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Assays for the Specific Growth Rate and Cell-binding Ability of Rotavirus
Published on: January 28, 2019
Active, population-based surveillance for severe rotavirus gastroenteritis in children in the United States
Daniel C Payne1, Mary Allen Staat, Kathryn M Edwards
1Epidemiology Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS-A34, Atlanta, GA 30333, USA. dvp6@cdc.gov
Insights
Before the US rotavirus vaccine program, rotavirus caused significant illness in young children, leading to many hospitalizations and emergency department visits. This surveillance established crucial baseline data for monitoring vaccine impact.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Public health surveillance
Background:
- Routine rotavirus vaccination for US infants began in 2006.
- The Centers for Disease Control and Prevention (CDC) established a surveillance network to monitor acute gastroenteritis in children under 3.
- This system aimed to establish baseline rotavirus disease burden and track vaccine impact.
Purpose of the Study:
- To establish baseline estimates of rotavirus disease burden in US children under 3 years of age.
- To enable prospective monitoring of the impact of the rotavirus vaccination program.
- To conduct population-based surveillance of acute gastroenteritis.
Main Methods:
- Surveillance of children under 3 with acute gastroenteritis across hospital, emergency department, and outpatient settings in 3 US counties.
- Data collection via parental interviews and medical chart review.
- Laboratory testing of stool specimens for rotavirus using enzyme immunoassays and genotyping via reverse transcription-polymerase chain reaction.
Main Results:
- 44% of 516 enrolled children with acute gastroenteritis tested positive for rotavirus.
- The predominant strain was P[8]G1 (84%).
- Rotavirus cases were associated with higher rates of vomiting, diarrhea, fever, and lethargy, with significant hospitalization (22.5/10,000) and emergency department visit (301.0/10,000) rates.
Conclusions:
- Pre-vaccination surveillance revealed a substantial burden of rotavirus disease on the US healthcare system.
- Laboratory-confirmed rotavirus surveillance provided critical baseline data before vaccine implementation.
- Findings underscore the importance of rotavirus vaccination in reducing childhood illness.
Objectives:
Routine vaccination of US infants against rotavirus was implemented in 2006, prompting the Centers for Disease Control and Prevention New Vaccine Surveillance Network to begin population-based acute gastroenteritis surveillance among US children<3 years of age. This surveillance system establishes baseline estimates of rotavirus disease burden and allows for the prospective monitoring of rotavirus vaccination impact.
Methods:
Eligible children with acute gastroenteritis (>or=3 episodes of diarrhea and/or any vomiting in a 24-hour period) who were hospitalized, were seen in emergency departments, or visited selected outpatient clinics in 3 US counties during the period of January through June 2006 were enrolled. Epidemiological and clinical information was obtained through parental interview and medical chart review, and stool specimens were tested for rotavirus with enzyme immunoassays. Rotavirus-positive specimens were genotyped by using reverse transcription-polymerase chain reaction assays.
Results:
Stool specimens were collected from 516 of the 739 enrolled children with acute gastroenteritis (181 inpatient, 201 emergency department, and 134 outpatient) and 44% tested positive for rotavirus (227 of 516 specimens). The most common strain was P[8]G1 (84%), followed by P[4]G2 (5%) and P[6]G12 (4%). None of the 516 children had received rotavirus vaccine. The rotavirus detection rate was 50% for hospitalized acute gastroenteritis cases, 50% for emergency department visits, and 27% for outpatient visits. Rotavirus-related acute gastroenteritis cases were more likely than non-rotavirus-related acute gastroenteritis cases to present with vomiting, diarrhea, fever, and lethargy. Directly calculated, population-based rates for rotavirus hospitalizations and emergency department visits were 22.5 hospitalizations and 301.0 emergency department visits per 10 000 children<3 years of age, respectively. A sentinel outpatient clinic visit rate of 311.9 outpatient visits per 10,000 children<3 years of age was observed.
Conclusions:
Population-based, laboratory-confirmed rotavirus surveillance in the final rotavirus season before implementation of the US rotavirus vaccine program indicated a considerable burden of disease on the US health care system.
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