths has been observed. Still, numerous countries do not recommend rotavirus mass vaccination because of assumed lack of cost-effectiveness and potential risk of intussusception which is estimated at 1 per 50-70,000 doses of rotavirus vaccines. Cost-effectiveness of vaccination is affected in some countries by high price. Inclusion of herd protection and indirect costs in calculations for cost effectiveness results in clear benefit: costs saved by health systems due to reduced rotavirus gastroenteritis hospitalizations exceed by far costs for implementation of rotavirus vaccination. There have been objections that high rotavirus vaccination coverage could put selective pressure on certain rotavirus strains against which protection after vaccination is less distinct. However, data now strongly suggest that even if there might be a relative increase of some specific genotypes after the use of rotavirus vaccines, this is not an absolute increase in incidence from certain genotypes and does not affect the overall effectiveness of rotavirus mass vaccination which resulted in a major decrease of severe cases of rotavirus gastroenteritis in both industrialized and resource deprived countries. Copyright © 2015. Published by Elsevier Ltd.
    Full-text · Article · Feb 2015 · Clinical Microbiology and Infection
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