Detection and Clinical Implications of Monovalent Rotavirus Vaccine-Derived Virus Strains in Children with Gastroenteritis in Alberta, Canada

Background: While rotavirus vaccine programs effectively protect against severe rotavirus gastroenteritis, rotavirus vaccine strains have been identified in the stool of vaccinated children and their close contacts suffering from acute gastroenteritis. The prevalence of vaccine strains, the emergence of vaccine-derived strains and their role in acute gastroenteritis are not well studied. Methods: We developed a Locked Nucleic Acid Reverse Transcription real-time PCR assay (LNA-RTqPCR) to detect the monovalent rotavirus vaccine (RV1) Rotarix non-structural protein 2 in children with acute gastroenteritis and healthy controls and validated it using sequence confirmed RV1 strains. The association between RV1-derived strains and gastroenteritis was determined using logistic regression. Results: The new assay exhibited 100% (95%CI: 91.7%, 100%) diagnostic sensitivity and 99.4% (95%CI: 96.2%, 100%) diagnostic specificity, with a detection limit of 9.86 copies/reaction and qPCR efficiency of 99.7%. Using this assay, we identified the presence of RV1-derived NSP2 sequences in 7.7% of rotavirus gastroenteritis cases and 98.6% of rotavirus positive healthy children (94.4% had previously received the RV1). Among gastroenteritis cases, those whose stool contained RV1-derived strains had milder gastroenteritis symptoms compared to that of natural rotavirus infections. We observed no significant association between RV1-derived strains and gastroenteritis (OR 0.98; 95% CI 0.60, 1.72). Conclusion: Our study demonstrated that the new assay is suitable for monitoring RV1-derived rotavirus strain circulation and that the RV1-derived strains are not associated with development of gastroenteritis symptoms.

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Impact of rotavirus vaccine on admissions due to acute gastroenteritis and rotavirus gastroenteritis in Israel

Acta Paediatrica ◽

10.1111/apa.15480 ◽

2020 ◽

Author(s):

Amir Klivitsky ◽

Salam Algabria ◽

Gideon Paret ◽

Nadav Michaan ◽

Lior Goldberg ◽

...

Keyword(s):

Acute Gastroenteritis ◽

Rotavirus Vaccine ◽

Rotavirus Gastroenteritis

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Determination of a Viral Load Threshold To Distinguish Symptomatic versus Asymptomatic Rotavirus Infection in a High-Disease-Burden African Population

Journal of Clinical Microbiology ◽

10.1128/jcm.00875-15 ◽

2015 ◽

Vol 53 (6) ◽

pp. 1951-1954 ◽

Cited By ~ 31

Author(s):

A. Bennett ◽

N. Bar-Zeev ◽

K. C. Jere ◽

J. E. Tate ◽

U. D. Parashar ◽

...

Keyword(s):

Viral Load ◽

Acute Gastroenteritis ◽

Gold Standard ◽

Disease Burden ◽

Rotavirus Vaccine ◽

Quantitative Real Time Pcr ◽

Rotavirus Gastroenteritis ◽

Asymptomatic Children ◽

High Disease Burden

We evaluated quantitative real-time PCR to establish the diagnosis of rotavirus gastroenteritis in a high-disease-burden population in Malawi using enzyme immunoassay as the gold standard diagnostic test. In 146 children with acute gastroenteritis and 65 asymptomatic children, we defined a cutoff point in the threshold cycle value (26.7) that predicts rotavirus-attributable gastroenteritis in this population. These data will inform the evaluation of direct and indirect rotavirus vaccine effects in Africa.

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Burden and Trends of Severe Rotavirus Infections and Allcause Acute Gastroenteritis Hospital Episodes in Children Under Five Years Old in Mainland Portugal

Acta Médica Portuguesa ◽

10.20344/amp.15706 ◽

2021 ◽

Vol 34 (10) ◽

pp. 669

Author(s):

Héloïse Lucaccioni ◽

Rita Sá Machado

Keyword(s):

Acute Gastroenteritis ◽

Vaccine Coverage ◽

Current Knowledge ◽

Seasonal Pattern ◽

Rotavirus Vaccine ◽

Children Under Five ◽

Under Five ◽

Mainland Portugal ◽

The Impact ◽

Rotavirus Infections

Introduction: Rotavirus infections are a leading cause of severe acute gastroenteritis in children under five years old. In December 2019, Portugal announced the inclusion of the rotavirus vaccine, already available for private purchase, in the National Immunization Program. We present the first nationwide analysis of the burden and trends of rotavirus and acute gastroenteritis hospital episodes in children under five years old in mainland Portugal (2014 - 2017).Material and Methods: We used the hospital morbidity database and the Death Certificate Information System to identify hospital episodes and deaths of rotavirus and acute gastroenteritis based on the codes of the International Classification of Diseases. We described the number and rates of hospital episodes disaggregated by age group, sex, geographical units, and the seasonality and trends over the study period.Results: On average, during the study period, there were 1985 annual hospital episodes among children under five years old. The annual rate was 48.0/10 000 children (95% CI 46.9 - 49.0). Rates were consistently higher in younger children, and 67.8% episodes occurred in children under 24 months. We found a seasonal pattern with a major peak in the early spring.Discussion: Our results were consistent with the current knowledge on rotavirus and acute gastroenteritis hospital episodes in Europe. Additional studies are needed to identify the risk factors and high-risk groups for hospital attendance.Conclusion: Rotavirus and acute gastroenteritis hospital episodes in children under five years old in mainland Portugal represent an important health and economic burden. In the future, monitoring this burden and these trends in relation with rotavirus vaccine coverage could be useful in order to assess the impact of the vaccination programme on the change in hospital episodes.

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Human medicines European public assessment report (EPAR): RotaTeq, rotavirus vaccine, live, Immunization,Rotavirus Infections, Date of authorisation: 26/06/2006, Revision: 27, Status: Authorised

Case Medical Research ◽

10.31525/cmr-59960f ◽

2018 ◽

Author(s):

Keyword(s):

Rotavirus Vaccine ◽

Assessment Report ◽

European Public ◽

European Public Assessment Report ◽

Rotavirus Infections

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Acute Gastroenteritis in Children Below 5 Years of Age at Tirupati, Andhra Pradesh, India Post Introduction of Rotavirus Vaccine into National Immunization Programme

The Indian Journal of Pediatrics ◽

10.1007/s12098-020-03606-3 ◽

2021 ◽

Author(s):

Manohar Badur ◽

Vinod Kumar Reddy Pidugu ◽

Latheef Kasala ◽

Samarasimha Reddy N ◽

Varunkumar Thiyagarajan

Keyword(s):

Acute Gastroenteritis ◽

Andhra Pradesh ◽

Rotavirus Vaccine ◽

Immunization Programme ◽

National Immunization ◽

National Immunization Programme

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Benign Convulsions with Mild Rotavirus and Norovirus Gastroenteritis: Nationwide Data from the Health Insurance Review and Assessment Service in South Korea

Children ◽

10.3390/children8040263 ◽

2021 ◽

Vol 8 (4) ◽

pp. 263

Author(s):

Dong Hyun Kim ◽

Dong Jun Ha ◽

Yeong Seok Lee ◽

Min Jun Chun ◽

Young Se Kwon

Keyword(s):

Health Insurance ◽

South Korea ◽

Large Scale ◽

Rotavirus Vaccine ◽

Annual Increase ◽

Rotavirus Vaccination ◽

Rotavirus Gastroenteritis ◽

Norovirus Gastroenteritis ◽

Increasing Trend

There have been no large-scale studies on the epidemiology of benign convulsions with mild gastroenteritis (CwG) since the introduction of the rotavirus vaccine in South Korea in 2007. This study aimed to analyze the trends in rotavirus gastroenteritis (RVGE) and rotavirus-associated CwG (RaCwG) after rotavirus vaccination. Further, we aimed to analyze changes in norovirus gastroenteritis (NVGE) and norovirus-associated CwG (NaCwG) using nationwide data from the Korean Health Insurance Review and Assessment Service. Between 2007 and 2019, this study analyzed children aged <6 years who were diagnosed with RVGE, NVGE, RaCwG and NaCwG. The changes in the prevalence of each disease and the ratio of CwG to enteritis were analyzed and the effects of age, sex and season were also analyzed. RVGE, RaCwG, NVGE and NaCwG were diagnosed in 273,898, 4246, 35,593 and 337 patients, respectively. The prevalence of RVGE was on a decreasing trend every year, but the prevalence of NaCwG and NVGE was on an increasing trend. There was a significant annual increase in the ratio of CwG to enteritis in both viruses. In order to control the prevalence of RaCwG, measures other than the rotavirus vaccine are required and measures to prevent norovirus are necessary.

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1381. Rotavirus Gastroenteritis among older adults: discussion based on a systematic literature review

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1563 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S700-S701

Author(s):

Cristina Carias ◽

Susanne Hartwig ◽

M Nabi Kanibir ◽

Ya-Ting Chen

Keyword(s):

Older Adults ◽

High Risk ◽

Acute Gastroenteritis ◽

Rate Ratio ◽

Rotavirus Gastroenteritis ◽

Incident Rate Ratio ◽

The Us ◽

Incident Rate ◽

The Uk ◽

Retrospective Database

Abstract Background While the burden of Rotavirus Gastroenteritis (RGE) is well recognized in young children, it is less so in older adults. However, older adults are also at high-risk of Acute Gastroenteritis (AGE) severe outcomes. In this review, we thus aimed to comprehensively assess RGE burden and vaccination impact in older individuals. Methods We performed a systematic literature review with PubMed and Scopus, from 2000 to 2019, using MESH and free-range terms. We included only studies that reported the incidence, and/or RV vaccination impact, in adults aged 60 and above and using regional specific data-sources. Results We analyzed 11 manuscripts for individuals aged 60 and above (Figure 1). Studies spanned Australia, Sweden, Netherlands, Canada (2), Germany (2), UK (2), and the US (2). Yearly inpatient RV incidence varied between 1.6 per 100,000 in Australia for those 65+ (retrospective database analyses, pre-vaccine); and 26 per 100,000 for those 85+ in Canada (modeling estimates for 2006-10, pre-vaccine). The incidence rate ratio for inpatient RGE between the post and pre-vaccine periods for those 65+ was 0.57 [95% CI: 0.10 – 3.15] in Canada, but 2.24 [95%CI: 1.78-2.83] in Australia, which may be due to increased testing for RV in the elderly post-vaccine. Reductions in the post-vaccination burden of RV and AGE among 60+ were reported in the UK (2 studies), and the US (2 studies) via retrospective database analyses In the UK, post-vaccine reductions in AGE health care-utilization were reported in the Emergency Department (21%), and outpatient centers (walk-in centers: 47%; general practice consultations: 36%). Retrospective database analyses documenting the incident rate ratio (IRR) of Rotavirus Gastroenteritis (RGE) and Acute Gastroenteritis (AGE) in older adults between the pre and post-vaccine period. Retrospective database analyses documenting the incident rate ratio (IRR) of Rotavirus Gastroenteritis (RGE) and Acute Gastroenteritis (AGE) in older adults between the pre and post-vaccine period. Conclusion While the burden of RGE mainly falls on young children, it also affects older adults. Retrospective database analyses reveal that, likely due to indirect vaccination benefits, increases in RV vaccination coverage have had an impact on lowering RGE, and AGE cases and healthcare utilization in older adults, a group at high-risk of severe outcomes for AGE. Disclosures Cristina Carias, PhD, Merck (Employee, Shareholder) Susanne Hartwig, n/a, MSD Vaccins (Employee) M.Nabi Kanibir, MD, Merck/MSD (Employee, Shareholder) Ya-Ting Chen, PhD, Merck & Co., Inc. (Employee, Shareholder)

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