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Over-diagnosis of Rotavirus Infection in Infants Due to Detection of Vaccine Virus
David M Whiley1,2, Suifang Ye2,3, Sarah Tozer4
1Faculty of Medicine, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia.
Insights
Accurate rotavirus diagnosis is crucial for infant health. Many positive rotavirus tests in infants were due to vaccine shedding, highlighting the need to differentiate between vaccine and wild-type viruses.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Diagnostic microbiology
Background:
- Accurate rotavirus diagnosis is essential for effective clinical management.
- Monitoring rotavirus disease and vaccine effectiveness relies on precise diagnostic methods.
- Distinguishing between wild-type and vaccine strains of rotavirus is clinically significant.
Purpose of the Study:
- To evaluate the proportion of rotavirus-positive results attributable to vaccine virus shedding in infants.
- To highlight the need for diagnostic tests that differentiate vaccine from wild-type rotavirus.
Main Methods:
- Retrospective analysis of laboratory data for rotavirus testing in infants.
- Review of results from 2016-2018.
- Calculation of the percentage of positive results due to vaccine shedding.
Main Results:
- Between 2016 and 2018, 71 out of 152 (46.7%) infants tested for rotavirus had positive results.
- A significant proportion of these positive results were identified as vaccine virus shedding.
- This indicates a substantial overlap between vaccine shedding and active rotavirus infection in diagnostic results.
Conclusions:
- Routine infant rotavirus diagnostic testing frequently detects vaccine virus shedding.
- Current diagnostic approaches may not adequately distinguish between vaccine and wild-type rotavirus.
- Future diagnostic strategies should aim to differentiate vaccine-induced shedding from wild-type rotavirus infections for accurate clinical assessment and surveillance.
Abstract:
An accurate rotavirus diagnosis is important for clinical management and monitoring active disease and vaccine effectiveness. Between 2016-2018, rotavirus-positive results in our laboratory were from vaccine virus shedding in 71/152 (46.7%) infants with a request for rotavirus testing. Routine infant diagnostic testing should ideally distinguish vaccine from wild-type viruses.
