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Prospective population-based study on rotavirus disease in Germany
B Ehlken1, B Laubereau, W Karmaus
1NORDIG Institut für Gesundheitsforschung und Prävention, Hamburg, Germany.
Insights
Rotavirus (RV) causes significant severe acute gastroenteritis (AGE) in young German children. Immunization against common RV serotypes could prevent over 122,000 annual illnesses.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Community-acquired acute gastroenteritis (AGE) is a common illness in children.
- Rotavirus (RV) is a major viral pathogen responsible for AGE globally.
- Understanding the epidemiology of RV-AGE in specific populations is crucial for public health interventions.
Purpose of the Study:
- To determine the incidence and clinical features of rotavirus-associated acute gastroenteritis in German children aged 0-4 years.
- To identify the predominant rotavirus serotypes circulating in Germany during the study period.
- To compare the severity of rotavirus-positive AGE with rotavirus-negative AGE.
Main Methods:
- Prospective study conducted in 20 pediatric practices across 5 German regions from May 1997 to April 1998.
- Children aged 0-4 years presenting with AGE symptoms were eligible for inclusion.
- Stool samples were tested for rotavirus antigen using ELISA; serotyping was performed by PCR. Disease severity and hospitalization rates were recorded.
Main Results:
- Out of 15,451 children, 3980 (26%) had AGE, and 748 (24%) of 3156 tested stool samples were RV-positive.
- The incidence of AGE was 25.2 per 100 children/year, with RV-AGE incidence at 4.0 per 100 children/year, peaking in February/March 1998.
- RV-positive AGE cases were significantly more severe than RV-negative cases (28% vs 12% severe, 6.2% vs 2.0% hospitalization rate, p < 0.001).
- The predominant genotypes were G1/P[8] (77%) and G4/P[8] (17%).
Conclusions:
- Rotavirus is a significant contributor to severe acute gastroenteritis in young children in Germany.
- Effective prevention strategies, including vaccination against prevalent serotypes, could substantially reduce the burden of RV-AGE.
- An estimated 122,000 children in Germany could be protected annually from RV-AGE through immunization.
Unlabelled:
The aim of this study was to collect representative data on the incidence and clinical characteristics of community-acquired acute gastroenteritis (AGE) due to rotavirus (RV) in German children up to 4 y of age. In 20 paediatric practices in 5 German regions every child aged 0-4 y presenting with symptoms of AGE from May 1997 to April 1998 was eligible for inclusion into the study. Stool samples were tested for RV antigen by enzyme-linked immunosorbent assay and polymerase chain reaction was performed for serotyping. The course of the disease, additional diagnoses and treatment regimen were recorded. Incidences adjusted for month and region of observation were calculated by Poisson regression. Of 15,451 children under observation 3980 (26%) presented with AGE. Of 3156 stool samples available 748 (24%) proved RV positive. The incidence of AGE and RV-positive AGE was 25.2 and 4.0 per 100 children per year, respectively, with a maximum in February/March 1998. RV-positive cases were more severe than RV-negative cases (28% vs 12% severe cases, hospitalization rate 6.2% vs 2.0%, p < 0.001). The predominant genotype of RV isolated was G1/P[8] (77%), followed by G4/P[8] (17%).
Conclusion:
Rotavirus accounts for a substantial part of severe cases of AGE in children up to 4 y of age. Efficient prevention, including immunization against the circulating serotypes, could save at least 122,000 children in Germany from falling ill with RV-AGE each year.