Rotavirus in adults, Brazil, 2004–2011: G2P[4] dominance and potential impact on vaccination

Luchs, Adriana; Cilli, Audrey; Morillo, Simone Guadagnucci; Carmona, Rita de Cássia Compagnoli; Timenetsky, María do Carmo Sampaio Tavares

doi:10.1016/j.bjid.2013.05.010

Cited by 29 publications

(19 citation statements)

References 52 publications

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“…This study provides further evidence that RVA is a cause of acute adult diarrhea in China, but other study show that RVA was not an etiological agent with diarrhea [32]. The frequency of RVA infection (7.4%) was close to other study (9.6%) [39], but was higher than in the study (2.6%) conducted in adolescents or adults (10–89 years) in Italy [40]. …”

Section: Discussionsupporting

confidence: 69%

Case–control study of diarrheal disease etiology in individuals over 5 years in southwest China

Zhang

Yang

et al. 2016

Gut Pathog

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BackgroundAcute diarrhea is one of the major public health problems worldwide. Most of studies on acute diarrhea have been made on infants aged below 5 years and few efforts have been made to identify the etiological agents of acute diarrhea in people over five, especially in China.Methods271 diarrhea cases and 149 healthy controls over 5 years were recruited from four participating hospitals between June 2014 and July 2015. Each stool specimen was collected to detect a series of enteric pathogens, involving five viruses (Rotavirus group A, RVA; Norovirus, NoV; Sapovirus, SaV; Astrovirus, As; and Adenovirus, Ad), seven bacteria (diarrheagenic Escherichia coli, DEC; non-typhoidal Salmonella, NTS; Shigella spp.; Vibrio cholera; Vibrio parahaemolyticus; Aeromonas spp.; and Plesiomonas spp.) and three protozoa (Cryptosporidium spp., Giardia lamblia, G. lamblia, and Blastocystis hominis, B. hominis). Standard microbiological and molecular methods were applied to detect these pathogens. Data was analyzed using Chi square, Fisher-exact tests and logistic regressions.ResultsThe prevalence of at least one enteric pathogen was detected in 29.2% (79/271) acute diarrhea cases and in 12.1% (18/149) in healthy controls (p < 0.0001). Enteric viral infections (14.4%) were the most common in patients suffering from acute diarrhea, followed by bacteria (13.7%) and intestinal protozoa (4.8%). DEC (12.5%) was the most common causative agent in diarrhea cases, followed by NoV GII (10.0%), RVA (7.4%) and B. hominis (4.8%). The prevalence of co-infection was statistically higher (p = 0.0059) in the case group (7.7%) than in the healthy control (1.3%). RVA–NoV GII (3.0%) was the most common co-infection in symptomatic cases.ConclusionsDEC was the most predominant pathogen in diarrhea cases, but it was largely overlooked because the lack of laboratory capacities. Because of the high prevalence of co-infections, it is recommended the urgent development of alternative laboratory methods to assess polymicrobial infections. Such methodological improvements will result in a better prevention and treatment strategies to control diarrhea illness in China.Electronic supplementary materialThe online version of this article (doi:10.1186/s13099-016-0141-1) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 69%

Case–control study of diarrheal disease etiology in individuals over 5 years in southwest China

Zhang

Yang

et al. 2016

Gut Pathog

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“…The adult population is susceptible to the same RV genotypes as children, and infections tend to appear at the same time of the year. The authors suggest that adults act as reservoirs for viruses and are in part responsible for outbreaks among infants [26]. The frequency of NoV infection in the elderly in this work (11.8%) was similar to that found in Spain (11.1%) in 2011 [27].…”

Section: Discussionsupporting

confidence: 85%

“…The research conducted by Anderson et al [25] showed that the vaccination of children against RV is correlated with an almost 50% reduction in RV among adults [25]. Other reports reviewed the number of registered cases of nonspecific gastroenteritis caused by RV [26]. In this context, the RV vaccine was able to reduce cases of this disease in the United States and indirectly protected the population aged 5 to 44 years [1].…”

Section: Discussionmentioning

confidence: 99%

“…Curiously enough, people under 5 and over 44 years of age were not protected by the vaccine [1]. In Brazil, it was shown that the immunization of children did not reduce diarrhea cases in individuals older than 18 years [26]. The adult population is susceptible to the same RV genotypes as children, and infections tend to appear at the same time of the year.…”

Section: Discussionmentioning

confidence: 99%

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Detecção de rotavírus e norovírus na população idosa na cidade de Caxias do Sul, Rio Grande do Sul, Brasil, de 2010 a 2012

Paesi

Modena

Roesch‐Ely

2015

Sci Med

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Aims: Rotavirus (RV) and norovirus (NoV) are the most common causes of diarrhea in children aged less than five years throughout the world. However, RV and NoV have frequently been overlooked as pathogens in elderly individuals. This study examined the frequency of RV and NoV among elderly patients with complaints of diarrhea in the city of Caxias do Sul, southern Brazil. Methods: Between 2010 and 2012, stool samples from patients aged 60 years or older with acute gastroenteritis treated at a private healthcare center were analyzed, seeking to identify RV and NoV. RV detection was performed by latex agglutination (LA) methods and polyacrylamide gel electrophoresis (PAGE). One third of the samples were further tested for NoV by reverse transcription polymerase chain reaction (RT-PCR). Results: A total of 145 stool samples from patients aged 60 to 105 years were analyzed. RV was detected in 6/145 (4.14%) and 5/125 (4.00%) of the samples by LA and PAGE, respectively. NoV was detected in 6/51 (11.76%). Mixed infection (RV and NoV) was detected in a single sample: 1/51 (1.96%). Conclusions: This study adds further evidence that viral agents are involved in the etiology of gastroenteritis in the elderly, contributing significantly to the understanding of RV and NoV infections in the mature population.

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“…5b). Also, studies not included in the meta-analysis indicated a greater magnitude of effectiveness than would be expected from the proportion of vaccinated children, suggesting an indirect herd effect [51–55]. …”

Section: Discussionmentioning

confidence: 99%

Efficacy, safety and effectiveness of licensed rotavirus vaccines: a systematic review and meta-analysis for Latin America and the Caribbean

et al. 2017

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Background RotaTeq™ (RV5; Merck & Co. Inc., USA) and Rotarix™ (RV1, GlaxoSmithKline, Belgium) vaccines, developed to prevent rotavirus diarrhea in children under five years old, were both introduced into national immunization programs in 2006. As many countries in Latin America and the Caribbean have included either RV5 or RV1 in their routine childhood vaccination programs, we conducted a systematic review and meta-analysis to analyze efficacy, safety and effectiveness data from the region.MethodsWe conducted a systematic search in PubMed, EMBASE, Scielo, Lilacs and the Cochrane Central Register, for controlled efficacy, safety and effectiveness studies published between January 2000 until December 2011, on RV5 and RV1 across Latin America (where both vaccines are available since 2006). The primary outcome measures were: rotavirus-related gastroenteritis of any severity; rotavirus emergency department visits and hospitalization; and severe adverse events.ResultsThe results of the meta-analysis for efficacy show that RV1 reduced the risk of any-severity rotavirus-related gastroenteritis by 65% (relative risk (RR) 0.35, 95% confidence interval (CI) 0.25; 0.50), and of severe gastroenteritis by 82% (RR 0.18, 95%CI 0.12; 0.26) versus placebo. In trials, both vaccines significantly reduced the risk of hospitalization and emergency visits by 85% (RR 0.15, 95%CI 0.09; 0.25) for RV1 and by 90% (RR 0.099, 95%CI 0.012; 0.77) for RV5. Vaccination with RV5 or RV1 did not increase the risk of death, intussusception, or other severe adverse events which were previously associated with the first licensed rotavirus vaccine. Real-world effectiveness studies showed that both vaccines reduced rotavirus hospitalization in the region by around 45–50% for RV5 (for 1 to 3 doses, respectively), and, by around 50–80% for RV1 (for 1 to 2 doses, respectively). For RV1, effectiveness against hospitalization was highest (around 80–96%) for children vaccinated before 12 months of age, compared with 5–60% effectiveness in older children. Both vaccines were most effective in preventing more severe gastroenteritis (70% for RV5 and 80–90% for RV1) and severe gastroenteritis (50% for RV5 and 70–80% for RV1).ConclusionThis systematic literature review confirms rotavirus vaccination has been proven effective and well tolerated in protecting children in Latin America and the Caribbean.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0771-y) contains supplementary material, which is available to authorized users.

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Rotavirus in adults, Brazil, 2004–2011: G2P[4] dominance and potential impact on vaccination

Cited by 29 publications

References 52 publications

Case–control study of diarrheal disease etiology in individuals over 5 years in southwest China

Case–control study of diarrheal disease etiology in individuals over 5 years in southwest China

Detecção de rotavírus e norovírus na população idosa na cidade de Caxias do Sul, Rio Grande do Sul, Brasil, de 2010 a 2012

Efficacy, safety and effectiveness of licensed rotavirus vaccines: a systematic review and meta-analysis for Latin America and the Caribbean

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