Rotavirus epidemiology before and after vaccine introduction

Assis, Andrêssa Silvino Ferreira; Valle, Daniel Almeida do; Antunes, Gustavo Resende; Tibiriçá, Sandra Helena Cerrato; Assis, Rosane Maria Santos de; Leite, José Paulo Gagliardi; Carvalho, Iná Pires de; Silva, Maria Luzia da Rosa e

doi:10.1016/j.jped.2013.02.019

Cited by 25 publications

(19 citation statements)

References 25 publications

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“…In each of the three sites, the reduction in rotavirus prevalence were observed post‐vaccine introduction. These findings convincingly demonstrate the impact of vaccination in reducing the burden of severe rotavirus disease in Moroccan children, consistent with data from other studies worldwide studies [Zeller et al, ; Assis et al, ; Pendleton et al, ]. During the pre‐vaccine period, the prevalence of rotavirus hospitalizations peaked during the cooler months of September–December with a defined peak in November.…”

Section: Discussionsupporting

confidence: 91%

Effect of monovalent rotavirus vaccine on rotavirus disease burden and circulating rotavirus strains among children in Morocco

Benhafid

Elomari

Idrissi

et al. 2015

Journal of Medical Virology

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Rotarix(TM) vaccine was introduced into the National Program of Immunization of Morocco in October 2010, reaching quickly 87% of the target population of children nationally. The incidence of rotavirus gastroenteritis and the prevalence of circulating rotavirus strains has been monitored in three sentinel hospitals since June 2006. The average percentage of rotavirus positive cases among all children under 5 years old hospitalized for gastroenteritis during the pre-vaccine period (2006-2010) was 44%. This percentage dropped to 29%, 15% and 24% in the 3 years post vaccine introduction (2011, 2012 and 2013), which is a decline of 34%, 66%, and 45%, respectively. Declines in prevalence were greatest among children 0-1 years of age (53%) and were most prominent during the winter and autumn rotavirus season. The prevalence of the G2P[4] and G9P[8] genotype sharply increased in the post vaccine period (2011-2013) compared to the previous seasons (2006-2010). Rotavirus vaccines have reduced greatly the number of children hospitalized due to rotavirus infection at the three sentinel hospitals; it is however unclear if the predominance of G2P[4] and G9P[8] genotypes is related to the vaccine introduction, or if this is attributable to normal genotype fluctuations. Continued surveillance will be pivotal to answer this question in the future.

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Section: Discussionsupporting

confidence: 91%

Effect of monovalent rotavirus vaccine on rotavirus disease burden and circulating rotavirus strains among children in Morocco

Benhafid

Elomari

Idrissi

et al. 2015

Journal of Medical Virology

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“…RV is responsible for 1 in 3 cases of severe acute gastroenteritis in children less than 5 years of age hospitalized with diarrhea in urban Pakistani hospitals. The detection rate of 30.5% is lower than the estimated overall Asia burden of 37.5%, though wide variability ranging from 12% in Hong Kong to 56% in Cambodia has been reported [25] – [28] . Our study showed that most cases of RV are in children under the age of 2 years (87%), similar to that described from other Asian settings.…”

Section: Discussionmentioning

confidence: 79%

Sentinel Hospital-Based Surveillance for Assessment of Burden of Rotavirus Gastroenteritis in Children in Pakistan

et al. 2014

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ObjectivesTo determine the burden and molecular epidemiology of rotavirus gastroenteritis in children hospitalized with severe acute watery diarrhea in Pakistan prior to introduction of rotavirus vaccine.MethodsA cross-sectional study was carried out over a period of two years from 2006 – 2008 at five sentinel hospitals in the cities of Karachi, Lahore, Rawalpindi, and Peshawar. Stool samples collected from children under five years of age hospitalized with severe acute watery diarrhea were tested for rotavirus antigen via enzyme immunoassay (EIA) (IDEA REF K6020 Oxoid Ltd (Ely), Cambridge, United Kingdom). A subset of EIA positive stool samples were further processed for genotyping.Results6679 children were enrolled and stool specimens of 2039 (30.5%) were positive for rotavirus. Rotavirus positivity ranged from 16.3% to 39.4% in the 5 hospitals with highest positivity in Lahore. 1241 (61%) of all rotavirus cases were in infants under one year of age. Among the strains examined for G-serotypes, the occurrence of G1, G2, G9 and G4 strains was found to be 28%, 24%, 14% and 13%, respectively. Among P-types, the most commonly occurring strains were P6 (31.5%) followed by P8 (20%) and P4 (12%). Prevalent rotavirus genotype in hospitalized children of severe diarrhea were G1P[8] 11.6% (69/593), followed by G2P[4] 10.4% (62/593), and G4P[6] 10.1% (60/593).ConclusionsApproximately one third of children hospitalized with severe gastroenteritis in urban centers in Pakistan have rotavirus. Introduction of rotavirus vaccine in Pakistan's national immunization program could prevent many severe episodes and diarrheal deaths.

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“…A possible hypothesis is that the introduction of RV1 vaccine into the NIP has helped to decrease the prevalence of predominant Wa-like strains facilitating the increase of the heterotypic (DS-1-like) RVA strain G2P [4] in the Brazilian population. In addition, the long period of low or no circulation of genotype G2P [4] in Brazil previous to RV1 introduction would have created favorable conditions for the accumulation of immunological susceptible individuals (Carvalho-Costa et al, 2009;Assis et al, 2013). These facts, together with the genetic diversity found in different geographical regions throughout the years before, and after the introduction of the vaccine might explained the high prevalence of genotype G2P [4] in Brazil since 2005.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and genomic characterization of G2P[4] group A rotavirus strains during monovalent vaccine introduction in Brazil

Gómez

Carvalho-Costa

Volotão

et al. 2014

Infection, Genetics and Evolution

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This study aims to: estimate the prevalence of G2P[4] rotaviruses in Brazil between 2001-2011 from patients with acute gastroenteritis; perform phylogenetic analyses of G2P[4] Brazilian strains (from vaccinated and non-vaccinated children) based on VP7 and VP8(∗) encoding genes and analyze the antigenic regions of these proteins comparing with RV1; and assess the full genetic background of eleven selected Brazilian strains. The G2P[4] detection rate among RVA positive samples was 0/157 in 2001, 3/226 (1.3%) in 2002, 0/514 in 2003, 0/651 in 2004, 31/344 (9%)/2005, 112/227 (49%)/2006, 139/211 (66%)/2007, 240/284 (85%)/2008, 66/176 (37.5%)/2009, 367/422 (87%)/2010 and 75/149 (50%)/2011. For the VP7 and VP8(∗) encoding genes, 52 sequences were analyzed and shared up to 99% nucleotide identity with other contemporary G2P[4] strains detected worldwide, grouping into different clusters. Most differences inside antigenic epitopes of VP7 and VP8(∗) have been maintained in the G2P[4] Brazilian strains along the years, and all were present before RV1 introduction. Eleven G2P[4] strains (4-vaccinated/7-non-vaccinated) were completely characterized and possessed the typical DS-1-like genotype constellation (G2-P[4]-I2-R2-C2-M2-A2-N2-T2-E2-H2) sharing up to 99% of nucleotide identity with contemporary worldwide strains. Reassortments between Brazilian G2P[4] human strains were observed. In conclusion, the data obtained in the current study suggests that implementation of RV1 vaccination might not influence the genetic diversity observed in G2P[4] analyzed strains. Several factors might have contributed to the increased prevalence of this genotype in Brazil since 2005: the introduction of RV1 into the Brazilian National Immunization Program has resulted in a decrease in the relative prevalence of predominant Wa-like RVA strains facilitating the increase of the heterotypic (DS-1-like) RVA strain G2P[4] in the Brazilian population; the genetic diversity found in different geographical regions throughout the years before, and after the introduction of RV1; the long period of low or no circulation of this genotype in Brazil previous to RV1 introduction could have created favorable conditions for the accumulation of immunological susceptible individuals.

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Rotavirus epidemiology before and after vaccine introduction

Abstract: The study evidenced a significant decrease in the prevalence of rotavirus, mainly in children aged between 0 and 36 months in the 2007-2011 period, as well as a reduction in G1 genotype circulation.

Cited by 25 publications

References 25 publications

Effect of monovalent rotavirus vaccine on rotavirus disease burden and circulating rotavirus strains among children in Morocco

Effect of monovalent rotavirus vaccine on rotavirus disease burden and circulating rotavirus strains among children in Morocco

Sentinel Hospital-Based Surveillance for Assessment of Burden of Rotavirus Gastroenteritis in Children in Pakistan

Prevalence and genomic characterization of G2P[4] group A rotavirus strains during monovalent vaccine introduction in Brazil

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