“…Given the low overall rotavirus incidence rate, nonvaccinated children may have been protected from rotavirus disease (herd protection), as this effect is well described in other oral vaccines administered for other diseases, such as oral polio (Conyn-Van Spaendonck et al 2001, Ebrahim 2001). This effect may account for the pattern of rotavirus disease observed following national immunization in the United States of America, where children too old to have received the rotavirus vaccine were found to have a reduced incidence of rotavirus disease (Tate et al 2009).…”
Section: Discussionmentioning
confidence: 99%
“…2001, Ebrahim 2001. This effect may account for the pattern of rotavirus disease observed following national immunization in the United States of America, where children too old to have received the rotavirus vaccine were found to have a reduced incidence of rotavirus disease (Tate et al 2009).…”
Rotavirus is an important cause of childhood diarrhoea. A monovalent rotavirus vaccine (Rotarix ® ) was introduced into the Immunization Program of Brazil in 2006. In this study, we describe the incidence and burden of disease of rotavirus diarrhoea in two cohorts of children (vaccinated and unvaccinated). We followed two groups of 250 children under one year old, who were enrolled in December 2006 from a low-income residential area inNortheast Brazil. The children were monitored every two weeks for two years. Stool samples from children with diarrhoea were examined for the presence of rotavirus. Rotaviruses were genotyped using real time-polymerase chain reaction. The mean numbers of all-cause diarrhoea episodes/child (adjusted for age) in the first year were 0. 87 and 0.84, in vaccinated and unvaccinated children, respectively. During the second year, the number of episodes/ child decreased to 0.52 and 0.42. Only 16 (4.9%) of 330 stool samples were rotavirus-positive (10 vaccinated and 6 unvaccinated children) and only P[4]G2 rotaviruses were identified. All-cause diarrhoea episodes were more severe in unvaccinated children in the first year of age (p < 0.05), while vaccinated children had more severe episodes 18 months after vaccination. Rotavirus diarrhoea incidence was very low in both groups.
Key words: diarrhoea -rotavirus -vaccine -cohort -children -BrazilRotavirus diarrhoea in vaccinated children • Sarah Cristina Fontes Vieira et al.
331ties were visited at home in 2006 and their parents were invited to enrol their children in the study, independent of their vaccination status. The parents of the first 250 children who had received two oral doses of the Rotarix ® vaccine (GlaxoSmithKline Biologicals, Rixensart, Belgium) at two and four months of age (vaccinated cohort) were invited to participate and a further 250 children who had not received the vaccine comprised the unvaccinated cohort. Vaccination status was verified using the child's vaccination card and the Health Centre's databases. The youngest unvaccinated children registered were selected, despite the fact that the two groups could not be matched by age, as unvaccinated children had to be ineligible for vaccination at the time of enrolment, and therefore at least four months of age. Unvaccinated children serving as the control group were not offered the vaccine due to EPI guidelines that exclude children greater than or e�ual to four months of age to avoid the risk of intussusception among older infants (WHO 2007).After obtaining informed parental consent, all children were visited at home for the following two years, independently of their age at the time of enrolment. Visits were conducted every two weeks by three trained interviewers who in�uired as to whether or not the child had experienced diarrhoea episodes during the previous twoweek period. If the parent indicated that the child had diarrhoea, the interviewer collected information regarding the date of the episode and clinical presentation. The severity of the diarrhoea episodes wa...
“…Given the low overall rotavirus incidence rate, nonvaccinated children may have been protected from rotavirus disease (herd protection), as this effect is well described in other oral vaccines administered for other diseases, such as oral polio (Conyn-Van Spaendonck et al 2001, Ebrahim 2001). This effect may account for the pattern of rotavirus disease observed following national immunization in the United States of America, where children too old to have received the rotavirus vaccine were found to have a reduced incidence of rotavirus disease (Tate et al 2009).…”
Section: Discussionmentioning
confidence: 99%
“…2001, Ebrahim 2001. This effect may account for the pattern of rotavirus disease observed following national immunization in the United States of America, where children too old to have received the rotavirus vaccine were found to have a reduced incidence of rotavirus disease (Tate et al 2009).…”
Rotavirus is an important cause of childhood diarrhoea. A monovalent rotavirus vaccine (Rotarix ® ) was introduced into the Immunization Program of Brazil in 2006. In this study, we describe the incidence and burden of disease of rotavirus diarrhoea in two cohorts of children (vaccinated and unvaccinated). We followed two groups of 250 children under one year old, who were enrolled in December 2006 from a low-income residential area inNortheast Brazil. The children were monitored every two weeks for two years. Stool samples from children with diarrhoea were examined for the presence of rotavirus. Rotaviruses were genotyped using real time-polymerase chain reaction. The mean numbers of all-cause diarrhoea episodes/child (adjusted for age) in the first year were 0. 87 and 0.84, in vaccinated and unvaccinated children, respectively. During the second year, the number of episodes/ child decreased to 0.52 and 0.42. Only 16 (4.9%) of 330 stool samples were rotavirus-positive (10 vaccinated and 6 unvaccinated children) and only P[4]G2 rotaviruses were identified. All-cause diarrhoea episodes were more severe in unvaccinated children in the first year of age (p < 0.05), while vaccinated children had more severe episodes 18 months after vaccination. Rotavirus diarrhoea incidence was very low in both groups.
Key words: diarrhoea -rotavirus -vaccine -cohort -children -BrazilRotavirus diarrhoea in vaccinated children • Sarah Cristina Fontes Vieira et al.
331ties were visited at home in 2006 and their parents were invited to enrol their children in the study, independent of their vaccination status. The parents of the first 250 children who had received two oral doses of the Rotarix ® vaccine (GlaxoSmithKline Biologicals, Rixensart, Belgium) at two and four months of age (vaccinated cohort) were invited to participate and a further 250 children who had not received the vaccine comprised the unvaccinated cohort. Vaccination status was verified using the child's vaccination card and the Health Centre's databases. The youngest unvaccinated children registered were selected, despite the fact that the two groups could not be matched by age, as unvaccinated children had to be ineligible for vaccination at the time of enrolment, and therefore at least four months of age. Unvaccinated children serving as the control group were not offered the vaccine due to EPI guidelines that exclude children greater than or e�ual to four months of age to avoid the risk of intussusception among older infants (WHO 2007).After obtaining informed parental consent, all children were visited at home for the following two years, independently of their age at the time of enrolment. Visits were conducted every two weeks by three trained interviewers who in�uired as to whether or not the child had experienced diarrhoea episodes during the previous twoweek period. If the parent indicated that the child had diarrhoea, the interviewer collected information regarding the date of the episode and clinical presentation. The severity of the diarrhoea episodes wa...
“…39 Experiences with the Hungarian, Cuban and Brazilian vaccination programmes thus became the basis for the eradication strategy recommended by the WHO, notably that children under 5 years were to be immunised on National Immunisation Days in two rounds, four to six weeks apart. 40 One crucial element seems to stand out from the models used in the Global Polio Eradication Initiative well into the twenty-first century: all were implemented by so-called authoritarian regimes. As the concerns surrounding the development and safety of the Sabin vaccine show, Cold War rhetoric and stereotypes regarding political systems played crucial roles in the global evaluation of the Sabin vaccine.…”
Section: Global Significance: Eastern Europe's Role In Polio Eradicationmentioning
By the end of the 1950s Hungary became an unlikely leader in what we now call global health. Only three years after Soviet tanks crushed the revolution of 1956, Hungary became one of the first countries to introduce the Sabin vaccine into its national vaccination programme. This immunisation campaign was built on years of scientific collaboration between East and West, in which scientists, specimens, vaccines and iron lungs crossed over the Iron Curtain. Dóra Vargha uses a series of polio epidemics in communist Hungary to understand the response to a global public health emergency in the midst of the Cold War. She argues that despite the antagonistic international atmosphere of the 1950s, spaces of transnational cooperation between blocs emerged to tackle a common health crisis. At the same time, she shows that epidemic concepts and policies were influenced by the very Cold War rhetoric that medical and political cooperation transcended. Also available as Open Access.
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