BackgroundThe disease burden and associated medical costs of rotavirus infections in inpatient and outpatient sectors in Taiwan were examined in anticipation of the availability of new rotavirus vaccines.MethodsThe yearly national case number and medical costs for all for inpatients and outpatients with acute gastroenteritis (AGE) were extracted from the Bureau of National Health Insurance database in Taiwan according to ICD-9-CM codes. A retrospective study was also performed using records of children with AGE seen at three hospitals in Taiwan in 2001 to identify laboratory confirmed rotavirus infection cases. The annual incidence and related medical costs of AGE due to rotavirus infection were then estimated.ResultsChildren <5 years old comprised 83.6% of inpatient and 62.0% of outpatient pediatric AGE cases in Taiwan in 2001. Rotavirus was the most common agent detected among AGE patients in this age group in the three hospitals, and was detected in 32.9% (221/672) of inpatient and 24% (23/96) of outpatient stool specimens tested for microbial etiologies. An estimated 277,400 to 624,892 cases of rotavirus infections sought medical care in Taiwan in 2001, equaling one in 2 to 5 children <5 years old required medical care due to rotavirus infection. The incidence of hospitalization due to rotavirus infections was 1,528–1,997/100,000 for children <5 years old. The total associated medical costs due to rotavirus infection were estimated at US $10–16 millions in Taiwan in 2001. Although the per-capita medical cost of rotavirus infection was lower in Taiwan than in the United States or Hong Kong, the personal economic burden was similar among the three places when normalized for gross national incomes per capita.ConclusionInfections caused by rotavirus constitute an important human and economic burden among young children in Taiwan. A safe and effective vaccine is urgently needed.

No abstract

No abstract

No abstract

This study examined the effects of high-pressure processing (HPP) on microbial shelf-life, starch contents, and starch gelatinization characteristics of pigeon pea milk. HPP at 200 MPa/240 s, 400 MPa/210 s, and 600 MPa/150 s reduced the count of Escherichia coli O157:H7 in pigeon pea milk by more than 5 log CFU/mL. During the subsequent 21-day refrigerated storage period, the same level of microbial safety was achieved in both HPP-treated and high-temperature short-time (HTST)-pasteurized pigeon pea milk. Differential scanning calorimetry and scanning electron microscope revealed that HPP at 600 MPa and HTST caused a higher degree of gelatinization in pigeon pea milk, with enthalpy of gelatinization (∆H) being undetectable for both treatments. In contrast, HPP at 400 MPa led to an increase in the onset temperature, peak temperature, and conclusion temperature, and a decrease in ∆H, with gelatinization percentages only reaching 18.4%. Results of an in vitro digestibility experiment indicate that maximum resistant starch and slowly digestible starch contents as well as a decreased glycemic index were achieved with HPP at 400 MPa. These results demonstrate that HPP not only prolongs the shelf-life of pigeon pea milk but also alters the structural characteristics of starches and enhances the nutritional value.