Impact of Acute Rotavirus Gastroenteritis on Pediatric Outpatient Practices in the United States

Coffin, Susan; Elser, Joseph M.; Marchant, Colin D.; Sawyer, Mark H.; Pollara, Bernard; Fayorsey, Ruby; Nelson, Linda; Lawley, Diane; Goveia, Michelle G.; Stek, Jon E.; Hille, Darcy A.; DiNubile, Mark J.

doi:10.1097/01.inf.0000220251.27595.74

Cited by 55 publications

(43 citation statements)

References 23 publications

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“…Case definition of subjects admitted to the ED Gastroenteritis was defined as the presence of diarrhoea (> 3 watery stools within a period of 24 h) and/or vomiting, with or without fever [14]. All subjects recruited met the clinical case definition.…”

Section: Study Populationmentioning

confidence: 99%

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Burden of rotavirus infections in Liguria, northern Italy: hospitalisations and potential savings by vaccination

Panatto

Amicizia

Giacchino

et al. 2011

Eur J Clin Microbiol Infect Dis

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Purpose We evaluated the rates of gastroenteritis admissions to the emergency department and of rotavirusrelated hospitalisations in children ≤5 years in 2006 at an Italian paediatric hospital; we calculated the number of rotavirus cases avoidable through the universal vaccination of children.Methods Epidemiological data were extracted from the Data Elaboration Centre. To calculate the hospitalisation rate due to rotavirus, the virus was sought in the faeces of children hospitalised for acute gastroenteritis by means of rapid immunochromatographic assay.Results Emergency department admissions due to gastroenteritis numbered 2396 (11.58% of total admissions).Of these, 276 children (11.52%) were examined and then sent home; 1286 (53.67%) were kept in short observation and 776 (32.38%) were hospitalised. In 27.83% of hospitalised cases, the rotavirus test proved positive. The RV hospitalization rate was 55 per 10000 children ≤5 years in Genoa in 2006. In 85.6% of hospitalised patients with community-acquired rotavirus infection, the disease was severe. ConclusionsThe number of avoidable cases confirmed that the vaccination of children ≤1 year of age could reduce the burden of rotavirus infection, especially with regard to hospitalisation (45 per 10000 children ≤5 years) and admissions to short observation (85 per 10000), generating benefits for Italian healthcare system.

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Section: Study Populationmentioning

confidence: 99%

“…When the onset of gastroenteritis (presence of diarrhoea > 3 watery stools within a period of 24 h and/or vomiting, with or without fever [14]) occurred after three days of hospitalisation, nosocomial infection was assumed. Nosocomial RV infections were included in the study.…”

Section: Nosocomial Case Definitionmentioning

confidence: 99%

Burden of rotavirus infections in Liguria, northern Italy: hospitalisations and potential savings by vaccination

Panatto

Amicizia

Giacchino

et al. 2011

Eur J Clin Microbiol Infect Dis

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“…The whole illness lasts about 3 or 4 days, but loose stools can persist for weeks. 7,8 Early on, vomiting may be rate limiting in terms of attempts at oral rehydration.…”

Section: Disease Burdenmentioning

confidence: 99%

Rotavirus Disease and Prevention Through Vaccination

Marshall¹

2009

Pediatric Infectious Disease Journal

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Rotavirus is the most common cause of acute infectious gastroenteritis in children and is associated with substantial morbidity in the United States and morbidity and mortality in the developing world. Two orally administered vaccines, a live bovine reassortant vaccine (RV5; licensed in 2006) and a live attenuated human vaccine (RV1; licensed in 2008), are now being used in a universal infant vaccination program in the United States. There is already ecologic evidence and data from post-licensure effectiveness studies that this program will be an unequivocal success in reducing the impact of rotavirus disease. This overview presents the structure, pathogenesis, and mechanisms of natural immunity to rotavirus, key concepts in understanding the rationale behind vaccine-induced protection. The history of rotavirus vaccine development is also included, along with a discussion of the safety, efficacy, and recommended use of the approved vaccines.

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“…Although rotavirus accounts for an estimated half-million deaths each year in the developing world (17), the public health burden of rotavirus gastroenteritis in industrialized nations is largely measured in infant morbidity, healthcare costs, missed daycare, and loss of time from work for parents/guardians (6,9,11,13,15,16,19,23,35,36). The rotavirus epidemic season in the United States typically begins in the autumn in the Southwest and spreads across the country ending in the spring of the following calendar year in the Northeast (31).…”

Section: Discussionmentioning

confidence: 99%

Unexpectedly high burden of rotavirus gastroenteritis in very young infants

et al. 2010

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Background: The highest incidence of rotavirus gastroenteritis has generally been reported in children 6-24 months of age. Young infants are thought to be partially protected by maternal antibodies acquired transplacentally or via breast milk. The purpose of our study was to assess the age distribution of children with confirmed community-acquired rotavirus gastroenteritis presenting to an urban referral hospital. Methods: Children presenting to The Children's Hospital of Philadelphia with acute gastroenteritis have been monitored for the presence of rotavirus antigen in the stool by ELISA (followed by genotyping if ELISA-positive) since the 1994-95 epidemic season. Results: Over the last 12 rotavirus seasons prior to the introduction of the pentavalent rotavirus vaccine in 2006, stool specimens from 1646 patients tested positive for community-acquired rotavirus infection. Gender or age was not recorded in 6 and 5 cases, respectively. Overall, 58% of the cases occurred in boys. G1 was the predominant VP7 serotype, accounting for 72% of cases. The median (IQR) age was 11 (5-21) months. A total of 790 (48%) cases occurred in children outside the commonly quoted peak age range, with 27% in infants <6 months of age and 21% in children >24 months of age. A total of 220 (13%) cases occurred during the first 3 months of life, and the highest number of episodes per month of age [97 (6%)] was observed during the second month of life. Conclusions:The incidence of community-acquired rotavirus gastroenteritis monitored over 12 seasons in the prevaccine era at a major university hospital was nearly constant for each month of age during the first year of life, revealing an unexpectedly high incidence of symptomatic rotavirus disease in infants <3 months old. A sizeable fraction of cases occurred in children too young to have been vaccinated according to current recommendations.

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Impact of Acute Rotavirus Gastroenteritis on Pediatric Outpatient Practices in the United States

Cited by 55 publications

References 23 publications

Burden of rotavirus infections in Liguria, northern Italy: hospitalisations and potential savings by vaccination

Burden of rotavirus infections in Liguria, northern Italy: hospitalisations and potential savings by vaccination

Rotavirus Disease and Prevention Through Vaccination

Unexpectedly high burden of rotavirus gastroenteritis in very young infants

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