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Published on: January 28, 2019
Characterization of Rotavirus Infection in Hospitalized Children under 5 with Acute Gastroenteritis 5 Years after
Hye Sun Yoon1, Yong-Hak Sohn2, Jeong Don Chae3
1Department of Pediatrics, Nowon Eulji Medical Center, School of Medicine, Eulji University, Seoul 01830, Korea.
Insights
Rotavirus vaccines significantly reduced hospitalizations in young children in South Korea, showing 84.9% effectiveness. The study found no new rotavirus strains, indicating vaccine success.
Area of Science:
- Pediatrics
- Infectious Diseases
- Vaccinology
Background:
- Rotavirus gastroenteritis is a major cause of hospitalization in children under five.
- Introduction of rotavirus vaccines aims to reduce disease burden.
- Post-vaccine surveillance is crucial to monitor rotavirus strains and vaccine effectiveness.
Purpose of the Study:
- To characterize rotavirus infection in hospitalized children after vaccine introduction in South Korea.
- To determine rotavirus genotypes circulating in the study population.
- To estimate the effectiveness of rotavirus vaccines against hospitalization.
Main Methods:
- A test-negative case-control study design was employed.
- Enzyme-linked fluorescent immunoassay (ELISA) detected rotavirus antigens.
- G and P genotyping used nested multiplex PCR and sequencing; vaccine effectiveness calculated via multivariate logistic regression.
Main Results:
- Rotavirus was detected in 13.2% of 121 hospitalized children, peaking in April 2012.
- Dominant genotypes were G3P[8] (33.3%) and G4P[6] (26.7%).
- Vaccine effectiveness against rotavirus hospitalization was 84.9% in fully vaccinated children. Children with siblings showed higher infection rates and lower vaccination history.
Conclusions:
- Rotavirus prevalence showed a decreasing trend post-vaccination, with no emergence of non-vaccine strains.
- Rotavirus vaccines demonstrated high effectiveness (84.9%) against hospitalization.
- Children with siblings were more susceptible to rotavirus infection and less likely to be vaccinated.
Abstract:
We herein characterized rotavirus infection in hospitalized children under 5 years of age with gastroenteritis after introducing rotavirus vaccines in South Korea from 20 February 2012, to 31 March 2013. Enzyme-linked fluorescent immunoassay was performed to detect rotavirus antigens. G and P genotyping was performed using nested multiplex PCR. For the failed PCR samples, sequencing was conducted. We performed a test-negative case-control study to estimate vaccine effectiveness. Vaccine effectiveness was measured using a multivariate logistic regression model. Rotavirus was detected in 16 (13.2%) of the 121 patients, with a seasonal peak in April 2012. The dominant genotypes detected were G3P[8] (33.3%) and G4P[6] (26.7%), and vaccine effectiveness against rotavirus hospitalization was 84.9% [95% CI: 23.2−97.0] in the complete vaccinated group. A higher prevalence of rotavirus infection was observed among children with siblings than those without siblings (p < 0.001). Also, the presence of siblings was significantly associated with a history of nonvaccination (p < 0.001). In conclusion, the prevalence of rotavirus followed a decreasing trend, and there was no evidence of emergences of nonvaccine-type strains. Vaccine effectiveness against rotavirus hospitalization was 84.9%. Although children with siblings were more susceptible to rotavirus infection, they were less likely to receive vaccination against rotavirus.
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