Incidencia y factores de riesgo para adquirir diarrea aguda en una comunidad rural de la selva peruana

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César Henríquez Camacho

2002-04-01

Full Text Available Objetivo: Determinar la incidencia y factores de riesgo para adquirir diarrea aguda en una comunidad rural localizada en la selva del departamento de San Martín, Perú. Material y métodos: Una cohorte de 119 personas fue seleccionada al azar entre la población de 446 habitantes y seguida diariamente por un mes entre enero y febrero de 1999, buscando casos de diarrea aguda, definida como tres ó más cámaras de deposiciones al día por no más de 3 días. Un estudio caso control pareado fue diseñado para determinar los factores de riesgo para adquirir diarrea. Resultados: Fueron observados 18 casos de diarrea aguda; la incidencia fue 15.1 casos por 100 personas-mes (IC 95%: 9.45-23.12. La edad media de los casos fue de 10.7 años (rango: 1-34 años y 66% de los casos fueron niños menores de 10 años de edad. Los factores de riesgo para adquirir diarrea fueron: consumo de alimentos crudos, RR: 2.2 (IC 95%: 1.12-4.33, consumo de alimentos no lavados, RR: 4.47 (IC 95%: 1.56-12.82, falta de lavado de manos antes de alimentarse, RR: 9.61 (95% IC: 1.44-64.16, consumo de agua no hervida, RR: 4.52 (IC 95%: 1.23-16.65 y alimentación fuera de casa, RR: 2.2 (IC 95%: 1.51-3.20. La diferencia en el número promedio (DE de personas que vivían por casa entre casos y controles fue de 4.38 (1.03 vs. 3.22 (0.54, p=0.0003, respectivamente. No hubo diferencia en el tiempo de residencia en la comunidad entre casos y controles, media de 5.61 ( 5.04 años vs. 8.83 (9.79, p=0.5747. Conclusiones: Diarrea aguda es un problema de salud pública en la selva de San Martín. Hacinamiento, carencia de saneamiento y pobres prácticas higiénicas son los responsables para adquirir diarrea aguda en esta comunidad de bajo nivel socioeconómico. Campañas educativas y mejora en las condiciones sanitarias son claramente necesarias para superar este problema.

Conocimientos, actitudes y prácticas maternas frente a la diarrea infantil aguda

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Ocampo Montero, María Belén

2014-01-01

Entre las enfermedades más predominantes de la primera infancia las diarreas explican el 18% de las muertes de niños a nivel mundial. Particularmente en Argentina las diarreas y las infecciones gastrointestinales están dentro de las doce causas de muerte más importantes entre los niños menores de 5 años, lo que genera un gran problema de salud pública en los países en desarrollo, por su alta carga de morbilidad y mortalidad. Objetivo: Indagar sobre los conocimientos, actitudes,...

Diarrea y micronutrientes

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Alonso Zea; Theresa Ochoa

2013-01-01

La diarrea continúa siendo una causa importante de morbi-mortalidad en niños pequeños. Si bien el uso de las sales de rehidratación oral ha sido de gran ayuda para disminuir la mortalidad asociada a deshidratación, aún se requieren de estrategias efectivas para disminuir la morbilidad asociada a esta enfermedad. El zinc y la vitamina A son dos micronutrientes que han demostrado ser útiles en la prevención y tratamiento de la diarrea en niños. La suplementación de zinc actualmente es recomenda...

Enteropatógenos de importancia en salud pública

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Maribel Riveros

Full Text Available La diarrea continúa siendo la tercera causa de muerte en niños menores de 5 años, pese a los avances recientes en el manejo y prevención de esta enfermedad. Es causada por múltiples patógenos, sin embargo, la prevalencia de cada uno varía según el grupo de edad, la zona geográfica y el escenario donde se registran los casos (comunitario vs hospitalario. Los patógenos de mayor relevancia en salud pública son aquellos asociados con mayor carga de enfermedad, severidad, complicaciones y mortalidad. En nuestro medio, el norovirus, Campylobacter y las E. coli diarrogénicas, son los patógenos más prevalentes a nivel comunitario en niños. En este artículo se revisa la epidemiología local y las potenciales áreas de desarrollo en cinco patógenos seleccionados: rotavirus, norovirus, E. coli productora de toxina Shiga (STEC, Shigella y Salmonella. De estos, el rotavirus es el más importante en la población pediátrica y el principal responsable de la mortalidad infantil por diarrea. La introducción de la vacunación contra rotavirus en nuestro país tendrá un importante impacto en la carga de enfermedad y la mortalidad por diarrea. Sin embargo, se requieren estudios de vigilancia para determinar el impacto de la vacunación y el cambio en la epidemiología de la diarrea en el Perú luego de la introducción de nuevas vacunas, así como la vigilancia de las tasas de resistencia antibiótica para las bacterias de importancia clínica.

Fisiopatología de la diarrea aguda

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Raúl L. Riverón Corteguera

1999-06-01

Full Text Available Es un artículo de revisión de los aspectos importantes de la fisiopatología de la diarrea. Se hace una descripción de la fisiopatología intestinal que incluye la anatomía del intestino y de su superficie de absorción y la estructura funcional de la mucosa intestinal. La fisiopatología normal de los líquidos intestinales. Mecanismo de absorción del agua y los electrólitos. Absorción de sodio por difusión electrogénica, unido al ion cloro, intercambio con el ion hidrógeno y unido a sustancias orgánicas como glucosa, aminoácidos y algunos oligopéptidos; secreción intestinal de agua y electrólitos. Control intracelular de la secreción. Mediadores y moduladores extracelulares del transporte intestinal. Factores que aumentan la absorción y reducen la secreción. Factores que estimulan la secreción y reducen la absorción Mecanismo fisiopatológico de la diarrea. Clasificación de la diarrea infecciosa aguda: acuosa secretoria y osmótica; diarrea con sangre invasiva y no invasiva.This a review of some important aspects of the physiopathology of diarrhea. A description is made of the intestinal physiopathology, including the anatomy of the intestine and of its surface of absorption, as well as the functional structure of the intestinal mucosa: the normal physiopathology of the intestinal fluids; the mechanism of absorption of water and electrolites; the absorption of sodium by electrogenic difussion, joined to the chloride ion; the interchange with the hydrogen ion and attached to organic substances, such as glucose, aminoacids and some oligopeptides; the intestinal secretion of water and electrolites; the intracellular control of secretion, the extracellular mediators and modulators of intestinal transport; the factors that increase absorption and reduce secretion; the factors that stimulate secretion and absorption; and the physiopathological mechanism of diarrhea. The classification of acute infectious diarrhea in aqueous

Enterobacterias como agentes etiológicos de la diarrea en la comunidad

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Carlos Agudelo

1992-06-01

Full Text Available Con el fin de identificar, a nivel de la comunidad, los enteropatógenos bacterianos que producen diarrea en niños menores de 10 años, tomamos muestras de heces de 204 pacientes con cuadro diarreico de 1 a 7 días de evolución y de un grupo control, sin diarrea, conformado por 48 niños. Evaluamos también la recuperación de los microorganismos empleando o no medio de Cary-Blair como medio de transporte e identificamos las categorías de Escherichia coli aisladas empleando pruebas biológicas e inmunológicas. Se destacaron como agentes etiológicos de la diarrea E. coli (58,8%, E. coli enterotoxigénica, productora de toxina labil (ECET-TL (5,1%, Salmonella enteritidis (6,9% y Shigella sonnei (5,9%. Cuando no se usó el medio de transporte de Cary-Blair la sensibilidad en la recuperación de los microorganismos fue del 37%. Se destaca la importancia de determinar la frecuencia real de las categorías de E. coli en nuestro medio.

Economic impact of a rotavirus vaccination program in Mexico Impacto económico de un programa de vacunación contra rotavirus en México

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Dagna Constenla

2009-06-01

vacunar. A partir de datos nacionales publicados se estimó el número de casos y muertes por rotavirus, los años de vida ajustados por la discapacidad (AVAD que se evitarían y la relación costo-efectividad incremental (US$/AVAD de una cohorte anual hipotética de 2 285 000 niños; se partió de algunos supuestos sobre el costo, la cobertura y las tasas de eficacia. RESULTADOS: Con una cobertura de 93% y un precio de la vacuna de US$ 16,00 por esquema (dos dosis, se estima que un programa de vacunación contra rotavirus en México evitaría 651 muertes (0,28 muertes por 1 000 niños, 13 833 hospitalizaciones (6,05 hospitalizaciones por 1 000 niños y 414 927 visitas de consulta externa (182 consultas por 1 000 niños por gastroenteritis aguda asociada a rotavirus (GAR. La vacunación podría reducir la carga económica por GAR en México al evitar gastos por US$ 14 millones (71% de la carga total por atención sanitaria. A un precio de US$ 16,00 por esquema, la relación costo-efectividad sería de US$ 1 139,00 por AVAD evitado. Una reducción en el precio del programa de vacunación contra rotavirus (US $8,00 por esquema generaría una menor relación costo-efectividad incremental de US$ 303,00 por AVAD evitado. CONCLUSIONES: Un programa nacional de vacunación contra rotavirus en México reduciría la incidencia y la mortalidad infantiles y sería altamente efectivo en función del costo, según los umbrales de las intervenciones de costo-efectividad de la Organización Mundial de la Salud.

Effect of Lactobacillus strains and Saccharomyces boulardii on persistent diarrhea in children

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D. Gaon

2003-08-01

Full Text Available The efficacy of probiotics on persistent diarrhea remains uncertain. The purpose of this study was to evaluate the effect of Lactobacillus sp and Saccharomyces boulardii on persistent diarrhea in children. In a double-blind trial eighty-nine children, aged 6-24 months were randomly distributed to receive pasteurized cow milk containing 2 viable lyophilized strains Lactobacillus casei and Lactobacillus acidophillus strains CERELA, (1010-1012 colony-forming units per g (n =30, or lyophilized S. boulardii, (1010-1012 colony forming units per g (n =30 or pasteurized cow milk as placebo (n =29; on each diet 175 g was given twice a day for a 5 day period. Number of depositions, duration of illness and frequency of vomiting were considered. Enteric pathogens were isolated from stools in 40% of the patients, 27% had rotavirus. Lactobacillus and S.boulardii significantly reduced the number of depositions (p La eficacia de los probióticos sobre la diarrea persistente en niños aún no ha sido comprobada. Este trabajo controlado doble ciego tuvo como propósito evaluar ese efecto usando Lactobacillus sp y Saccharomyces boulardii. Ochenta y nueve niños entre 6 meses y 2 años de edad fueron distribuidos al azar para recibir leche pasteurizada conteniendo cepas liofilizadas de Lactobacillus casei y Lactobacillus acidophillus desarrolladas por CERELA (Centro de Referencia para Lactobacilos (1010-1012 CFU por g, n=30, o cepas liofilizadas de S. boulardii (1010-1012 CFU por g, n = 30, o placebo, n =29. Cada niño recibió 175 g dos veces por día durante 5 días. Se evaluó el número de deposiciones/día, la duración de la diarrea y la duración de los síntomas. Se aislaron gérmenes patógenos en las heces en el 40% de los casos: 27% eran rotavirus. Lactobacillus sp y S. boulardii redujeron significativamente el número de deposiciones (p < 0.001, la duración de la diarrea y el número de vómitos (p< 0.005 y (p< 0.002 respectivamente, comparado con

Varón de 48 años con diarrea y colestasis

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A. Jímenez Jurado

2015-09-01

Full Text Available Presentamos el caso de un varón de 48 años derivado a la consulta por un cuadro clínico de diarrea crónica (> 6 semanas junto con alteración de las pruebas de función hepática consistente en un patrón de colestasis. La presencia de diarrea crónica y colestasis nos obligaron al diagnóstico diferencial entre las siguientes entidades: enfermedad celíaca, enferme-dad inflamatoria intestinal, enfermedades infecciosas crónicas (tuber-culosis intestinal, micobacterium avium en inmunodeprimidos, causas metabólicas como la amiloidosis, obstrucción de la vía biliar intrahepatica (ductopenia del adulto, colangitis esclerosante primaria o secundaria, toma de fármacos y finalmente causas tumorales (colangiocarcinoma, linfoma de Hodgkin, adenocarcinoma colon. En el caso que presentamos, la colangio resonancia magnética nuclear fue la herramienta diagnóstica fundamental para el diagnóstico de la entidad

Burden of diarrhea among children in Honduras, 2000-2004: estimates of the role of rotavirus La diarrea infantil en Honduras, 2000-2004: estimados del papel desempeñado por el rotavirus

OpenAIRE

José Orlando Solórzano Girón; Ida Berenice Molina; Reina M. Turcios-Ruiz; Claudia E. Quiroz Mejia; Luis Miguel Amendola; Lucia Helena de Oliveira; Jon K. Andrus; Paul W. Stupp; Joseph S. Bresee; Roger I. Glass

2006-01-01

OBJECTIVES: To estimate the annual burden of diarrhea and of diarrhea that is associated with rotavirus (RV) in children who are treated at public clinics and hospitals in Honduras. METHODS: Data were collected from computerized records of all children < 5 years old treated for diarrhea at clinics and hospitals operated by the Secretary of Health for the period of 2000 through 2004. A review of studies of RV in Honduras and neighboring countries provided estimates of detection rates of RV amo...

Escherichia coli enteroagregativa en niños con diarrea de un hospital de Lima

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Isabel Arias B

2004-07-01

Full Text Available Entre las Escherichia coli diarreogénicas la categoría E. coli enteroagregativa (ECEA es una de las más importantes y frecuentemente asociada a diarreas infantiles. El presente estudio se realizó con la finalidad de detectar los factores de virulencia que caracterizan a esta categoría patogénica mediante hibridación por colony blot usando sondas de ADN específicas. Se evaluaron 233 cepas aisladas en el laboratorio del Hospital de Emergencias Pediátricas durante los meses de diciembre 1998 y abril de 1999. Del total de muestras analizadas, se encontró que 17,16% de las cepas poseen el factor de virulencia característico de esta categoría. Los resultados obtenidos demuestran que un importante número de aislamientos de niños con diarrea presentan E. coli enteroagregativa.

Interferencia de la infección por rotavirus mediante la inhibición de la actividad de la proteína disulfuro isomerasa (DPI de la membrana celular de las líneas MA104 y Caco-2.

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Carlos Arturo Guerrero Fonseca

2008-12-01

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Economic and health burden of rotavirus gastroenteritis for the 2003 birth cohort in eight Latin American and Caribbean countries Carga económica y de morbilidad de la gastroenteritis por rotavirus en la cohorte de nacidos en 2003 en ocho países de América Latina y el Caribe

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Richard D. Rheingans

2007-04-01

Full Text Available OBJECTIVE: To estimate the health and economic burden of rotavirus gastroenteritis in hospital and outpatient settings in eight Latin American and Caribbean countries (Argentina, Brazil, Chile, Dominican Republic, Honduras, Mexico, Panama, and Venezuela. METHODS: An economic model was constructed using epidemiological data from published articles, national health administration studies, and country-specific cost estimates. For each of the eight countries, the model estimated the rotavirus outcomes for the 2003 birth cohort during the first five years of life. The main outcome measures included health care costs, transportation costs, lost wages, and disease burden expressed in disability-adjusted life years. Estimates were expressed in 2003 US dollars. All future costs and disability-adjusted life year estimates were discounted at a rate of 3%. Sensitivity analyses evaluated the impact of specific variables on the medical cost of treating rotavirus. RESULTS: For every 1 000 children born during 2003 in the eight Latin American and Caribbean countries studied here, we estimated that rotavirus gastroenteritis would result in an average of 246 outpatient visits, 24 hospitalizations, 0.6 deaths, and US$ 7 971 in direct medical costs during their first five years of life. The incidence of rotavirus-associated outpatient visits and the cost of outpatient visits were predicted to have the largest impact on the total medical cost per child. CONCLUSIONS: Rotavirus gastroenteritis is likely to result in substantial disease and economic burden to health systems in Latin American and Caribbean countries, and the foreseeable burden should be an important consideration in evaluating the cost-effectiveness of vaccination.OBJETIVO: Estimar la carga económica y de morbilidad de la gastroenteritis por rotavirus en hospitales y servicios ambulatorios de ocho países de América Latina y el Caribe (Argentina, Brasil, Chile, Honduras, México, Panamá, Rep

Rotavirosis en niños de la región de la Baixada Fluminense, Rio de Janeiro, Brasil

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Fabiano Guerra-Sanches

2013-10-01

Full Text Available La infección por rotavirus es la principal causa de diarrea aguda en el mundo. Se estima que esta infección es responsable de aproximadamente 138 millones de casos de diarrea aguda y de 44 mil muertes al año en niños con edad menor de cinco años. Objetivos: Determinar la frecuencia de rotavirosis en niños con gastroenteritis atendidos en los servicios de salud de la región de la Baixada Fluminense. Material y métodos: Entre enero de 2009 y abril de 2010 se colectaron muestras fecales de 1067 niños menores de cinco años afectados de gastroenteritis. Se utilizó la técnica de reacción inmunocromatográfica para detectar antígenos de rotavirus (Rotavirus Tira Látex Test Bioeasy. Resultados: El 21,3% de los niños examinados tuvieron antígenos de rotavirus en las muestras fecales. No se encontró diferencias entre niños y niñas. Conclusiones: La incidencia de rotavirosis en la región de la Baixada Fluminense se encuentra en un nivel medio en comparación con poblaciones semejantes en países de Latinoamérica.

Saneamiento, educación, medio ambiente y diarreas: el caso del Conurbano Bonaerense

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Monteverde, Malena; Cipponeri, Marcos; Angelaccio, Carlos M.

2010-01-01

El objetivo del estudio es analizar los efectos del déficit en servicios de saneamiento, factores socio-económicos y factores ambientales que, por sí mismos o en combinación, incrementan el riesgo de padecimiento de diarreas entre la población del Conurbano Bonaerense, una de las áreas mas densamente pobladas de la Argentina y uno de los once conglomerados urbanos más grandes del mundo. Para la medición de los efectos se utilizan datos primarios obtenidos mediante una encuesta ad-hoc y se est...

Evaluación de dos equipos inmunocromatográficos comerciales para el diagnóstico rápido de la infección por rotavirus Evaluation of two immunochromatography kits for rapid diagnosis of rotavirus infections

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C. J. Téllez

2008-09-01

Full Text Available Se realizó un estudio prospectivo para evaluar dos equipos comerciales inmunocromatográficos para el diagnóstico rápido de infección por rotavirus a partir de muestras fecales: VIKIA® Rota-Adeno, de bioMérieux, y Simple Rota- Adeno, de Operon. Como método de referencia se utilizó la transcripción reversa y reacción en cadena de la polimerasa (RT-PCR con cebadores específicos del gen de la proteína VP7 de rotavirus del grupo A. La sensibilidad y la especificidad respecto de la RT-PCR fueron del 98,4% y 84,8% para el Simple Rota-Adeno, y del 100% y 24,2% para el VIKIA® Rota-Adeno. Es de destacar la baja especificidad de este último equipo diagnóstico, que presentó un elevado número de falsos positivos, por lo que el valor predictivo de un resultado positivo es sólo del 71,6%. Asimismo, se identificaron los genotipos de las cepas de rotavirus detectadas; la mayoría de ellas correspondieron al genotipo G9P(8 (65%, seguido de los genotipos G1P(8 (25,4% y G2P(8 (3,2%.A prospective study was conducted to evaluate two immunochromatography (ICG commercial kits for diagnosis of rotavirus infection, VIKIA® Rota-Adeno (bioMérieux and Simple Rota-Adeno (Operon. Reverse transcriptase and polymerase chain reaction (RT-PCR with specific primers for the VP7 gene of group A rotavirus was used as the reference method. The sensitivity and specificity of the ICG tests compared with those of the reference method were 98.4% and 84.8%, respectively, for Simple Rota-Adeno (Operon, and 100% and 24.2% for VIKIA® Rota-Adeno (bioMérieux. It is remarkable the low specificity of the latter method, which yields a high number of false positive results. The predictive value of a positive result by this method was only 71.6%. Most of the detected rotavirus strains corresponded to genotype G9P(8 (65%, followed by G1P(8 (25.4% and G2P(8 (3.2%.

Efecto del zinc aminoquelado y el sulfato de zinc en la incidencia de la infección respiratoria y la diarrea en niños preescolares de centros infantiles

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Juliana Sánchez

2014-03-01

Full Text Available Introducción. El déficit de zinc es común en niños de poblaciones en desarrollo. La deficiencia de zinc altera el sistema inmunológico y la resistencia a las infecciones. Objetivo. Evaluar el efecto de dos compuestos de zinc en la prevención de la infección respiratoria y la diarrea agudas. Materiales y métodos. Se llevó a cabo un ensayo comunitario triple ciego en 301 niños entre dos y cinco años de edad de centros infantiles de Medellín. Fueron seis conglomerados distribuidos aleatoriamente en tres grupos de intervención que recibieron zinc aminoquelado, sulfato de zinc y placebo durante cinco días de la semana a lo largo de 16 semanas. Se evaluaron diariamente los síntomas de infección respiratoria, diarrea aguda y efectos secundarios. Resultados. La incidencia de la infección respiratoria fue menor con el zinc aminoquelado (1,42 por 1.000 días-niño comparado con el sulfato de zinc (1,57 por 1.000 días-niño (RR=0,90, IC95%: 0,382 a 2,153, p=0,999 y con el placebo (3,3 por 1.000 días-niño (RR=0,43, IC95%: 0,196 a 0,950, p=0,049. La incidencia de diarrea aguda con el zinc aminoquelado (0,15 por 1.000 días-niño fue menor que con el sulfato de zinc (1,18 0,78 por 1.000 días-niño (RR=0,20, IC95%: 0,0043 a 1,662, p=0,361 y que la del grupo placebo (0,49 por 1.000 días-niño (RR=0,32, IC95%: 0,006 a 3,990, p=0,346. Conclusiones. El zinc aminoquelado tuvo mejor efecto en la disminución de la incidencia de la infección respiratoria y la diarrea agudas en niños preescolares comparado con los otros grupos de estudio. Identificador en clinicaltrials.gov: NCT01791608

Diarrea del viajero asociada a Aeromonas hydrophila

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M. Martín Delgado

2001-06-01

Full Text Available Aeromonas hydrophila es una bacteria que se encuentra frecuentemente en aguas dulces y salobres. Desde hace varios años se conoce que determinadas cepas de la especie pueden causar enfermedad en pescados y en anfibios, existiendo cierta controversia sobre su patogeneicidad en humanos. No obstante, puede dar lugar a infección en personas, que la adquieren bien a través de heridas abiertas o bien por ingestión de alimentos o agua contaminados. Sin embargo, en prácticamente la totalidad de las publicaciones se hace referencia a casos aislados más que a brotes producidos por esta bacteria. Generalmente la infección por A. hydrophila da lugar a gastroenteritis en personas sanas, pudiendo generar una septicemia en individuos inmunodeprimidos.En 1998 se produjo una alarma en el sector hotelero por un incremento considerable de los casos de gastroenteritis entre los turistas que acudían durante sus vacaciones a determinadas zonas costeras de la isla de Tenerife.Tras tener conocimiento de la situación, la Dirección General de Salud Pública inició una investigación epidemiológica con el objetivo de conocer la magnitud real del problema detectado e identificar los factores asociados a la misma, para poner en marcha las medidas correctoras y de control necesarias. El análisis inicial permitió determinar que se trataba de un proceso de gran magnitud en su extensión aunque de carácter leve, que afectaba únicamente a los turistas en una zona costera en concreto, compatible por lo tanto con la diarrea del viajero, planteándose un origen probablemente hídrico.

An atypical rotavirus detected in a child with gastroenteritis in Rio de Janeiro, Brazil

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H. G. Pereira

1983-09-01

Full Text Available Particles morphologically identical to rotaviruses were found in the faeces of a nine week-old child with gastroenteritis. Analysis of the viral RNA genome by polyacrylamine gel electrophoresis revealed 10 bands (probably 11 segments some of wich differed in migration rate from those of the great majority of rotaviruses infecting man and other animal hosts. The virus was not detected by a highly sensitive enzyme immunoassay (ELISA and therefore probably lacked the crossreactive antigen(s shared by the majority rotaviruses. This was the only strain with such behaviour among 230 rotaviruses of human origin examined in this laboratory since 1979. The implications of the existence of non-crossreactive rotaviruses are discussed.Partículas morfologicamente idênticas a rotavirus foram encontradas nas fezes de uma criança de dois meses com gastroenterite. Análise do genoma viral por eletroforese em gel de poliacrilamida revelou 10 faixas (provavelmente 11 segmentos de RNA, algumas das quais diferem em velocidade de migração das observadas na grande maioria de rotavirus de hospedeiros humanos e de diversas espécies de animais. O vírus não foi revelado por um ensaio imuno-enzimático de alta sensibilidade, o que sugere a ausência do antígeno de grupo que da reações cruzadas entre a maioria dos rotavirus. O vírus descrito no presente trabalho foi o único com tal comportamento entre 230 amostras analisadas por nós desde 1979. A relevância de existência de rotavirus não relacionados antigenicamente a outros membros do grupo é discutida.

Rotavirus infection

Science.gov (United States)

Crawford, Sue E.; Ramani, Sasirekha; Tate, Jacqueline E.; Parashar, Umesh D.; Svensson, Lennart; Hagbom, Marie; Franco, Manuel A.; Greenberg, Harry B.; O’Ryan, Miguel; Kang, Gagandeep; Desselberger, Ulrich; Estes, Mary K.

2017-01-01

Rotavirus infections are a leading cause of severe, dehydrating gastroenteritis in children rotavirus over a decade ago, rotavirus infections still result in >200,000 deaths annually, mostly in low-income countries. Rotavirus primarily infects enterocytes and induces diarrhoea through the destruction of absorptive enterocytes (leading to malabsorption), intestinal secretion stimulated by rotavirus non-structural protein 4 and activation of the enteric nervous system. In addition, rotavirus infections can lead to antigenaemia (which is associated with more severe manifestations of acute gastroenteritis) and viraemia, and rotavirus can replicate in systemic sites, although this is limited. Reinfections with rotavirus are common throughout life, although the disease severity is reduced with repeat infections. The immune correlates of protection against rotavirus reinfection and recovery from infection are poorly understood, although rotavirus-specific immunoglobulin A has a role in both aspects. The management of rotavirus infection focuses on the prevention and treatment of dehydration, although the use of antiviral and anti-emetic drugs can be indicated in some cases. PMID:29119972

DIARREA VIRAL BOVINA: PATOGÉNESIS E INMUNOPATOLOGÍA

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Iang Rondón

2006-05-01

Full Text Available La diarrea viral bovina (DVB representa un problema de ámbito mundial que causa considerables pérdidastanto en ganado de carne como lechero, afectándolo de diversas formas las cuales están supeditadas ala edad del animal, estado inmunológico y momento de la gestación en el que se produce la infección.La DVB es causada por un virus ARN, género Pestivirus, familia Flaviviridae, el cual ha sido clasificado en2 biotipos (citopático y no citopático según su comportamiento en células de cultivo y en 2 genotipos (Iy II basados en su secuencia genética. Dependiendo de las cepas infectantes se presenta un cuadroclínico particular variando en severidad desde una forma subclínica, pasando por la forma clínica eincluso produciendo la fatal enfermedad de las mucosas o causando efectos deletéreos sobre el feto. Apesar de que en nuestro medio ya existen estudios sobre esta entidad, la implementación de metodologíasdiagnósticas constituye una limitante para el manejo de la misma. La presente revisión se enfoca en lapatogenia e inmunopatología de la DVB.

Epidemiologia das infecções por rotavírus no Brasil e os desafios para o seu controle Rotavirus infection in Brazil: epidemiology and challenges for control

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Alexandre C. Linhares

2000-09-01

Full Text Available Os rotavírus causam de 600.000 a 870.000 óbitos por ano entre crianças em todo o mundo. Esses vírus foram visualizados pela primeira vez no Brasil em 1976, a partir da microscopia eletrônica das fezes de crianças diarréicas em Belém, Pará. Estudos conduzidos em hospitais registraram prevalência de diarréia por rotavírus de 12% e 42%. A par disso, investigações longitudinais assinalaram taxa média de 0,25 episódio de diarréia por criança/ano. Os tipos G1, G2, G3 e G4 representam cerca de 2/3 das amostras circulantes, porém, sustenta-se que o genótipo P[8], G5 associa-se a, no mínimo, 10% das diarréias. Estudos sobre a imunidade natural para rotavírus revelaram que 70% das crianças adquirem anticorpos já aos 4-5 anos de idade. A vacina tetravalente, de origem símio-humana (RRV-TV conferiu proteção de 35% após dois anos de estudo; contudo, o nível protetor alcançou 60% no primeiro ano de vida. A RRV-TV, no norte do Brasil, revelou eficácia de 75% frente às diarréias graves. Há poucos meses interrompeu-se o uso dessa vacina nos EUA devido à ocorrência de intussuscepção como efeito colateral. É provável que futuros experimentos no Brasil contemplem outras "candidatas" a vacina contra rotavírus, que não a RRV-TV.Worldwide, rotaviruses account for 600,000 to 870,000 deaths per year among infants and young children. In Brazil, rotaviruses were first seen in 1976 by scanning electron microscopy of stool samples from diarrheic infants in Belém, Pará. Hospital-based studies have shown that rotaviruses are associated with 12-42% of cases of acute diarrhea. In addition, community-based studies yielded an average of 0.25 rotavirus-related diarrheal episodes per child per year. G types 1 to 4 account for about two-thirds of circulating strains, but the (unusual P[8],G5 genotype has been claimed to cause over 10% of rotavirus diarrheal episodes. It has been shown that over 70% of children develop rotavirus antibodies

Diarrea funcional como causa de diarrea crónica Functional diarrhea as cause of chronic diarrhea

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Trini Fragoso Arbelo

2010-12-01

Full Text Available La diarrea funcional se presenta con frecuencia en la práctica pediátrica, y generalmente no se asocia a alteraciones nutricionales, pero sí a esquemas dietéticos incorrectos. Se actualiza su importancia clínica, se hace énfasis en la patogenia, diagnóstico y en los métodos de tratamiento. Consideramos que es la causa más frecuente de diarrea crónica inespecífica, y que el interrogatorio dirigido según los criterios de Roma es útil para su diagnóstico. La mayoría de los pacientes con esta enfermedad en la infancia deben ser tratados en la atención primaria.The functional diarrhea is frequent in the pediatric practice and in general it is not associated with nutritional alterations, but to incorrect dietary schemes. Its clinical significance is updated and its pathogenesis, diagnosis and treatment methods are emphasized. Authors considered that the functional diarrhea is the more frequent cause of unspecific chronic diarrhea and the questioning directed according the Rome criteria is very useful for its diagnosis. Most of patients presenting with this disease during childhood must to be treated in primary care services.

Rotavirus Vaccine

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Why get vaccinated?Rotavirus is a virus that causes diarrhea, mostly in babies and young children. The diarrhea can be severe, and lead ... and fever are also common in babies with rotavirus.Before rotavirus vaccine, rotavirus disease was a common ...

Rotavirus (For Parents)

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español Rotavirus KidsHealth / For Parents / Rotavirus What's in this article? ... the Doctor Print en español El rotavirus About Rotavirus Almost all kids have had a rotavirus infection ...

Rotavirus vaccines

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Yen, Catherine; Tate, Jacqueline E; Hyde, Terri B; Cortese, Margaret M; Lopman, Benjamin A; Jiang, Baoming; Glass, Roger I; Parashar, Umesh D

2014-01-01

Rotavirus is the leading cause of severe diarrhea among children rotavirus vaccines have been efficacious and effective, with many countries reporting substantial declines in diarrheal and rotavirus-specific morbidity and mortality. However, the full public health impact of these vaccines has not been realized. Most countries, including those with the highest disease burden, have not yet introduced rotavirus vaccines into their national immunization programs. Research activities that may help inform vaccine introduction decisions include (1) establishing effectiveness, impact, and safety for rotavirus vaccines in low-income settings; (2) identifying potential strategies to improve performance of oral rotavirus vaccines in developing countries, such as zinc supplementation; and (3) pursuing alternate approaches to oral vaccines, such as parenteral immunization. Policy- and program-level barriers, such as financial implications of new vaccine introductions, should be addressed to ensure that countries are able to make informed decisions regarding rotavirus vaccine introduction. PMID:24755452

Rotavirus Symptoms

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... Search Form Controls Cancel Submit Search The CDC Rotavirus Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Rotavirus Home About Rotavirus Symptoms Transmission Treatment Photos Vaccination ...

Rotavirus Treatment

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... Search Form Controls Cancel Submit Search The CDC Rotavirus Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Rotavirus Home About Rotavirus Symptoms Transmission Treatment Photos Vaccination ...

La enfermedad diarreica aguda: un reto para la salud pública en Colombia Acute diarrheal disease: a public health challenge in Colombia

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Diana Carolina Cáceres

2005-01-01

Full Text Available OBJETIVOS: Establecer la relación entre la infección por rotavirus y la deshidratación por diarrea en niños colombianos menores de 5 años y determinar los factores de riesgo de la diarrea con deshidratación. MÉTODOS: Se realizó un estudio de casos y testigos en un hospital urbano de Bogotá, Colombia, entre abril de 2000 y febrero de 2001. Se seleccionaron 290 niños menores de 5 años de edad de uno u otro sexo; de ellos 145 estaban hospitalizados por enfermedad diarreica aguda (EDA con deshidratación (casos y 145 tenían diagnóstico de EDA sin signos de deshidratación (testigos. A todos los niños se les realizó un examen físico completo. Las madres respondieron un cuestionario con variables demográficas; socioeconómicas; de conocimientos, actitudes y hábitos higiénicos; y de acceso a los servicios de salud. Se determinó la presencia de rotavirus en muestras de heces fecales tomadas durante las primeras 48 horas del ingreso al estudio. RESULTADOS: Se encontró una asociación estadística entre la diarrea con deshidratación y la presencia de rotavirus en las muestras de heces (razón de posibilidades [RP] = 3,46; intervalo de confianza de 95% [IC95%]: 1,71 a 7,00, el peso al nacer OBJECTIVES: To establish the relationship between rotavirus infection and dehydration from diarrhea in Colombian children under 5 years of age, and to identify risk factors for diarrhea with dehydration. METHODS: A case-control study was performed in an urban hospital in Bogotá, Colombia, between April 2000 and February 2001. The sample was composed of 290 children of both sexes under 5 years of age; of these children, 145 of them were hospitalized for acute diarrheal disease (ADD with dehydration (cases, and 145 had a diagnosis of ADD but no signs of dehydration (controls. All children underwent a complete physical examination. Mothers responded to a questionnaire containing items on demographic and socioeconomic variables, as well as on

Infección por Campylobacter y Shigella como causa de Diarrea Aguda Infecciosa en niños menores de dos años en el Distrito de la Victoria, Lima-Perú

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María Perales D; Máximo Camiña; Carmen Quiñones

2002-01-01

Objetivo: Determinar la frecuencia de Campylobacter y Shigella como agentes etiológicos en diarrea aguda acuosa en niños menores de dos años atendidos en 4 centros de salud del distrito de La Victoria (Lima, Perú) Materiales y métodos: en este estudio transversal analítico se realizaron coprocultivos bajo técnica microbiológica estándar a los niños menores de dos años con diarrea aguda acuosa atendidos en 4 centros de salud de La Victoria entre abril y octubre de 2001. Fueron excluidos aquell...

Experiencia con pacientes hospitalizados en la unidad de capacitación para el tratamiento de la diarrea del Hospital Univertario San Vicente de Paúl de Medellín Experience with hospitalized children at a training unit for diarrhea treatment, in Medellín, Colombia

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Carlos A. Bernal Parra

1995-02-01

Full Text Available

Entre 1988 y 1994 se atendieron 1.755 niños en la sala de hospitalización de la Unidad de Capacitación para el Tratamiento de la Diarrea, del Hospital Universitario San Vicente de Paúl, de Medellín; 1.022 (58.2% fueron hombres y 733 (41.8% mujeres; mil setenta y ocho eran menores de un año (61.4% y 677 (38.6% tenían más de un año. Eran desnutridos 888 (50.6%. Presentaban diarrea persistente 418 (23.8%; 1.056 (82.2% diarrea acuosa, 213 (16.6% diarrea disentérica y 16 (1.2% solamente vómitos. Novecientos trece pacientes (52% consultaron o estuvieron en la sala de hidratación oral y 276 (15.7% habían estado hospitalizados por diarrea durante el último mes. Al ingreso 670 (38.2% se encontraban hidratados, 151 (8.6% tenían deshidratación grave y 934 (53.2% presentaban otros grados de deshidratación. La bacteria más frecuentemente identificada fue Salmonella enteritidis (258 casos; 23.9%. Setecientos ochenta y seis pacientes (44.8% recibieron los líquidos solamente por vía oral o por sonda nasogástrica y 969 (55.2% por vía intravenosa. Al egreso 1.088 (62% tuvieron el diagnóstico de diarrea aguda y 667 (38% el de diarrea persistente. La mortalidad fue de 1.5% (27 pacientes.

We present the results of our experience in the in-patient treatment of children with diarrhea. Between 1988 and 1994,1.755 children were hospitalized for this purpose at the Training Unit for Diarrhea Treatment, Hospital San Vicente, in Medellín, Colombia; 1.022 (58.2% were males and 733 (41.8% females; 1.078 (61.4% were younger than one year and 677 (38.6% were above this age. Eight hundred and eighty eight (50.6% were undernourished. At admission, persistent diarrhea was found in 418 (23.8%; stools were watery in 1.056 (82.2% and dysenteric in 213 (16.6%; 16

Rotavirus infection and the current status of rotavirus vaccines

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Shou-Chien Chen

2012-04-01

Full Text Available Among children, rotaviruses are the most common cause of severe gastroenteritis worldwide and of diarrheal deaths in developing countries. Current vaccines (e.g., Rotarix, GlaxoSmithKline Biologicals; RotaTeq, Merck and Company effectively reduce rotaviral gastroenteritis, emergency department visits, and hospitalizations. The tremendous burden of rotavirus-related diarrhea in children across the world continues to drive the remarkable pace of vaccine development. This review assesses the global epidemiological and economic burden of rotavirus diseases, summarizes the relevant principles of the development of rotavirus vaccines, and presents data on the efficacy and effectiveness of currently licensed vaccines in both developed and developing countries.

Impact of rotavirus vaccination on child mortality, morbidity, and rotavirus-related hospitalizations in Bolivia.

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Inchauste, Lucia; Patzi, Maritza; Halvorsen, Kjetil; Solano, Susana; Montesano, Raul; Iñiguez, Volga

2017-08-01

The public health impact of rotavirus vaccination in countries with high child mortality rates remains to be established. The RV1 rotavirus vaccine was introduced in Bolivia in August 2008. This study describes the trends in deaths, hospitalizations, and healthcare visits due to acute gastroenteritis (AGE) and in rotavirus-related hospitalizations, among children rotavirus-related AGE was assessed using data from the active surveillance hospitals. Compared with the 2001-2008 pre-vaccine baseline, the mean number of rotavirus-related hospitalizations was reduced by 40.8% (95% confidence interval (CI) 21.7-66.4%) among children rotavirus disease. Over the post-vaccine period, changes in rotavirus epidemiology were observed, manifested by variations in seasonality and by a shift in the mean age of those with rotavirus infection. The significant decrease in main AGE-related health indicators in children rotavirus vaccine provides evidence of a substantial public health impact of rotavirus vaccination in Bolivia, as a measure for protecting children against AGE. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Rotavirus vaccines: an overview.

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Midthun, K; Kapikian, A Z

1996-01-01

Rotavirus vaccine development has focused on the delivery of live attenuated rotavirus strains by the oral route. The initial "Jennerian" approach involving bovine (RIT4237, WC3) or rhesus (RRV) rotavirus vaccine candidates showed that these vaccines were safe, well tolerated, and immunogenic but induced highly variable rates of protection against rotavirus diarrhea. The goal of a rotavirus vaccine is to prevent severe illness that can lead to dehydration in infants and young children in both...

Group A rotavirus gastroenteritis: post-vaccine era, genotypes and zoonotic transmission.

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Luchs, Adriana; Timenetsky, Maria do Carmo Sampaio Tavares

2016-01-01

ABSTRACTThis article provides a review of immunity, diagnosis, and clinical aspects of rotavirus disease. It also informs about the changes in epidemiology of diarrheal disease and genetic diversity of circulating group A rotavirus strains following the introduction of vaccines. Group A rotavirus is the major pathogen causing gastroenteritis in animals. Its segmented RNA genome can lead to the emergence of new or unusual strains in human populations via interspecies transmission and/or reassortment events.RESUMOEste artigo fornece uma revisão sobre imunidade, diagnóstico e aspectos clínicos da doença causada por rotavírus. Também aponta as principais mudanças no perfil epidemiológico da doença diarreica e na diversidade genética das cepas circulantes de rotavírus do grupo A, após a introdução vacinal. O rotavírus do grupo A é o principal patógeno associado à gastroenterite em animais. Seu genoma RNA segmentado pode levar ao surgimento de cepas novas ou incomuns na população humana, por meio de transmissão entre espécies e eventos de rearranjo.

Burden of Norovirus and Rotavirus in Children after Rotavirus Vaccine Introduction, Cochabamba, Bolivia

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McAtee, Casey L.; Webman, Rachel; Gilman, Robert H.; Mejia, Carolina; Bern, Caryn; Apaza, Sonia; Espetia, Susan; Pajuelo, Mónica; Saito, Mayuko; Challappa, Roxanna; Soria, Richard; Ribera, Jose P.; Lozano, Daniel; Torrico, Faustino

2016-01-01

The effectiveness of rotavirus vaccine in the field may set the stage for a changing landscape of diarrheal illness affecting children worldwide. Norovirus and rotavirus are the two major viral enteropathogens of childhood. This study describes the prevalence of norovirus and rotavirus 2 years after widespread rotavirus vaccination in Cochabamba, Bolivia. Stool samples from hospitalized children with acute gastroenteritis (AGE) and outpatients aged 5–24 months without AGE were recruited from an urban hospital serving Bolivia's third largest city. Both viruses were genotyped, and norovirus GII.4 was further sequenced. Norovirus was found much more frequently than rotavirus. Norovirus was detected in 69/201 (34.3%) of specimens from children with AGE and 13/71 (18.3%) of those without diarrhea. Rotavirus was detected in 38/201 (18.9%) of diarrheal specimens and 3/71 (4.2%) of non-diarrheal specimens. Norovirus GII was identified in 97.8% of norovirus-positive samples; GII.4 was the most common genotype (71.4% of typed specimens). Rotavirus G3P[8] was the most prevalent rotavirus genotype (44.0% of typed specimens) and G2P[4] was second most prevalent (16.0% of typed specimens). This community is likely part of a trend toward norovirus predominance over rotavirus in children after widespread vaccination against rotavirus. PMID:26598569

Burden of Norovirus and Rotavirus in Children After Rotavirus Vaccine Introduction, Cochabamba, Bolivia.

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McAtee, Casey L; Webman, Rachel; Gilman, Robert H; Mejia, Carolina; Bern, Caryn; Apaza, Sonia; Espetia, Susan; Pajuelo, Mónica; Saito, Mayuko; Challappa, Roxanna; Soria, Richard; Ribera, Jose P; Lozano, Daniel; Torrico, Faustino

2016-01-01

The effectiveness of rotavirus vaccine in the field may set the stage for a changing landscape of diarrheal illness affecting children worldwide. Norovirus and rotavirus are the two major viral enteropathogens of childhood. This study describes the prevalence of norovirus and rotavirus 2 years after widespread rotavirus vaccination in Cochabamba, Bolivia. Stool samples from hospitalized children with acute gastroenteritis (AGE) and outpatients aged 5-24 months without AGE were recruited from an urban hospital serving Bolivia's third largest city. Both viruses were genotyped, and norovirus GII.4 was further sequenced. Norovirus was found much more frequently than rotavirus. Norovirus was detected in 69/201 (34.3%) of specimens from children with AGE and 13/71 (18.3%) of those without diarrhea. Rotavirus was detected in 38/201 (18.9%) of diarrheal specimens and 3/71 (4.2%) of non-diarrheal specimens. Norovirus GII was identified in 97.8% of norovirus-positive samples; GII.4 was the most common genotype (71.4% of typed specimens). Rotavirus G3P[8] was the most prevalent rotavirus genotype (44.0% of typed specimens) and G2P[4] was second most prevalent (16.0% of typed specimens). This community is likely part of a trend toward norovirus predominance over rotavirus in children after widespread vaccination against rotavirus. © The American Society of Tropical Medicine and Hygiene.

Patrones de adherencia de cepas de Escherichia coli Difusamente adherente (DAEC provenientes de niños con y sin diarrea Adhesion patterns in diffusely adherent Escherichia coli (DAEC strains isolated from children With and without diarrhea

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Maribel Riveros

2011-03-01

Full Text Available Introducción. Las E. coli de adherencia difusa (DAEC son el sexto grupo de E. coli diarrogénicas reconocidas. Su asociación con diarrea es controversial. No se conoce la variabilidad en los patrones de adherencia de cepas clínicas. Objetivos. Comparar los patrones de adherencia entre cepas aisladas de niños con y sin diarrea. Materiales y métodos. Se analizó 31 cepas DAEC, 25 de diarrea y 6 de niños asintomáticos (control aislados de un estudio de cohorte de niños menores de 12 meses en el cono sur de Lima. Las DAEC fueron identificadas por PCR (gen daaD. Se evaluó el patrón y grado de adherencia en cultivos de células HEp-2; la polimerización de actina se evaluó por la prueba de coloración de fluorescencia de actina (FAS; y la motilidad se evaluó por métodos convencionales microbiológicos. Resultados. El patrón de adherencia difusa se encontró en el 88% de muestras de diarrea y en el 100% de muestras control. La cantidad de bacterias adheridas por célula fue significativamente menor en las muestras de diarrea (pIntroduction. Diffusely adherent E. coli (DAEC is the sixth recognized group of diarrheagenic E. coli. However, its association with diarrhea remains controversial. Variability in the adherence patterns of clinical strains is unknown. Objectives. To compare the adherence patterns between strains isolated from children with and without diarrhea. Materials and methods. A total of 31 DAEC strains were analyzed, 25 from children with diarrhea and 6 from asymptomatic (control children, isolated from a cohort study of children under one year of age in the southern districts of Lima. DAEC were identified by PCR (daaD gene. The pattern and adherence score in HEp-2 cell culture were evaluated, Actin polimerization was determined by fluorescence actin staining (FAS and motility was evaluated by conventional microbiology methods. Results. Diffuse adherence pattern was found in 88% of diarrhea samples and in the total of

Current status of rotavirus vaccines.

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Wang, Ching-Min; Chen, Shou-Chien; Chen, Kow-Tong

2015-11-01

Rotaviruses remain the major cause of childhood diarrheal disease worldwide and of diarrheal deaths of infants and children in developing countries. The huge burden of childhood rotavirus-related diarrhea in the world continues to drive the remarkable pace of vaccine development. Research articles were searched using terms "rotavirus" and "rotavirus vaccine" in MEDLINE and PubMed. Articles not published in the English language, articles without abstracts, and opinion articles were excluded from the review. After preliminary screening, all articles were reviewed and synthesized to provide an overview of current vaccines and vaccination programs. In this review of the global rotavirus vaccines and vaccination programs, the principles of rotavirus vaccine development and the efficacy of the currently licensed vaccines from both developed and developing countries were summarized. Rotavirus is a common cause of diarrhea in children in both developed and developing countries. Rotavirus vaccination is a cost-effective measure to prevent rotavirus diarrhea.

Rotavirus vaccine and health-care utilization for rotavirus gastroenteritis in Tsu City, Japan

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Kamiya, Hajime; Suga, Shigeru; Nagao, Mizuho; Ichimi, Ryoji; Fujisawa, Takao; Umemoto, Masakazu; Tanaka, Takaaki; Ito, Hiroaki; Tanaka, Shigeki; Ido, Masaru; Taniguchi, Koki; Ihara, Toshiaki; Nakano, Takashi

2016-01-01

Background Rotavirus vaccines were introduced in Japan in November 2011. We evaluated the subsequent reduction of the health-care burden of rotavirus gastroenteritis. Methods We conducted active surveillance for rotavirus gastroenteritis among children under 5 years old before and after the vaccine introduction. We surveyed hospitalization rates for rotavirus gastroenteritis in children in Tsu City, Mie Prefecture, Japan, from 2007 to 2015 and surveyed the number of outpatient visits at a Tsu City clinic from 2010 to 2015. Stool samples were obtained for rotavirus testing and genotype investigation. We assessed rotavirus vaccine coverage for infants living in Tsu City. Results In the pre-vaccine years (2007–2011), hospitalization rates for rotavirus gastroenteritis in children under 5 years old were 5.5, 4.3, 3.1 and 3.9 cases per 1000 person-years, respectively. In the post-vaccine years (2011–2015), the rates were 3.0, 3.5, 0.8 and 0.6 cases per 1000 person-years, respectively. The hospitalization rate decreased significantly in the 2013–2014 and 2014–2015 seasons compared to the average of the seasons before vaccine introduction (P rotavirus infection was 66. In the post-vaccine years (2011–2015), the numbers for each season was 23, 23, 7 and 5, respectively. The most dominant rotavirus genotype shifted from G3P[8] to G1P[8] and to G2P[4]. The coverage of one dose of rotavirus vaccine in Tsu City was 56.5% in 2014. Conclusion After the vaccine introduction, the hospitalization rates and outpatient visits for rotavirus gastroenteritis greatly decreased. PMID:28246579

Pagos por desempeño para mejorar el estado nutricional infantil: impacto de los convenios de apoyo presupuestario en tres regiones peruanas con alta prevalencia de desnutrición crónica infantil, 2010-2014

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Viviana Cruzado de la Vega

Full Text Available RESUMEN Objetivos. Estimar el impacto de un esquema de pago por desempeño, denominado convenios de apoyo presupuestario, aplicado por el Gobierno a las tres regiones con mayores tasas de desnutrición crónica infantil (DCI en 2008, Apurimac, Ayacucho y Huancavelica, sobre indicadores de cobertura de servicios de cuidado infantil (vacunación, controles de crecimiento y desarrollo infantil, suplemento de hierro y del estado nutricional del niño (desnutrición, anemia, diarrea. Mediante estos convenios se transferían recursos a los presupuestos de dichas regiones condicionados al cumplimiento de compromisos de gestión y metas de cobertura con el objetivo de mejorar el estado nutricional infantil. Materiales y métodos. A partir de los datos de la Encuesta Demográfica y de Salud Familiar de 2008 a 2014, se compara la evolución en los indicadores evaluados de una muestra de niños que residen en los ámbitos donde se suscribieron los convenios y una muestra de control, mientras los convenios estuvieron vigentes y en los años posteriores para reportar el estimador de diferencias en diferencias del impacto promedio de los convenios Resultados. se encuentran impactos positivos sobre el incremento de coberturas de vacunas del esquema básico y de la vacuna rotavirus y, a través de ellos, en la reducción de la ocurrencia de diarrea y desnutrición. Conclusiones. el esquema habría sido efectivo en activar la cadena mayor cobertura de vacunas y menor DCI, pero no parece mejorar la cobertura de otras prestaciones como las atenciones de crecimiento y desarrollo del niño y entrega de suplementos de hierro al niño y gestante.

Rotavirus Infections

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Rotavirus is a virus that causes gastroenteritis. Symptoms include severe diarrhea, vomiting, fever, and dehydration. Almost all ... the U.S. are likely to be infected with rotavirus before their 5th birthday. Infections happen most often ...

Effective treatment of common variable immunodeficiency associated diarrhea Diarrea asociada a inmunodeficiencia común variable tratada con budesonida

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H. Córdova Guevara

2009-03-01

Full Text Available Common variable immunodeficiency disorder (CVID, the commonest symptomatic primary antibody deficiency syndrome, is characterised by recurrent bacterial infections, particularly of the upper and lower airways; it is also associated with an increased incidence of autoimmune and neoplastic disorders. CVID has a high prevalence of infectious, inflammatory and neoplastic gastrointestinal diseases. Up to 60% of the patients with non-treated CVID develop diarrhea and 10% associated idiopathic malabsorption with weight loss. The case of a 50-year-old woman with CVID-associated diarrhea, abdominal pain and bloating of one year's duration is reported. An exhaustive evaluation made for secondary causes of her symptoms was unrevealing; she was treated with loperamide and diet, without improvement. She later followed a course of oral budesonide for 3 months; her clinical symptoms disappeared and her quality of life improved. In conclusion, we report the case of a patient with CVID-related chronic diarrhea who responded well to oral budesonide treatment. This outcome provides the gastroenterologist with a new therapeutic option in this difficult group of patients.La inmunodeficiencia común variable (IDCV es la deficiencia primaria de anticuerpos sintomática más frecuente y está caracterizada por infecciones bacterianas recurrentes, especialmente de las vías aéreas superiores e inferiores, y también asociada a incremento de enfermedades autoinmunes y neoplasias. Presenta alta prevalencia de enfermedades gastrointestinales infecciosas, inflamatorias y neoplásicas. Hasta el 60% de los pacientes con IDCV no tratados desarrollan diarrea y el 10% desarrollan malabsorción idiopática asociado a pérdida de peso. Presentamos el caso de una mujer de 50 años con IDCV que presenta diarrea crónica, con dolor y distensión abdominal desde hace 1 año. Realizándose múltiples exploraciones y descartando causas secundarias de diarrea crónica, se inicia

Potential cost-effectiveness of vaccination for rotavirus gastroenteritis in eight Latin American and Caribbean countries Efectividad potencial en función del costo de la vacunación contra la gastroenteritis por rotavirus en ocho países de América Latina y el Caribe

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Richard D. Rheingans

2007-04-01

Full Text Available OBJECTIVES: To estimate the costs, benefits and cost-effectiveness of vaccination for rotavirus gastroenteritis in eight Latin American and Caribbean countries: Argentina, Brazil, Chile, the Dominican Republic, Honduras, Mexico, Panama, and Venezuela. METHODS: An economic model was constructed to estimate the cost-effectiveness of vaccination from the health care system perspective, using national administrative and published epidemiological evidence, country-specific cost estimates, and vaccine efficacy data. The model was applied to the first five years of life for the 2003 birth cohort in each country. The main health outcome was the disability-adjusted life year (DALY, and the main summary measure was the incremental cost per DALY averted. A 3% discount rate was used for all predicted costs and benefits. Sensitivity analyses evaluated the impact of uncertainty regarding key variables on cost-effectiveness estimates. RESULTS: According to the estimates obtained with the economic model, vaccination would prevent more than 65% of the medical visits, deaths, and treatment costs associated with rotavirus gastroenteritis in the eight countries analyzed here. At a cost of US$ 24 per course (for a two-dose vaccine, the incremental cost-effectiveness ratio ranged from US$ 269/DALY in Honduras to US$ 10 656/DALY in Chile. Cost-effectiveness ratios were sensitive to assumptions about vaccine price, mortality, and vaccine efficacy. CONCLUSIONS: Vaccination would effectively reduce the disease burden and health care costs of rotavirus gastroenteritis in the Latin American and Caribbean countries analyzed here. From the health care system perspective, universal vaccination of infants is predicted to be cost-effective, based on current standards.OBJETIVOS: Estimar los costos, los beneficios y la efectividad en función del costo de la vacunación contra la gastroenteritis por rotavirus en ocho países de América Latina y el Caribe: Argentina, Brasil

Comparasion of polyacrylamide gel electrophoresis (PAGE, immuno-electron microscopy (IEM and enzyme immunoassay (EIA for the rapid diagnosis of rotavirus infection in children

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H. G. Pereira

1983-12-01

Full Text Available Detection of rotavirus RNA by polyacrylamide gel electrophoresis (PAGE proved to be a highly sensitive and rapid diagnostic test. A comparison of this assay with immuno-electron microscopy (IEM and enzyme immunoassay (EIA in 245 faeces from children with gastroenteritis revealed complete agreement between the three assays in 238 (97.14% samples. Among 75 samples positive in at least one of the three assays, negative results were observed in 5 (6.48% by PAGE, in 6 (6.76% by EIA and in none by IEM. Silver staining greatly increased the sensitivity of the PAGE assay. We conclude that although IEM remains the most sensitive and rapid rotavirus diagnostic assay, the PAGE technique has many advantages in its favour, including the non-requirement of expensive equipment, the use of only chemically defined reagents and the capacity to distinguish virus subgroup and variants and to detect non-crossreactive rotaviruses which are missed in serological assays.A evidenciação da presença de ácido ribonucleico (ARN viral por eletroforese em gel de policrilamida (EGPA foi comprovada como um método altamente sensível e rápido para o diagnóstico de infecções por rotavirus. Uma comparação desta prova com a imunomicroscopia eletrônica (IEM e com o ensaio imunoenzimático (EIE no exame de 245 fezes de crianças com gastroenterite revelou completa concordancia entre os três ensaios em 238 (97.14% amostras. Entre 75 amostras positivas pelo menos em um dos três ensaios, resultados negativos foram observados em 5 (6.48% por EGPA, em 6 (6.76% por EIE e em nenhum por IEM. Coloração pela prata aumentou consideravelmente a sensibilidade do ensaio por EGPA. Concluímos que embora a IEM ainda seja a prova mais sensível e rápida para o diagnóstico de infecções por rotavirus, o ensaio por EGPA tem muitas vantagens em seu favor, sendo as principais as de não necessitar equipamentos caros, de empregar exclusivamente reagentes quimicamente definidos, de

Global Seasonality of Rotavirus Disease

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Patel, Manish M.; Pitzer, Virginia; Alonso, Wladimir J.; Vera, David; Lopman, Ben; Tate, Jacqueline; Viboud, Cecile; Parashar, Umesh D.

2012-01-01

Background A substantial number of surveillance studies have documented rotavirus prevalence among children admitted for dehydrating diarrhea. We sought to establish global seasonal patterns of rotavirus disease before widespread vaccine introduction. Methods We reviewed studies of rotavirus detection in children with diarrhea published since 1995. We assessed potential relationships between seasonal prevalence and locality by plotting the average monthly proportion of diarrhea cases positive for rotavirus according to geography, country development, and latitude. We used linear regression to identify variables that were potentially associated with the seasonal intensity of rotavirus. Results Among a total of 99 studies representing all six geographical regions of the world, patterns of year-round disease were more evident in low- and low-middle income countries compared with upper-middle and high income countries where disease was more likely to be seasonal. The level of country development was a stronger predictor of strength of seasonality (P=0.001) than geographical location or climate. However, the observation of distinctly different seasonal patterns of rotavirus disease in some countries with similar geographical location, climate and level of development indicate that a single unifying explanation for variation in seasonality of rotavirus disease is unlikely. Conclusion While no unifying explanation emerged for varying rotavirus seasonality globally, the country income level was somewhat more predictive of the likelihood of having seasonal disease than other factors. Future evaluation of the effect of rotavirus vaccination on seasonal patterns of disease in different settings may help understand factors that drive the global seasonality of rotavirus disease. PMID:23190782

Infección por Campylobacter y Shigella como causa de Diarrea Aguda Infecciosa en niños menores de dos años en el Distrito de la Victoria, Lima-Perú

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María Perales D

2002-10-01

Full Text Available Objetivo: Determinar la frecuencia de Campylobacter y Shigella como agentes etiológicos en diarrea aguda acuosa en niños menores de dos años atendidos en 4 centros de salud del distrito de La Victoria (Lima, Perú Materiales y métodos: en este estudio transversal analítico se realizaron coprocultivos bajo técnica microbiológica estándar a los niños menores de dos años con diarrea aguda acuosa atendidos en 4 centros de salud de La Victoria entre abril y octubre de 2001. Fueron excluidos aquellos niños con disentería y aquellos que habían recibido tratamiento antibiótico previo a la atención. Resultados: se estudiaron un total de 248 casos, de los cuales 48 (19,4% coprocultivos fueron positivos: 33 (13.3% a Campylobacter, 12 (4,8% a Shigella y 3 (1,2% a Salmonella. No se identificaron otros patógenos. Las especies de Shigella identificadas fueron: Shigella flexneri en 9 (75,0% casos y Shigella sonnei en 3 (25,0% La única especie de Campylobacter identificada fue Campylobacter jejuni siendo el biotipo I el más frecuente (84,6% Conclusiones: Campylobacter y Shigella juegan un importante papel como agentes etiológicos causantes de diarrea aguda acuosa en niños menores de dos años.

Human neonatal rotavirus vaccine (RV3-BB) targets rotavirus from birth

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Thobari, Jarir At; Satria, Cahya Dewi; Handley, Amanda; Watts, Emma; Cowley, Daniel; Nirwati, Hera; Ackland, James; Standish, Jane; Justice, Frances; Byars, Gabrielle; Lee, Katherine J.; Barnes, Graeme L.; Bachtiar, Novilia S.; Icanervilia, Ajeng Viska; Boniface, Karen; Bogdanovic-Sakran, Nada; Pavlic, Daniel; Bishop, Ruth F.; Kirkwood, Carl D.; Buttery, Jim P.; Soenarto, Yati

2018-01-01

Background A birth dose strategy using a neonatal rotavirus vaccine to target early prevention of rotavirus disease may address remaining barriers to global vaccine implementation. Methods We conducted a randomized, placebo-controlled trial in Indonesia to evaluate the efficacy of an oral human neonatal rotavirus vaccine (RV3-BB) to prevent rotavirus gastroenteritis. Healthy newborns received three doses of RV3-BB administered in a neonatal schedule at 0-5 days, 8 and 14 weeks or infant schedule at 8, 14 and 18 weeks, or placebo. Laboratory-confirmed rotavirus gastroenteritis was graded using a modified Vesikari score. The primary analysis was efficacy against severe rotavirus gastroenteritis from two weeks after all doses to 18 months in the combined vaccine group (neonatal and infant schedule) compared with placebo. Results Vaccine efficacy against severe rotavirus gastroenteritis to 18 months was 63% in the combined vaccine group (95% CI 34, 80; p<0.001), 75% in the neonatal vaccine group (95% confidence interval [CI] 44, 91; p<0.001) and 51% in the infant vaccine group (95% CI 7, 76; p=0.03) in the per protocol analysis, with similar results in the intention-to-treat analysis. Vaccine efficacy to 12 months was 94% in the neonatal vaccine group (95%CI 56, 99; p=0.006). Vaccine take occurred in 78/83 (94%) in the neonatal vaccine group and 83/84 (99%) in the infant vaccine group. The vaccine was well tolerated, with similar incidence of adverse events in vaccine and placebo recipients. Conclusion RV3-BB was efficacious, immunogenic and well-tolerated when administered in a neonatal or infant schedule in Indonesia. PMID:29466164

Impact of rotavirus vaccination on rotavirus and all-cause gastroenteritis in peri-urban Kenyan children.

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Wandera, Ernest Apondi; Mohammad, Shah; Bundi, Martin; Komoto, Satoshi; Nyangao, James; Kathiiko, Cyrus; Odoyo, Erick; Miring'u, Gabriel; Taniguchi, Koki; Ichinose, Yoshio

2017-09-12

A monovalent rotavirus vaccine (RV1) was introduced into the National Immunization Program in Kenya in July 2014. We examined the impact of the vaccine on hospitalization for all-cause acute gastroenteritis (AGE) and rotavirus-specific AGE and strain distribution at a large referral hospital which serves a predominantly peri-urban population in Central Kenya. Data on rotavirus AGE and strain distribution were derived from ongoing hospital-based AGE surveillance. Hospital administrative data were used to compare trends in all-cause AGE. Pre-vaccine (July 2009-June 2014) and post-vaccine (July 2014-June 2016) periods were compared for changes in hospitalization for all-cause AGE and rotavirus AGE and strain distribution. Following the vaccine introduction, the proportion of children aged rotavirus declined by 30% (95% CI: 19-45%) in the first year and 64% (95% CI: 49-77%) in the second year. Reductions in rotavirus positivity were most pronounced among the vaccine-eligible group (rotavirus and all-cause AGE were reduced substantially. There was an increased detection of G2P[4], G3P[6] and G3P[8], which coincided temporally with the timing of the vaccine introduction. Thus, introducing the rotavirus vaccine into the routine immunization program in Kenya has resulted in a notable decline in rotavirus and all-cause AGE hospitalizations in Central Kenya. This provides early evidence for public health policy makers in Kenya to support the sustained use of the rotavirus vaccine in routine immunizations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development of a rotavirus vaccine: clinical safety, immunogenicity, and efficacy of the pentavalent rotavirus vaccine, RotaTeq.

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Ciarlet, Max; Schödel, Florian

2009-12-30

Initial approaches for rotavirus vaccines were based on the classical "Jennerian" approach and utilized simian and bovine rotavirus strains, which provided cross-protection against human rotavirus strains but did not cause illness in infants and young children because of their species-specific tropism. The demonstrated efficacy of these vaccines was not consistent across studies. Thus, human-animal reassortants containing an animal rotavirus backbone with human rotavirus surface G and/or P proteins were developed, which demonstrated more consistent efficacy than that observed with the non-reassortant rotavirus strains. The pentavalent rotavirus vaccine, RotaTeq, contains 5 human-bovine reassortant rotaviruses consisting of a bovine (WC3) backbone with human rotavirus surface proteins representative of the most common G (G1, G2, G3, G4) or P (P1A[8]) types worldwide. The present review focuses on the development of the pentavalent rotavirus vaccine RotaTeq. Results of a large-scale Phase III clinical study showed that three doses of RotaTeq were immunogenic, efficacious, and well tolerated with no increased clinical risk of intussusception. RotaTeq was efficacious against rotavirus gastroenteritis of any severity (74%) and severe disease (98-100%), using a validated clinical scoring system. Reductions in rotavirus-associated hospitalizations and emergency department (ED) visits, for up to 2 years post-vaccination, were 95% in Europe, 97% in the United States, and 90% in the Latin American/Caribbean regions. RotaTeq was recently shown to be up to 100% effective in routine use in the US in reducing hospitalizations and ED visits and 96% effective in reducing physician visits. Additional studies in 8 different locations in the US have shown 85-95% reduction in rotavirus-associated hospitalizations and/or ED visits in the first 2-2.5 years of routine use.

Relevamiento serológico de anticuerpos contra enfermedades virales de interés sanitario en llamas (Lama glama de la provincia de Jujuy, Argentina

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Elena S Barbieri

Full Text Available Las poblaciones de llamas de Argentina se concentran principalmente en la provincia de Jujuy; su explotación representa un importante recurso económico de las comunidades altoandinas. El objetivo de este trabajo fue evaluar la seroprevalencia de anticuerpos contra algunos agentes virales asociados a enfermedades de impacto productivo en rodeos de llamas de Jujuy. Se analizaron 349 sueros de llamas adultas de 6 departamentos de la puna jujeña ubicados por encima de los 3300 msnm. Se obtuvo una prevalencia del 100 % para rotavirus grupo A y del 70 % para el virus parainfluenza-3 bovino, mientras que no se detectaron reactores para herpesvirus bovino 1, virus de la diarrea viral bovina, influenza A humana (H1N1 e influenza equina (H3N8. Los resultados obtenidos confirman la amplia distribución de rotavirus y virus parainfluenza y la baja susceptibilidad a herpesvirus y pestivirus en las tropas de llamas de la puna jujeña.

Annual changes in rotavirus hospitalization rates before and after rotavirus vaccine implementation in the United States.

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Shah, Minesh P; Dahl, Rebecca M; Parashar, Umesh D; Lopman, Benjamin A

2018-01-01

Hospitalizations for rotavirus and acute gastroenteritis (AGE) have declined in the US with rotavirus vaccination, though biennial peaks in incidence in children aged less than 5 years occur. This pattern may be explained by lower rotavirus vaccination coverage in US children (59% to 73% from 2010-2015), resulting in accumulation of susceptible children over two successive birth cohorts. Retrospective cohort analysis of claims data of commercially insured US children aged rotavirus and for AGE from the 2002-2015 rotavirus seasons were examined. Median age and rotavirus vaccination coverage for biennial rotavirus seasons during pre-vaccine (2002-2005), early post-vaccine (2008-2011) and late post-vaccine (2012-2015) years. Age-stratified hospitalization rates decreased from pre-vaccine to early post-vaccine and then to late post-vaccine years. The clearest biennial pattern in hospitalization rates is the early post-vaccine period, with higher rates in 2009 and 2011 than in 2008 and 2010. The pattern diminishes in the late post-vaccine period. For rotavirus hospitalizations, the median age and the difference in age between biennial seasons was highest during the early post-vaccine period; these differences were not observed for AGE hospitalizations. There was no significant difference in vaccination coverage between biennial seasons. These observations provide conflicting evidence that incomplete vaccine coverage drove the biennial pattern in rotavirus hospitalizations that has emerged with rotavirus vaccination in the US. As this pattern is diminishing with higher vaccine coverage in recent years, further increases in vaccine coverage may reach a threshold that eliminates peak seasons in hospitalizations.

Efficacy of a pentavalent human-bovine reassortant rotavirus vaccine against rotavirus gastroenteritis among American Indian children.

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Grant, Lindsay R; Watt, James P; Weatherholtz, Robert C; Moulton, Lawrence H; Reid, Raymond; Santosham, Mathuram; O'Brien, Katherine L

2012-02-01

Before the widespread use of rotavirus vaccines, rotavirus was a leading cause of gastroenteritis among children. Navajo and White Mountain Apache children suffer a disproportionate burden of severe rotavirus disease compared with the general U.S. population. We enrolled Navajo and White Mountain Apache infants in a multicenter, double-blind, placebo-controlled trial of pentavalent human-bovine reassortant rotavirus vaccine (PRV). Subjects received 3 doses of vaccine or placebo at 4 to 10 week intervals, with the first dose given between 6 and 12 weeks of age. Gastroenteritis episodes were identified by active surveillance. Disease severity was determined by a standardized scoring system. There were 509 and 494 randomized children who received vaccine and placebo, respectively. Among placebo recipients, the incidence of rotavirus gastroenteritis was 34.2 episodes/100 child-years (95% confidence interval [95% CI]: 25.8-38.9) versus 8.1 episodes/100 child-years (95% CI: 5.4-12.5) in the vaccine group. The percentage of rotavirus episodes caused by serotypes G1, G2, and G3 was 72.3%, 23.4%, and 2.1%, respectively. There were no severe rotavirus episodes among vaccinees and 4 among placebo recipients. PRV was 77.1% (95% CI: 59.7-87.6), 89.5% (95% CI: 65.9-97.9), and 82.9% (95% CI: 61.1-93.6) effective against G1-G4 rotavirus disease, severe and moderate rotavirus disease combined, and outpatient visits for rotavirus disease, respectively. The risk of adverse events was similar for the vaccine and placebo groups. PRV was highly effective in preventing rotavirus disease and related health care utilization in these American Indian infants. Vaccine efficacy and immunogenicity were similar to the overall study population enrolled in the multicenter trial.

Impact and Effectiveness of Monovalent Rotavirus Vaccine Against Severe Rotavirus Diarrhea in Ghana.

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Armah, George; Pringle, Kimberly; Enweronu-Laryea, Christabel C; Ansong, Daniel; Mwenda, Jason M; Diamenu, Stanley K; Narh, Clement; Lartey, Belinda; Binka, Fred; Grytdal, Scott; Patel, Manish; Parashar, Umesh; Lopman, Ben

2016-05-01

Ghana was among the first African nations to introduce monovalent rotavirus vaccine (RV1) into its childhood immunization schedule in April 2012. We aimed to assess the impact of vaccine introduction on rotavirus and acute gastroenteritis (AGE) hospitalizations and to estimate vaccine effectiveness (VE). Using data from 2 teaching hospitals, monthly AGE and rotavirus admissions by age were examined 40 months before and 31 months after RV1 introduction using interrupted time-series analyses. From January 2013, we enrolled children vaccination by rotavirus case-patient status, controlling for potential confounders. Vaccine coverage ranged from 95% to 100% for dose 1 and 93% to 100% for dose 2. In the first 3 years after vaccine introduction, the percentage of hospital admissions positive for rotavirus fell from 48% in the prevaccine period to 28% (49% adjusted rate reduction; 95% confidence interval [CI], 32%-63%) postvaccination among vaccine coverage, it was not possible to arrive at robust VE estimates; any-dose VE against rotavirus hospitalization was estimated at 60% (95% CI, -2% to 84%;P= .056). Results from the first 3 years following RV1 introduction suggest substantial reductions of pediatric diarrheal disease as a result of vaccination. Our VE estimate is consistent with the observed rotavirus decrease and with efficacy estimates from elsewhere in sub-Saharan Africa. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Brote causado por Escherichia coli en Chalco, México

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Cortés-Ortiz Iliana Alejandra

2002-01-01

Full Text Available Objetivo. Identificar el agente causal del brote de diarrea asociado con el desbordamiento del canal de aguas negras en Chalco. Material y métodos. Estudio retrospectivo y transversal, efectuado en el Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE, de la Secretaría de Salud, con 1 550 hisopos rectales para el aislamiento e identificación bioquímica de V. cholerae y enterobacterias, obtenidos de la población del Valle de Chalco, que presentó diarrea y vómito durante el desastre natural acontecido el 31 de mayo de 2000. El análisis de los resultados se efectuó por la diferencia entre las proporciones de dos poblaciones (prueba de Ji cuadrada. Las cepas de E. coli se hibridaron por "colony blot" para los grupos ETEC, EIEC, EPEC y EHEC. Resultados. El 0.45% correspondió a Salmonella: S. agona, S. infantis, S. enteritidis, S. muenchen, S. typhimurium; 0.06% a Shigella flexneri 3a, y 76.6% a E. coli: 62.2% a ETEC (44.6 % con LT, 11.2% con ST, y 44.1% con ambas sondas, 0.84% a EIEC (sonda ial, 0.84% a EPEC (sonda bundle-forming pilus BFP, 0.08% a E. coli enterohemorrágica no-O157:H7 (sonda pCVD419, y 36.02% no hibridó. No se encontró asociación entre E. coli patógena con la edad y género. Conclusiones. Escherichia coli podría ser responsable del brote de diarrea. Es importante conocer el agente etiológico del brote para encaminar las estrategias en el estudio y control sanitario del mismo.

Prevention of rotavirus gastroenteritis in infants and children: rotavirus vaccine safety, efficacy, and potential impact of vaccines

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Aruna Chandran

2010-07-01

Full Text Available Aruna Chandran1, Sean Fitzwater1, Anjie Zhen2, Mathuram Santosham11Department of International Health, Division of Health Systems, 2Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAAbstract: Rotavirus infection is the most common cause of severe gastroenteritis globally, with greater than 86% of deaths occurring in low-income and middle-income countries. There are two rotavirus vaccines currently licensed in the United States and prequalified by the World Health Organization. RV1 is a monovalent attenuated human rotavirus strain, given orally in two doses. RV5 is a pentavalent human-bovine reassortant rotavirus vaccine, given orally in three doses. A third rotavirus vaccine, LLV, is a lamb rotavirus strain given orally as a single dose, which is currently available only in China. RV1 and RV5 have been shown to be highly efficacious in developed countries, and initial results from trials in Africa and Asia are promising as well. At least three other vaccines are in development, which are being developed by manufacturers of developing countries. Further studies are needed to clarify issues including administration of oral rotavirus vaccines with breastfeeding and other oral vaccines, and alterations in dosing schedule. Using new data on global diarrheal burden, rotavirus is estimated to cause 390,000 deaths in children younger than 5 years. Should rotavirus vaccines be introduced in the routine immunization programs of all countries, a potential of 170,000 deaths could be prevented annually. The largest impact on mortality would be seen in low-income and middle-income countries, despite poor immunization coverage and lower efficacy. Therefore, international efforts are needed to ensure that rotavirus vaccines reach the populations with highest burden of rotavirus disease.Keywords: vaccination, mortality, rotavirus, gastroenteritis

Intoxicación alimentaria por clostridium perfringens en el centro penitenciario cocori, cartago, costa rica, del 4 al 5 de septiembre del 2002

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Espinoza, A; Arguedas, H; Asenjo, A

2004-01-01

Introducción El 5 de setiembre del 2002 el Centro Penitenciario Cocorí en Cartago, notificó al Sistema de Vigilancia del Ministerio de Salud, la presencia de 133 casos de diarrea. Ante esta situación, las autoridades de salud plantearon la investigación, para identificar los factores asociados a la presencia del brote. Material y métodos Mediante la revisión de los expedientes de los casos atendidos por diarrea en el Centro Penitenciario, se identificaron los que cumplieran con la siguiente d...

Interacciones de las proteínas disulfuro isomerasa y de choque térmico Hsc70 con proteínas estructurales recombinantes purificadas de rotavirus

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Luz Y. Moreno

2016-01-01

Full Text Available Introducción. La entrada de rotavirus a las células parece estar mediado por interacciones secuenciales entre las proteínas estructurales virales y algunas moléculas de la superficie celular. Sin embargo, los mecanismos por los cuales el rotavirus infecta la célula diana aún no se comprenden bien. Existe alguna evidencia que muestra que las proteínas estructurales de rotavirus VP5* y VP8* interactúan con algunas moléculas de la superficie celular. La disponibilidad de las proteínas estructurales de rotavirus recombinantes en cantidad suficiente se ha convertido en un aspecto importante para la identificación de las interacciones específicas de los receptores virus-célula durante los eventos tempranos del proceso infeccioso. Objetivo. El propósito del presente trabajo es realizar un análisis de las interacciones entre las proteínas estructurales de rotavirus recombinante VP5*, VP8* y VP6, y las proteínas celulares Hsc70 y PDI utilizando sus versiones recombinantes purificadas. Materiales y métodos. Las proteínas recombinantes de rotavirus VP5* y VP8* y las proteínas recombinantes celulares Hsc70 y PDI se expresaron en E. coli BL21 (DE3, mientras que VP6 se expresó en células MA104 con virus vaccinia recombinante transfectada. La interacción entre el rotavirus y las proteínas celulares se estudió mediante ELISA, co-inmunoprecipitación y SDS-PAGE/ Western. Resultados. Las condiciones óptimas para la expresión de proteínas recombinantes se determinaron y se generaron anticuerpos contra ellas. Los resultados sugirieron que las proteínas virales rVP5* y rVP6 interactúan con Hsc70 y PDI in vitro. También se encontró que éstas proteínas virales recombinantes interactúan con Hsc70 en las balsas lipídicas (“Rafts” en un cultivo celular. El tratamiento de las células, ya sea con DLP o rVP6 produjo significativamente la inhibición de la infección por rotavirus. Conclusión. Los resultados permiten concluir que r

Pattern of acquisition of rotavirus antibody in children followed up from birth to the age of three years

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Alexandre C. Linhares

1989-03-01

Full Text Available Nine hundred and forty-eight serum samples from 83 children living in Belem, Brazil, collected'within their first three years of life, were testedfor the presence of group- specific rotavirus-antibody by an enzyme-linked immunosorbent assay (ELISA blocking-test. Passively transferred maternal antibody lasted about two and half months; subsequentely, low levels of rotavirus antibody started to appear at seven months, reaching a peak at eleven months of age. From one year onwards positivity gradually increased, reaching highest values at 34 months of life. Individual responses were examined in sera from 61 children who were followed up since birth to three years of age: 38 (62,3% ofthem developed a long-term immunity following first infection; eleven (18.0% children developed a short-term immunity after first infection by rotavirus; seven (11.5% had no antibody response within their first three years of life; and 5 (8.2% showed positive antibody response from birth to three years old.Amostras de soro, em número de 948, foram coletadas de 83 crianças, ao longo de seus três primeiros anos de vida, e testadas quanto àpresença de anticorpos grupo-especificos para rotavirus por um teste de bloqueio, utilizando-se o ensaio imunoenzimático (ELISA. Observou-se que anticorpos transferidos passivamente pela mãe persistiram por cerca de dois e meio meses; subseqüentemente, baixos níveis de anticorpos para rotavirus começaram a aparecer aos sete meses de idade, atingindo um pico por volta dos onze. A partir de um ano apositividade aumentou gradualmente, alcançando os mais altos valores aos 34 meses de vida. Respostas imunes individuais foram avaliadas em 61 crianças acompanhadas desde o seu nascimento até os três anos de idade, obtendo-se os seguintes resultados: 38 (62,3% delas desenvolveram imunidade de longa duração, após a primo-infecção; 11 (18,0% indivíduos apresentaram anticorpos específicos que se mantiveram por um intervalo de

Human Neonatal Rotavirus Vaccine (RV3-BB) to Target Rotavirus from Birth.

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Bines, Julie E; At Thobari, Jarir; Satria, Cahya Dewi; Handley, Amanda; Watts, Emma; Cowley, Daniel; Nirwati, Hera; Ackland, James; Standish, Jane; Justice, Frances; Byars, Gabrielle; Lee, Katherine J; Barnes, Graeme L; Bachtiar, Novilia S; Viska Icanervilia, Ajeng; Boniface, Karen; Bogdanovic-Sakran, Nada; Pavlic, Daniel; Bishop, Ruth F; Kirkwood, Carl D; Buttery, Jim P; Soenarto, Yati

2018-02-22

A strategy of administering a neonatal rotavirus vaccine at birth to target early prevention of rotavirus gastroenteritis may address some of the barriers to global implementation of a rotavirus vaccine. We conducted a randomized, double-blind, placebo-controlled trial in Indonesia to evaluate the efficacy of an oral human neonatal rotavirus vaccine (RV3-BB) in preventing rotavirus gastroenteritis. Healthy newborns received three doses of RV3-BB, administered according to a neonatal schedule (0 to 5 days, 8 weeks, and 14 weeks of age) or an infant schedule (8 weeks, 14 weeks, and 18 weeks of age), or placebo. The primary analysis was conducted in the per-protocol population, which included only participants who received all four doses of vaccine or placebo within the visit windows, with secondary analyses performed in the intention-to-treat population, which included all participants who underwent randomization. Among the 1513 participants in the per-protocol population, severe rotavirus gastroenteritis occurred up to the age of 18 months in 5.6% of the participants in the placebo group (28 of 504 babies), in 1.4% in the neonatal-schedule vaccine group (7 of 498), and in 2.7% in the infant-schedule vaccine group (14 of 511). This resulted in a vaccine efficacy of 75% (95% confidence interval [CI], 44 to 91) in the neonatal-schedule group (PBill and Melinda Gates Foundation and others; Australian New Zealand Clinical Trials Registry number, ACTRN12612001282875 .).

Serological evidence of rotavirus infection in guinea pig colony Evidência sorológica de infecção por rotavírus em uma clônia de cobaios

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L. de Castro

1988-12-01

Full Text Available Antibodies reacting with simian rotavirus SAII were detected by enzyme immunoassay (EIA and Western blot assay (WBA in sera from guinea pigs bred for experimental use at the Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. The proportion of antibody-positive animals and the antibody titres rose sharply in 1985, were maintained at a high levels in 1986 and declined in 1987. There were no obvious signs of disease coinciding with serological evidence of infection. Results of WBA suggest that the virus involved belongs to subgroup 1 of group A rotaviruses.Anticorpos reagindo com rotavírus símio SA11 foram demonstrados por ensaio imuno-enzimático (EIE e por "Western blot assay" (WBA em soros de cobaios mantidos para fins experimentais na Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. A proporção de animais soro-positivos e os níveis de anticorpos subiram rapidametne em 1985, mantiveram-se altos em 1986 e baixaram em 1987. Não foram observados sinais de doença coincidente com a elevação de anticorpos. Resultados de WBA sugerem que o rotavírus responsável pela resposta sorológica pertence ao subgrupo do grupo A.

Rotavirus diarrhea disease burden in Peru: the need for a rotavirus vaccine and its potential cost savings.

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Ehrenkranz, P; Lanata, C F; Penny, M E; Salazar-Lindo, E; Glass, R I

2001-10-01

To assess the disease burden of rotavirus diarrhea in Peru as well the need for and the potential cost savings with a rotavirus vaccine in that country. To assess the burden of rotavirus diarrhea in Peru, we reviewed published and unpublished reports where rotavirus was sought as the etiologic agent of diarrhea in children. Rotavirus detection rates obtained from these studies were combined with diarrhea incidence rates from a number of national surveys in order to estimate both the burden of rotavirus diarrhea in the country and its associated medical costs. Rotavirus is a significant cause of morbidity and mortality in Peruvian children. In their first 5 years of life, an estimated 1 in 1.6 children will experience an episode of rotavirus diarrhea, 1 in 9.4 will seek medical care, 1 in 19.7 will require hospitalization, and 1 in 375 will die of the disease. Per year, this represents approximately 384,000 cases, 64,000 clinic visits, 30,000 hospitalizations, and 1,600 deaths. The annual cost of medical care alone for these children is approximately US$ 2.6 million--and that does not take into account the indirect or societal costs of the illness and the deaths. Rotavirus immunization provides the prospect of decreasing the morbidity and mortality from diarrhea in Peru, but a vaccine regimen would have to be relatively inexpensive, a few dollars or less per child. Future cost-effectiveness analyses should explore the total costs (medical as well as indirect or societal) associated with rotavirus diarrhea. Newly licensed vaccines should be tested according to both their ability to avert deaths and their efficacy with fewer than three doses. All three of these factors could increase the cost savings associated with a rotavirus vaccine.

Rotavirus diarrhea disease burden in Peru: the need for a rotavirus vaccine and its potential cost savings

Directory of Open Access Journals (Sweden)

Peter Ehrenkranz

2001-10-01

Full Text Available Objective. To assess the disease burden of rotavirus diarrhea in Peru as well the need for and the potential cost savings with a rotavirus vaccine in that country. Methods. To assess the burden of rotavirus diarrhea in Peru, we reviewed published and unpublished reports where rotavirus was sought as the etiologic agent of diarrhea in children. Rotavirus detection rates obtained from these studies were combined with diarrhea incidence rates from a number of national surveys in order to estimate both the burden of rotavirus diarrhea in the country and its associated medical costs. Results. Rotavirus is a significant cause of morbidity and mortality in Peruvian children. In their first 5 years of life, an estimated 1 in 1.6 children will experience an episode of rotavirus diarrhea, 1 in 9.4 will seek medical care, 1 in 19.7 will require hospitalization, and 1 in 375 will die of the disease. Per year, this represents approximately 384 000 cases, 64 000 clinic visits, 30 000 hospitalizations, and 1 600 deaths. The annual cost of medical care alone for these children is approximately US$ 2.6 million--and that does not take into account the indirect or societal costs of the illness and the deaths. Conclusions. Rotavirus immunization provides the prospect of decreasing the morbidity and mortality from diarrhea in Peru, but a vaccine regimen would have to be relatively inexpensive, a few dollars or less per child. Future cost-effectiveness analyses should explore the total costs (medical as well as indirect or societal associated with rotavirus diarrhea. Newly licensed vaccines should be tested according to both their ability to avert deaths and their efficacy with fewer than three doses. All three of these factors could increase the cost savings associated with a rotavirus vaccine.

Protect Your Child from Rotavirus Disease

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... Submit What's this? Submit Button Past Emails Prevent Rotavirus Language: English (US) Español (Spanish) Recommend on Facebook ... likely to get rotavirus from December to June. Rotavirus Can Cause Dehydration Symptoms of Dehydration Decrease in ...

Reaching every child with rotavirus vaccine: Report from the 10th African rotavirus symposium held in Bamako, Mali.

Science.gov (United States)

Sow, Samba O; Steele, A Duncan; Mwenda, Jason M; Armah, George E; Neuzil, Kathleen M

2017-10-09

The Center for Vaccine Development - Mali (CVD - Mali), the World Health Organization's regional office in Africa (WHO/AFRO), and the CVD at the University of Maryland School of Medicine hosted the 10th African Rotavirus Symposium in Bamako, Mali on 1-2 June 2016. The symposium is coordinated by WHO/AFRO, the Regional Rotavirus Reference Laboratories, and the African Rotavirus Network (ARN), with support from the Bill & Melinda Gates Foundation. The event brings together leading rotavirus researchers, scientists, and policy-makers from across Africa and the world. Over 150 participants, from 31 countries, including 27 in Africa, joined forces to address the theme "Reaching Every Child in Africa with Rotavirus Vaccines." This symposium, the first in francophone Africa, occurred at an unprecedented time when 33 African countries had introduced rotavirus vaccines into their national immunization programs. The symposium concluded with a Call to Action to introduce rotavirus vaccines in the 21 remaining African countries, to increase access in countries with existing vaccination programs, and to continue surveillance and research on rotavirus and other diarrheal diseases. Copyright © 2017.

Analysis by rotavirus gene 6 reverse transcriptase-polymerase chain reaction assay of rotavirus-positive gastroenteritis cases observed during the vaccination phase of the Rotavirus Efficacy and Safety Trial (REST)

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Matson, David O; Vesikari, Timo; Dennehy, Penelope; Dallas, Michael D; Goveia, Michelle G; Itzler, Robbin F; Ciarlet, Max

2014-01-01

During the vaccination phase of the Rotavirus Efficacy and Safety Trial (REST), the period between the administration of dose 1 through 13 days after the administration of dose 3, there were more wild-type rotavirus gastroenteritis (RVGE) cases among vaccine recipients compared with placebo recipients using the protocol-specified microbiological plaque assay in the clinical-efficacy cohort, a subset of subjects where vaccine efficacy against RVGE of any severity was assessed. In this study, a rotavirus genome segment 6-based reverse transcriptase–polymerase chain reaction assay was applied post hoc to clarify the accuracy of type categorization of all these RVGE cases in vaccine recipients during the vaccination phase of REST. The assay characterized 147 (90%) of 163 re-assayed RVGE cases or rotavirus-associated health care contacts as type-determinable: either wild-type or vaccine-type rotavirus strains. In the clinical-efficacy cohort (N = 5673), 19 (18.8%) of 101 samples from RVGE cases contained wild-type rotavirus, 70 (69.3%) vaccine virus, and 12 (11.9%) were indeterminable. In the large-scale cohort (N = 68,038), 10 (34.5%) of 29 samples from RVGE-related health care contacts contained wild-type rotavirus strains, 15 (51.7%) vaccine-type rotavirus strains, and 4 (13.8%) were indeterminable. Of the 33 samples from RVGE cases in placebo recipients, all were confirmed to contain wild-type rotaviruses. Altogether, this post-hoc re-evaluation showed that the majority (75%) of type-determinable RVGE cases or health care contacts that occurred during the vaccination phase of REST in vaccine recipients were associated with vaccine-type rotavirus strains rather than wild-type rotavirus strains. PMID:25424931

Analysis by rotavirus gene 6 reverse transcriptase-polymerase chain reaction assay of rotavirus-positive gastroenteritis cases observed during the vaccination phase of the Rotavirus Efficacy and Safety Trial (REST).

Science.gov (United States)

Matson, David O; Vesikari, Timo; Dennehy, Penelope; Dallas, Michael D; Goveia, Michelle G; Itzler, Robbin F; Ciarlet, Max

2014-01-01

During the vaccination phase of the Rotavirus Efficacy and Safety Trial (REST), the period between the administration of dose 1 through 13 days after the administration of dose 3, there were more wild-type rotavirus gastroenteritis (RVGE) cases among vaccine recipients compared with placebo recipients using the protocol-specified microbiological plaque assay in the clinical-efficacy cohort, a subset of subjects where vaccine efficacy against RVGE of any severity was assessed. In this study, a rotavirus genome segment 6-based reverse transcriptase-polymerase chain reaction assay was applied post hoc to clarify the accuracy of type categorization of all these RVGE cases in vaccine recipients during the vaccination phase of REST. The assay characterized 147 (90%) of 163 re-assayed RVGE cases or rotavirus-associated health care contacts as type-determinable: either wild-type or vaccine-type rotavirus strains. In the clinical-efficacy cohort (N = 5673), 19 (18.8%) of 101 samples from RVGE cases contained wild-type rotavirus, 70 (69.3%) vaccine virus, and 12 (11.9%) were indeterminable. In the large-scale cohort (N = 68,038), 10 (34.5%) of 29 samples from RVGE-related health care contacts contained wild-type rotavirus strains, 15 (51.7%) vaccine-type rotavirus strains, and 4 (13.8%) were indeterminable. Of the 33 samples from RVGE cases in placebo recipients, all were confirmed to contain wild-type rotaviruses. Altogether, this post-hoc re-evaluation showed that the majority (75%) of type-determinable RVGE cases or health care contacts that occurred during the vaccination phase of REST in vaccine recipients were associated with vaccine-type rotavirus strains rather than wild-type rotavirus strains.

[Nosocomial rotavirus gastroenteritis].

Science.gov (United States)

Marinosci, A; Doit, C; Koehl, B; Belhacel, K; Mariani Kurkdjian, P; Melki, I; Renaud, A; Lemaitre, C; Ammar Khodja, N; Blachier, A; Bonacorsi, S; Faye, A; Lorrot, M

2016-11-01

Rotavirus is the most common cause of gastroenteritis in children requiring hospitalization. It is a very resistant and contagious virus causing nosocomial gastroenteritis. In France, the vaccine against rotavirus has been available since 2006, but the vaccine is not recommended for infant vaccination. The aim of this retrospective study was to describe nosocomial rotavirus gastroenteritis (NRGE) and to assess its impact on children hospitalized in the General Pediatrics Department of Robert-Debré Hospital (Paris) between 1 January 2009 and 31 December 2013. We analyzed the demographic characteristics of children (age, term birth, underlying diseases) and the severity of the NRGE (oral or intravenous hydration), and assessed whether these children could benefit from vaccination against rotavirus. One hundred thirty-six children presented nosocomial rotavirus infection, with an incidence of 2.5 NRGE per 1000 days of hospitalization. The incidence of NRGE was stable between 2009 and 2013 despite the introduction of specific hygiene measures. The average age of the children was 7 months (range: 0.5-111 months). Most often NRGE occurred in children hospitalized for respiratory diseases (65% of cases) and requiring prolonged hospitalization (median: 18 days). One-third of children were born premature (25%). Hydration was oral in 80 patients (59%), by intravenous infusion in 18 patients (13%), and intraosseous in one patient. Half of the patients were aged less than 5 months and could benefit from the protection afforded by vaccination. NRGE are common. Rotavirus mass vaccination should have a positive impact on the incidence of NRGE by reducing the number of children hospitalized for gastroenteritis, therefore indirectly reducing the number of hospital cross-infections of hospitalized children who are too young to be vaccinated. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Molecular characterization of rotavirus strains detected during a clinical trial of a human rotavirus vaccine in Blantyre, Malawi

Science.gov (United States)

Nakagomi, Toyoko; Nakagomi, Osamu; Dove, Winifred; Doan, Yen Hai; Witte, Desiree; Ngwira, Bagrey; Todd, Stacy; Steele, A Duncan; Neuzil, Kathleen M; Cunliffe, Nigel A

2014-01-01

The human, G1P[8] rotavirus vaccine (Rotarix) significantly reduced severe rotavirus gastroenteritis episodes in a clinical trial in South Africa and Malawi, but vaccine efficacy was lower in Malawi (49.5%) than reported in South Africa (76.9%) and elsewhere. The aim of this study was to examine the molecular relationships of circulating wild-type rotaviruses detected during the clinical trial in Malawi to RIX4414 (the strain contained in Rotarix) and to common human rotavirus strains. Of 88 rotavirus-positive, diarrhoeal stool specimens, 43 rotaviruses exhibited identifiable RNA migration patterns when examined by polyacrylamide gel electrophoresis. The genes encoding VP7, VP4, VP6 and NSP4 of 5 representative strains possessing genotypes G12P[6], G1P[8], G9P[8], and G8P[4] were sequenced. While their VP7 (G) and VP4 (P) genotype designations were confirmed, the VP6 (I) and NSP4 (E) genotypes were either I1E1 or I2E2, indicating that they were of human rotavirus origin. RNA-RNA hybridization using 21 culture-adapted strains showed that Malawian rotaviruses had a genomic RNA constellation common to either the Wa-like or DS-1 like human rotaviruses. Overall, the Malawi strains appear similar in their genetic make-up to rotaviruses described in countries where vaccine efficacy is greater, suggesting that the lower efficacy in Malawi is unlikely to be explained by the diversity of circulating strains. PMID:22520123

Rotavirus Infections - Multiple Languages

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... Are Here: Home → Multiple Languages → All Health Topics → Rotavirus Infections URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Rotavirus Infections - Multiple Languages To use the sharing features ...

Cost-effectiveness of Rotavirus vaccination in Vietnam

Directory of Open Access Journals (Sweden)

Goldie Sue J

2009-01-01

Full Text Available Abstract Background Rotavirus is the most common cause of severe diarrhea leading to hospitalization or disease-specific death among young children. New rotavirus vaccines have recently been approved. Some previous studies have provided broad qualitative insights into the health and economic consequences of introducing the vaccines into low-income countries, representing several features of rotavirus infection, such as varying degrees of severity and age-dependency of clinical manifestation, in their model-based analyses. We extend this work to reflect additional features of rotavirus (e.g., the possibility of reinfection and varying degrees of partial immunity conferred by natural infection, and assess the influence of the features on the cost-effectiveness of rotavirus vaccination. Methods We developed a Markov model that reflects key features of rotavirus infection, using the most recent data available. We applied the model to the 2004 Vietnamese birth cohort and re-evaluated the cost-effectiveness (2004 US dollars per disability-adjusted life year [DALY] of rotavirus vaccination (Rotarix® compared to no vaccination, from both societal and health care system perspectives. We conducted univariate sensitivity analyses and also performed a probabilistic sensitivity analysis, based on Monte Carlo simulations drawing parameter values from the distributions assigned to key uncertain parameters. Results Rotavirus vaccination would not completely protect young children against rotavirus infection due to the partial nature of vaccine immunity, but would effectively reduce severe cases of rotavirus gastroenteritis (outpatient visits, hospitalizations, or deaths by about 67% over the first 5 years of life. Under base-case assumptions (94% coverage and $5 per dose, the incremental cost per DALY averted from vaccination compared to no vaccination would be $540 from the societal perspective and $550 from the health care system perspective. Conclusion

Molecular characterization of rotavirus strains detected during a clinical trial of a human rotavirus vaccine in Blantyre, Malawi.

Science.gov (United States)

Nakagomi, Toyoko; Nakagomi, Osamu; Dove, Winifred; Doan, Yen Hai; Witte, Desiree; Ngwira, Bagrey; Todd, Stacy; Duncan Steele, A; Neuzil, Kathleen M; Cunliffe, Nigel A

2012-04-27

The human, G1P[8] rotavirus vaccine (Rotarix™) significantly reduced severe rotavirus gastroenteritis episodes in a clinical trial in South Africa and Malawi, but vaccine efficacy was lower in Malawi (49.5%) than reported in South Africa (76.9%) and elsewhere. The aim of this study was to examine the molecular relationships of circulating wild-type rotaviruses detected during the clinical trial in Malawi to RIX4414 (the strain contained in Rotarix™) and to common human rotavirus strains. Of 88 rotavirus-positive, diarrhoeal stool specimens, 43 rotaviruses exhibited identifiable RNA migration patterns when examined by polyacrylamide gel electrophoresis. The genes encoding VP7, VP4, VP6 and NSP4 of 5 representative strains possessing genotypes G12P[6], G1P[8], G9P[8], and G8P[4] were sequenced. While their VP7 (G) and VP4 (P) genotype designations were confirmed, the VP6 (I) and NSP4 (E) genotypes were either I1E1 or I2E2, indicating that they were of human rotavirus origin. RNA-RNA hybridization using 21 culture-adapted strains showed that Malawian rotaviruses had a genomic RNA constellation common to either the Wa-like or the DS-1 like human rotaviruses. Overall, the Malawi strains appear similar in their genetic make-up to rotaviruses described in countries where vaccine efficacy is greater, suggesting that the lower efficacy in Malawi is unlikely to be explained by the diversity of circulating strains. Copyright © 2011 Elsevier Ltd. All rights reserved.

Rotavirus infection in Saudi Arabia

International Nuclear Information System (INIS)

Kheyami, Ali M.; Cunliffe, Nigel A.; Hart, C. Anthony

2006-01-01

Human rotavirus, an important causative agent of severe gastroenteritis in infants and young children worldwide, leads to high morbidity in both developing and developed countries. Effective control depends upon an accurate understanding of disease burden and the relative importance of circulating serotypes. We examined the epidemiology and disease burden of rotavirus in Saudi Arabia through a review of 22 published studies of rotavirus and the antilogy diarrhea carried out from 1982 to 2003. The prevalence of rotavirus ranged between 10% to 46% with a median of 30%. Most cases were among children less than 2 years of age, and particularly in first year of life. There were significant differences in the seasonability within Saudi Arabia with increased infection during winter in some cities and during summer in others. G1 was the predominant serotype followed by G4, G3 and G2, in 4 studies where strains have been G-typed. The prevalence of noticeable strains ranged from 11.0% to 31.3%. No data were available on P types... Results of electropherotyping in 4 studies revealed that the long elctropherotype was predominant. Rotavirus is an important cause of severe diarrhea in Saudi children. However, the available data on rotavirus strains in circulation are limited. And there is an urgent need for up-to-date and comprehensive studies to evaluate rotavirus strains in circulation and identify unusual types that could be incorporated into future vaccines. (author)

Identificación de Arcobacter en heces de niños y adultos con/sin diarrea y en reservorios animales

OpenAIRE

Rito Zerpa Larrauri; Jorge O Alarcón Villaverde; Percy E Lezama Vigo; Lilian Patiño Gabriel; Alberto Reyes Dioses; Augusto M Valencia Ramírez; Jorge Velásquez; Carlos R Sevilla Andrade; Miriam J Alarcón León

2014-01-01

Introducción: Los microorganismos del género Arcobacter, considerados patógenos zoonóticos emergentes, son morfológicamente similares a Campylobacter. Los reportes de Arcobacter como agente etiológico de diarrea en humanos en América Latina son escasos. En el Perú no se ha comunicado su aislamiento en heces de humanos o en animales. Objetivos: Conocer la prevalencia de Arcobacter en heces de niños y adultos con/sin diarrea y en animales: aves, ganado vacuno, porcino, peces y mariscos. Diseño:...

Rotavirus vaccines

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Kang G

2006-01-01

Full Text Available Rotavirus, the most common cause of severe diarrhea and a leading cause of mortality in children, has been a priority target for vaccine development for the past several years. The first rotavirus vaccine licensed in the United States was withdrawn because of an association of the vaccine with intussusception. However, the need for a vaccine is greatest in the developing world, because the benefits of preventing deaths due to rotavirus disease are substantially greater than the risk of intussusception. Early vaccines were based on animal strains. More recently developed and licenced vaccines are either animal-human reassortants or are based on human strains. In India, two candidate vaccines are in the development process, but have not yet reached efficacy trials. Many challenges regarding vaccine efficacy and safety remain. In addition to completing clinical evaluations of vaccines in development in settings with the highest disease burden and virus diversity, there is also a need to consider alternative vaccine development strategies.

Rotavirus antigenemia in children is associated with viremia.

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Sarah E Blutt

2007-04-01

Full Text Available Antigenemia is commonly detected in rotavirus-infected children. Although rotavirus RNA has been detected in serum, definitive proof of rotavirus viremia has not been shown. We aimed to analyze a defined patient population to determine if infectious virus could be detected in sera from children with rotavirus antigenemia.Serum samples obtained upon hospitalization from children with gastroenteritis (57 stool rotavirus-positive and 41 rotavirus-negative, children with diagnosed bronchiolitis of known (n = 58 or unknown (n = 17 viral etiology, children with noninfectious, nonchronic conditions (n = 17, and healthy adults (n = 28 were tested for rotavirus antigen by enzyme immunoassay (EIA. Results of serum antigen testing were assessed for association with clinical and immunological attributes of the children. Rotavirus antigenemia was detected in 90% (51/57 of children with rotavirus-positive stools, in 89% (8/9 of children without diarrhea but with rotavirus-positive stools, in 12% (2/17 of children with bronchiolitis of unknown etiology without gastroenteritis, and in 12% (5/41 of children with gastroenteritis but with rotavirus-negative stools. Antigenemia was not detected in sera from children with noninfectious nonchronic conditions, children with bronchiolitis of known etiology and no gastroenteritis, or healthy adults. Neither age nor timing of serum collection within eight days after onset of gastroenteritis significantly affected levels of antigenemia, and there was no correlation between antigenemia and viral genotype. However, there was a negative correlation between serum rotavirus antigen and acute rotavirus-specific serum IgA (r = -0.44, p = 0.025 and IgG (r = -0.40, p = 0.01 titers. We examined 11 antigen-positive and nine antigen-negative sera for infectious virus after three blind serial passages in HT-29 cells using immunofluorescence staining for rotavirus structural and nonstructural proteins. Infectious virus was detected in

Rotavirus Antigenemia in Children Is Associated with Viremia

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Blutt, Sarah E; Matson, David O; Crawford, Sue E; Staat, Mary Allen; Azimi, Parvin; Bennett, Berkeley L; Piedra, Pedro A; Conner, Margaret E

2007-01-01

Background Antigenemia is commonly detected in rotavirus-infected children. Although rotavirus RNA has been detected in serum, definitive proof of rotavirus viremia has not been shown. We aimed to analyze a defined patient population to determine if infectious virus could be detected in sera from children with rotavirus antigenemia. Methods and Findings Serum samples obtained upon hospitalization from children with gastroenteritis (57 stool rotavirus-positive and 41 rotavirus-negative), children with diagnosed bronchiolitis of known (n = 58) or unknown (n = 17) viral etiology, children with noninfectious, nonchronic conditions (n = 17), and healthy adults (n = 28) were tested for rotavirus antigen by enzyme immunoassay (EIA). Results of serum antigen testing were assessed for association with clinical and immunological attributes of the children. Rotavirus antigenemia was detected in 90% (51/57) of children with rotavirus-positive stools, in 89% (8/9) of children without diarrhea but with rotavirus-positive stools, in 12% (2/17) of children with bronchiolitis of unknown etiology without gastroenteritis, and in 12% (5/41) of children with gastroenteritis but with rotavirus-negative stools. Antigenemia was not detected in sera from children with noninfectious nonchronic conditions, children with bronchiolitis of known etiology and no gastroenteritis, or healthy adults. Neither age nor timing of serum collection within eight days after onset of gastroenteritis significantly affected levels of antigenemia, and there was no correlation between antigenemia and viral genotype. However, there was a negative correlation between serum rotavirus antigen and acute rotavirus-specific serum IgA (r = −0.44, p = 0.025) and IgG (r = −0.40, p = 0.01) titers. We examined 11 antigen-positive and nine antigen-negative sera for infectious virus after three blind serial passages in HT-29 cells using immunofluorescence staining for rotavirus structural and nonstructural proteins

COSTE DE LA DIARREA ASOCIADA A CLOSTRIDIUM DIFFICILE EN ESPAÑA

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Ángel Asensio

2013-01-01

Full Text Available Fundamentos: No se dispone de estudios adecuados del coste de las diarreas asociadas a Clostridium difficile (DACD en España. El objetivo del estudio es estimar el coste de las DACD para el Sistema Nacional de Salud (SNS. Métodos: Se realizó un modelo económico para calcular el coste por episodio de DACD (por antibióticos, prolongación del ingreso hospitalario, procedimientos quirúrgicos, medidas de control de la infección, recurrencias de las infecciones tratadas y el coste anual de la DACD. El uso de recursos en la práctica clínica se obtuvo mediante un panel Delphi de clínicos españoles con experiencia en la DACD y los costes unitarios (€ 2012 de fuentes españolas. Resultados: Se estimó que anualmente se produjeron 7.601 episodios de DACD en España (incidencia de 17,1 episodios/año/10.000 altas hospitalarias con un gasto anual para el SNS de 32.157.093 €. Coste por episodio de DACD: 3.901 € (infección inicial, 4.875 € (primera recurrencia y 5.916 € (segunda recurrencia. Coste total de las recurrencias: 10.426.750 € anuales. El 95,6% del gasto se debería a la prolongación de la duración de la estancia hospitalaria, el 0,5% a tratamientos antibióticos, el 2,8% a intervenciones quirúrgicas y el 1,1% a las medidas de control de la infección. Los resultados del estudio fueron sensibles a la incidencia y tasa de letalidad de la DACD en España y a la duración de la prolongación de la duración de la estancia hospitalaria debida a la DACD. Conclusiones: Según este estudio, el gasto asociado a la DACD se debe fundamentalmente a la prolongación de los ingresos hospitalarios y tiene un gran impacto económico en el SNS.

Pathogenesis of Rotavirus Infection

NARCIS (Netherlands)

J.A. Boshuizen

2005-01-01

textabstractRotaviruses comprise a genus within the family of the Reoviridae and are recognized as the single most significant cause of severe gastroenteritis, malnutrition and diarrhea in young children. Each year rotavirus causes the death of about 440.000 children <5 years of age (313). The

Impact of routine rotavirus vaccination on all-cause and rotavirus hospitalizations during the first four years following vaccine introduction in Rwanda.

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Sibomana, Hassan; Rugambwa, Celse; Mwenda, Jason M; Sayinzoga, Felix; Iraguha, Gisele; Uwimana, Jeanine; Parashar, Umesh D; Tate, Jacqueline E

2018-05-10

Rwanda introduced pentavalent rotavirus vaccine into its national immunization program in 2012. To determine the long-term impact of rotavirus vaccine on disease burden in a high burden setting, we examined trends in rotavirus and all-cause diarrhea hospitalizations in the first four years following rotavirus vaccine introduction. We used data from an active surveillance system, from a review of pediatric ward registries, and from the Health Management Information System to describe trends in rotavirus and all-cause diarrhea hospitalizations from January 2009 through December 2016. Percent reductions were calculated to compare the number of all-cause and rotavirus diarrhea hospitalizations pre- and post-rotavirus vaccine introduction. The proportion of diarrhea hospitalizations due to rotavirus declined by 25-44% among all children introduction to 12-13% post-vaccine introduction. In the national hospital discharge data, substantial decreases were observed in all-cause diarrhea hospitalizations among children introduction era. Published by Elsevier Ltd.

Prevalence of rotavirus genotypes in children younger than 5 years of age before the introduction of a universal rotavirus vaccination program: report of rotavirus surveillance in Turkey.

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Riza Durmaz

Full Text Available BACKGROUND: Group A rotaviruses are the most common causative agent of acute gastroenteritis among children less than 5 years of age throughout the world. This sentinel surveillance study was aimed to obtain baseline data on the rotavirus G and P genotypes across Turkey before the introduction of a universal rotavirus vaccination program. METHODS: Rotavirus antigen-positive samples were collected from 2102 children less than 5 years of age who attended hospitals participating in the Turkish Rotavirus Surveillance Network. Rotavirus antigen was detected in the laboratories of participating hospitals by commercial serological tests such as latex agglutination, immunochromatographic test or enzyme immunoassay. Rotavirus G and P genotypes were determined by reverse transcription polymerase chain reaction (RT-PCR using consensus primers detecting the VP7 and VP4 genes, followed by semi-nested type-specific multiplex PCR. RESULTS: RT-PCR found rotavirus RNA in 1644 (78.2% of the samples tested. The highest rate of rotavirus positivity (38.7% was observed among children in the 13 to 24 month age group, followed by children in the age group of 25 to 36 months (28.3%. A total of eight different G types, six different P types, and 42 different G-P combinations were obtained. Four common G types (G1, G2, G3, and G9 and two common P types (P[8] and P[4] accounted for 95.1% and 98.8% of the strains, respectively. G9P[8] was the most common G/P combination found in 40.5% of the strains followed by G1P[8] (21.6%, G2P[8] (9.3%, G2P[4] (6.5%, G3P[8] (3.5%, and finally, G4P[8] (3.4%. These six common genotypes included 83.7% of the strains tested in this study. The rate of uncommon genotypes was 14%. CONCLUSION: The majority of the strains analyzed belonged to the G1-G4 and G9 genotypes, suggesting high coverage of current rotavirus vaccines. This study also demonstrates a dramatic increase in G9 genotype across the country.

Prevalence of Rotavirus Genotypes in Children Younger than 5 Years of Age before the Introduction of a Universal Rotavirus Vaccination Program: Report of Rotavirus Surveillance in Turkey

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Durmaz, Riza; Kalaycioglu, Atila Taner; Acar, Sumeyra; Bakkaloglu, Zekiye; Karagoz, Alper; Korukluoglu, Gulay; Ertek, Mustafa; Torunoglu, Mehmet Ali

2014-01-01

Background Group A rotaviruses are the most common causative agent of acute gastroenteritis among children less than 5 years of age throughout the world. This sentinel surveillance study was aimed to obtain baseline data on the rotavirus G and P genotypes across Turkey before the introduction of a universal rotavirus vaccination program. Methods Rotavirus antigen-positive samples were collected from 2102 children less than 5 years of age who attended hospitals participating in the Turkish Rotavirus Surveillance Network. Rotavirus antigen was detected in the laboratories of participating hospitals by commercial serological tests such as latex agglutination, immunochromatographic test or enzyme immunoassay. Rotavirus G and P genotypes were determined by reverse transcription polymerase chain reaction (RT-PCR) using consensus primers detecting the VP7 and VP4 genes, followed by semi-nested type-specific multiplex PCR. Results RT-PCR found rotavirus RNA in 1644 (78.2%) of the samples tested. The highest rate of rotavirus positivity (38.7%) was observed among children in the 13 to 24 month age group, followed by children in the age group of 25 to 36 months (28.3%). A total of eight different G types, six different P types, and 42 different G–P combinations were obtained. Four common G types (G1, G2, G3, and G9) and two common P types (P[8] and P[4]) accounted for 95.1% and 98.8% of the strains, respectively. G9P[8] was the most common G/P combination found in 40.5% of the strains followed by G1P[8] (21.6%), G2P[8] (9.3%), G2P[4] (6.5%), G3P[8] (3.5%), and finally, G4P[8] (3.4%). These six common genotypes included 83.7% of the strains tested in this study. The rate of uncommon genotypes was 14%. Conclusion The majority of the strains analyzed belonged to the G1–G4 and G9 genotypes, suggesting high coverage of current rotavirus vaccines. This study also demonstrates a dramatic increase in G9 genotype across the country. PMID:25437502

Rotavirus Immunization in Africa: A Perspective Re-visited

African Journals Online (AJOL)

trials in developed countries, the history of rotavirus vaccine in Africa has not been good. The earlier rotavirus vaccine candidates, based on bovine rotavirus strains, were ... trials in Peru and Brazil [19,20]. Other more obvious reasons may include vaccine-related issues (such as the antigenic make-up of the bovine rotavirus ...

Zoonotic Transmission of Rotavirus in Denmark; a Case Report

DEFF Research Database (Denmark)

Midgley, Sofie; Gram, N.; Hjulsager, Charlotte Kristiane

Rotavirus type A infection is a common cause of hospitalisation of children. However, in our laboratory almost 30% of rotavirus positive samples are from adults. Due to this an epidemiological study into the riskfactors for rotavirus infection in adults was set up. All identified rotavirus positive...... adults are sent a questionnaire to identify potential risk factors. Rotavirus type A infection can also occur in a range of animals, including domestic dogs, cats, cattle, horses, and birds. There is some data suggesting direct transmission between animals and humans. Rotavirus typing is carried out...... in Denmark as part of the EuroRotaNet vaccine study. Samples positive for rotavirus are type...

Human rotavirus vaccine Rotarix™ provides protection against diverse circulating rotavirus strains in African infants: a randomized controlled trial.

Science.gov (United States)

Steele, Andrew Duncan; Neuzil, Kathleen M; Cunliffe, Nigel A; Madhi, Shabir A; Bos, Pieter; Ngwira, Bagrey; Witte, Desiree; Todd, Stacy; Louw, Cheryl; Kirsten, Mari; Aspinall, Sanet; Van Doorn, Leen Jan; Bouckenooghe, Alain; Suryakiran, Pemmaraju V; Han, Htay Htay

2012-09-13

Rotaviruses are the most important cause of severe acute gastroenteritis worldwide in children rotavirus vaccine Rotarix™ significantly reduced severe rotavirus gastroenteritis episodes in a Phase III clinical trial conducted in infants in South Africa and Malawi. This paper examines rotavirus vaccine efficacy in preventing severe rotavirus gastroenteritis, during infancy, caused by the various G and P rotavirus types encountered during the first rotavirus-season. Healthy infants aged 5-10 weeks were enrolled and randomized into three groups to receive either two (10 and 14 weeks) or three doses of Rotarix™ (together forming the pooled Rotarix™ group) or three doses of placebo at a 6,10,14-week schedule. Weekly home visits were conducted to identify gastroenteritis episodes. Rotaviruses were detected by ELISA and genotyped by RT-PCR and nucleotide sequencing. The percentage of infants with severe rotavirus gastroenteritis caused by the circulating G and P types from 2 weeks post-last dose until one year of age and the corresponding vaccine efficacy was calculated with 95% CI. Overall, 4939 infants were vaccinated and 4417 (pooled Rotarix™ = 2974; placebo = 1443) were included in the per protocol efficacy cohort. G1 wild-type was detected in 23 (1.6%) severe rotavirus gastroenteritis episodes from the placebo group. This was followed in order of detection by G12 (15 [1%] in placebo) and G8 types (15 [1%] in placebo). Vaccine efficacy against G1 wild-type, G12 and G8 types were 64.1% (95% CI: 29.9%; 82%), 51.5% (95% CI:-6.5%; 77.9%) and 64.4% (95% CI: 17.1%; 85.2%), respectively. Genotype P[8] was the predominant circulating P type and was detected in 38 (2.6%) severe rotavirus gastroenteritis cases in placebo group. The remaining circulating P types comprised of P[4] (20 [1.4%] in placebo) and P[6] (13 [0.9%] in placebo). Vaccine efficacy against P[8] was 59.1% (95% CI: 32.8%; 75.3%), P[4] was 70.9% (95% CI: 37.5%; 87.0%) and P[6] was 55.2% (95% CI: -6

One Family's Struggles with Rotavirus

Medline Plus

Full Text Available ... getvaxed about GETVAXED print ads go to GETVAXED.ORG cme Immunizations Rotavirus One family's struggles with rotavirus ... free-of-charge. Branded videos contain the "PKIDs.ORG" end slate; unbranded videos are provided for organizations ...

One Family's Struggles with Rotavirus

Medline Plus

Full Text Available ... GETVAXED print ads go to GETVAXED.ORG cme Immunizations Rotavirus One family's struggles with rotavirus We provide ... not possible without a visit to your doctor. Immunizations stop disease from spreading. Check with your family ...

The impact of rotavirus gastroenteritis on the family

Directory of Open Access Journals (Sweden)

Kelly Claudia M

2009-02-01

Full Text Available Abstract Background Rotavirus is the leading cause of severe diarrhea in young children and causes substantial morbidity and mortality. Although the clinical aspects have been well described, little information is available regarding the emotional, social, and economic impact of rotavirus gastroenteritis on the family of a sick child. The objectives of this study were to: 1 assess the family impact of rotavirus gastroenteritis through qualitative interviews with parents; 2 compare the clinical severity of rotavirus-positive and negative gastroenteritis; 3 test a questionnaire asking parents to rank the importance of various factors associated with a case of rotavirus gastroenteritis. Methods The study enrolled parents and children (2–36 months of age brought to one of the study sites (outpatient clinic or ER if the child experienced ≥ 3 watery or looser-than normal stools and/or forceful vomiting within any 24-hour period within the prior 3 days. The clinical severity of each child's illness was rated using a clinical scoring system and stool samples were tested for rotavirus antigen. Parents of rotavirus-positive children were invited to participate in focus group or individual interviews and subsequently completed a questionnaire regarding the impact of their child's illness. Results Of 62 enrolled children, 43 stool samples were collected and 63% tested positive for rotavirus. Illness was more severe in children with rotavirus-positive compared to rotavirus-negative gastroenteritis (92% vs. 37.5% rated as moderate/severe. Seventeen parents of rotavirus-positive children participated in the interviews and completed the written questionnaire. Parents were frightened by the severity of vomiting and diarrhea associated with rotavirus gastroenteritis, and noted that family life was impacted in several ways including loss of sleep, missed work, and an inability to complete normal household tasks. They expressed frustration at the lack of a

Evaluación nutricional del niño con diarrea funcional Nutritional evaluation of the child with functional diarrhea

Directory of Open Access Journals (Sweden)

Tamara Díaz Lorenzo

2007-12-01

Full Text Available La diarrea funcional se presenta con frecuencia en la práctica pediátrica y generalmente no se asocia a alteraciones nutricionales, pero sí a esquemas dietéticos incorrectos. Con el objetivo de determinar la evaluación nutricional de los niños con este tipo de afección, y la influencia de la dieta en la aparición de la enfermedad, se realizó un estudio descriptivo transversal con 44 niños menores de 36 meses de edad, que fueron atendidos entre el 2003 y el 2005 en la consulta de gastroenterología del Hospital Pediátrico Universitario Pedro Borrás Astorga. Según los Criterios de Roma II, el diagnóstico correspondiente fue el de diarrea funcional. No hubo afectación nutricional relevante. La evaluación dietética demostró una alimentación no saludable, debida fundamentalmente al consumo poco variado, no equilibrado ni adecuado de los alimentos, que contribuyó a la génesis de las diarreas.Functional diarrhea appears frequently in the pediatric practice and it is not generally associated with nutritional disorders, but with inappropriate diet schemes. In order to determine the nutritional evaluation of the children with this type of affection, and the influence of the diet on the appearance of the disease, a cross-sectional descriptive study was conducted among 44 children under 36 months old that received attention at the gastroenterology office of “Pedro Borras Astorga” University Pediatric Hospital between 2003 and 2005. According to the criteria of Rome II, they were diagnosed functional diarrhea. No significant nutritional affection was observed. The dietetic evaluation showed an unhealthy nutrition that contributed to the genesis of the diarrea.

Creencias y conocimientos de un grupo de médicos sobre el manejo de la alimentación del niño con diarrea aguda

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Corral-Terrazas Martha

2002-01-01

Full Text Available Objetivo. Identificar las creencias y conocimientos de un grupo de médicos rurales sobre el manejo de alimentación en los casos de diarrea aguda de los menores de cinco años y compararlos con la recomendación de la Organización Mundial de la Salud (OMS. Material y métodos. Se realizó un estudio de antropología cognitiva con los 10 médicos que brindan atención a la población infantil en el Hospital Rural del IMSS-Solidaridad de San Juanito, Bocoyna, Chihuahua, México, de julio a diciembre de 1998. Se trianguló la información obtenida por las técnicas de grupos focales, viñetas, listado libre, sorteo de montones y cuestionario semiestructurado. Resultados. Los médicos reconocieron el impacto negativo de la diarrea sobre el estado nutricio del niño, pero no todos evaluaron su estado de nutrición. Como tratamientos predominaron los antimicrobianos, el manejo con líquidos y las recomendaciones sobre alimentación. De éstas, las más consistentes fueron la lactancia materna, la alimentación tardía y la dieta "escalonada". Conclusiones. La información obtenida contrasta con la recomendación de la OMS, en especial con la de alimentación sostenida.

Rotavirus vaccination in Europe: drivers and barriers.

Science.gov (United States)

Parez, N; Giaquinto, C; Du Roure, C; Martinon-Torres, F; Spoulou, V; Van Damme, P; Vesikari, T

2014-05-01

Rotavirus gastroenteritis is a vaccine-preventable disease that confers a high medical and economic burden in more developed countries and can be fatal in less developed countries. Two vaccines with high efficacy and good safety profiles were approved and made available in Europe in 2006. We present an overview of the status of rotavirus vaccination in Europe. We discuss the drivers (including high effectiveness and effect of universal rotavirus vaccination) and barriers (including low awareness of disease burden, perception of unfavourable cost-effectiveness, and potential safety concerns) to the implementation of universal rotavirus vaccination in Europe. By February, 2014, national universal rotavirus vaccination had been implemented in Belgium, Luxembourg, Austria, Finland, Greece, Luxembourg, Norway, and the UK. Four other German states have issued recommendations and reimbursement is provided by sickness funds. Other countries were at various stages of recommending or implementing universal rotavirus vaccination. Copyright © 2014 Elsevier Ltd. All rights reserved.

Rotavirus vaccines and vaccination in Latin America

Directory of Open Access Journals (Sweden)

Linhares Alexandre C.

2000-01-01

Full Text Available Worldwide, rotaviruses account for more than 125 million cases of infantile gastroenteritis and nearly 1 million deaths per year, mainly in developing countries. Rather than other control measures, vaccination is most likely to have a major impact on rotavirus disease incidence. The peak incidence of rotavirus diarrhea occurs between 6 and 24 months of age. In developing countries, however, cases are not uncommon among children younger than 6 months. G serotypes 1 to 4 are responsible for most disease, but there are indications that in Brazil that G type 5 is of emerging epidemiological importance. Both homotypic and heterotypic responses are elicited during natural rotavirus infection, and the immunological response at the intestinal mucosal surface is probably the more consistent predictor of clinical immunity. With the primary objective of protecting children against life-threatening dehydrating diarrhea, many approaches to rotavirus vaccine development have been attempted. One vaccine, the tetravalent rhesus-human reassortant rotavirus vaccine (RRV-TV, was given licensing approval in the United States of America, introduced to the market, and later withdrawn. A number of studies have found better efficacy of RRV-TV in developed countries than in developing ones. Field trials with a 4 X 10(4 plaque-forming units (PFU preparation of RRV-TV have been carried out in two countries in Latin America, Brazil and Peru. Those trials yielded protective efficacy rates against all rotavirus diarrhea ranging from 18% to 35%. Data from a large catchment trial in Venezuela with a higher RRV-TV dose, of 4 X 10(5 PFU/dose, indicated an efficacy rate of 48% against all rotavirus diarrhea and 88% against severe rotavirus diarrhea. It appears that breast-feeding does not compromise the efficacy of RRV-TV if three doses of the vaccine are administered. Similarly, possible interference of oral poliovirus vaccine with the "take" of the rotavirus vaccine can be

Rotavirus vaccines and vaccination in Latin America

Directory of Open Access Journals (Sweden)

Alexandre C. Linhares

2000-11-01

Full Text Available Worldwide, rotaviruses account for more than 125 million cases of infantile gastroenteritis and nearly 1 million deaths per year, mainly in developing countries. Rather than other control measures, vaccination is most likely to have a major impact on rotavirus disease incidence. The peak incidence of rotavirus diarrhea occurs between 6 and 24 months of age. In developing countries, however, cases are not uncommon among children younger than 6 months. G serotypes 1 to 4 are responsible for most disease, but there are indications that in Brazil that G type 5 is of emerging epidemiological importance. Both homotypic and heterotypic responses are elicited during natural rotavirus infection, and the immunological response at the intestinal mucosal surface is probably the more consistent predictor of clinical immunity. With the primary objective of protecting children against life-threatening dehydrating diarrhea, many approaches to rotavirus vaccine development have been attempted. One vaccine, the tetravalent rhesus-human reassortant rotavirus vaccine (RRV-TV, was given licensing approval in the United States of America, introduced to the market, and later withdrawn. A number of studies have found better efficacy of RRV-TV in developed countries than in developing ones. Field trials with a 4 X 10(4 plaque-forming units (PFU preparation of RRV-TV have been carried out in two countries in Latin America, Brazil and Peru. Those trials yielded protective efficacy rates against all rotavirus diarrhea ranging from 18% to 35%. Data from a large catchment trial in Venezuela with a higher RRV-TV dose, of 4 X 10(5 PFU/dose, indicated an efficacy rate of 48% against all rotavirus diarrhea and 88% against severe rotavirus diarrhea. It appears that breast-feeding does not compromise the efficacy of RRV-TV if three doses of the vaccine are administered. Similarly, possible interference of oral poliovirus vaccine with the "take" of the rotavirus vaccine can be

Impacto de la introducción de la vacuna contra el rotavirus en la hospitalización por gastroenteritis aguda grave en el Hospital del Niño de la Ciudad de Panamá Impact of rotavirus vaccine introduction on hospital admissions for severe acute gastroenteritis at the Children's Hospital in Panama City

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Javier Nieto Guevara

2008-09-01

Full Text Available OBJETIVOS: Determinar si la introducción de la vacunación infantil contra el rotavirus en Panamá permitió reducir la tasa de hospitalización por gastroenteritis en niños menores de 5 años. MÉTODOS: Estudio observacional de corte transversal en dos períodos: del 1 de enero al 31 de agosto de 2005 (antes de la introducción de la vacunación contra el rotavirus y del 1 de enero al 31 de agosto de 2007 (un año después de la introducción. Se estudiaron todos los niños y niñas entre 2 meses y 5 años de edad hospitalizados con diagnóstico de gastroenteritis aguda grave en la sala de corta estancia de gastroenteritis del Hospital del Niño, en Ciudad de Panamá, Panamá. Las variables fueron: número de episodios de gastroenteritis, número de casos hospitalizados por gastroenteritis aguda grave, días de hospitalización y uso de antibióticos, según dos grupos de edad (de 2 meses a 1 año y de más de 1 año a 5 años. Se calculó el riesgo relativo (RR con intervalos de confianza de 95% (IC95% y un nivel de significación P OBJECTIVES: To determine if infant rotavirus vaccination in Panama has reduced the rate of hospital admission for gastroenteritis among children under 5 years of age. METHODS: An observational, cross-sectional study of two time periods: 1 January-31 August 2005 (prior to initiating rotavirus vaccination and 1 January-31 August 2007 (one year after introducing rotavirus vaccination. All the children from 2 months-5 years of age admitted with a diagnosis of acute gastroenteritis to the short-stay gastroenteritis area of the Children's Hospital in Panama City, Panama, were studied. The variables were: number of gastroenteritis episodes; number of cases admitted for severe acute gastroenteritis; number of days hospitalized; and antibiotics treatment for each of the two age groups (2 months-1 year and >1-5 years. The relative risk (RR was calculated with a 95% confidence interval (95%CI and a significance level of P

Incidence and cost of rotavirus hospitalizations in Denmark

DEFF Research Database (Denmark)

Fischer, Thea Kølsen; Nielsen, Nete Munk; Wohlfahrt, Jan

2007-01-01

In anticipation of licensure and introduction of rotavirus vaccine into the western market, we used modeling of national hospital registry data to determine the incidence and direct medical costs of annual rotavirus-associated admissions over >11 years in Denmark. Diarrhea-associated hospitalizat......In anticipation of licensure and introduction of rotavirus vaccine into the western market, we used modeling of national hospital registry data to determine the incidence and direct medical costs of annual rotavirus-associated admissions over >11 years in Denmark. Diarrhea......-associated hospitalizations coded as nonspecified viral or presumed infectious have demonstrated a marked winter peak similar to that of rotavirus-associated hospitalizations, which suggests that the registered rotavirus-coded admissions are grossly underestimated. We therefore obtained more realistic estimates by 2...... different models, which indicated 2.4 and 2.5 (for children rotavirus-associated admissions per 1,000 children per year, respectively. These admissions amount to associated direct medical costs of US $1.7-1.8 million per year. Using 2 simple...

Rotavirus shedding following administration of RV3-BB human neonatal rotavirus vaccine.

Science.gov (United States)

Cowley, Daniel; Boniface, Karen; Bogdanovic-Sakran, Nada; Kirkwood, Carl D; Bines, Julie E

2017-08-03

The RV3-BB human neonatal rotavirus vaccine aims to provide protection from severe rotavirus disease from birth. A phase IIa safety and immunogenicity trial was undertaken in Dunedin, New Zealand between January 2012 and April 2014. Healthy, full-term (≥ 36 weeks gestation) babies, who were 0-5 d old were randomly assigned (1:1:1) to receive 3 doses of oral RV3-BB vaccine with the first dose given at 0-5 d after birth (neonatal schedule), or the first dose given at about 8 weeks after birth (infant schedule), or to receive placebo (placebo schedule). Vaccine take (serum immune response or stool shedding of vaccine virus after any dose) was detected after 3 doses of RV3-BB vaccine in >90% of participants when the first dose was administered in the neonatal and infant schedules. The aim of the current study was to characterize RV3-BB shedding and virus replication following administration of RV3-BB in a neonatal and infant vaccination schedule. Shedding was defined as detection of rotavirus by VP6 reverse transcription polymerase chain reaction (RT-PCR) in stool on days 3-7 after administration of RV3-BB. Shedding of rotavirus was highest following vaccination at 8 weeks of age in both neonatal and infant schedules (19/30 and 17/27, respectively). Rotavirus was detected in stool on days 3-7, after at least one dose of RV3-BB, in 70% (21/30) of neonate, 78% (21/27) of infant and 3% (1/32) placebo participants. In participants who shed RV3-BB, rotavirus was detectable in stool on day 1 following RV3-BB administration and remained positive until day 4-5 after administration. The distinct pattern of RV3-BB stool viral load demonstrated using a NSP3 quantitative qRT-PCR in participants who shed RV3-BB, suggests that detection of RV3-BB at day 3-7 was the result of replication rather than passage through the gastrointestinal tract.

Rotavirus and the Vaccine (Drops) to Prevent It

Science.gov (United States)

... Resources Maternal Immunization Resources Related Links Vaccines & Immunizations Rotavirus and the Vaccine (Drops) to Prevent It Language: ... the vaccine. Why should my child get the rotavirus vaccine? The rotavirus vaccine: Protects your child from ...

Rotaviruses

Centers for Disease Control (CDC) Podcasts

CDC's Dr. Jon Gentsch discusses rotaviruses, the most important cause of severe gastroenteritis in children less than five years of age. Essentially, all children around the world get the disease during the first few years of life.

Human rotavirus vaccine Rotarix™ provides protection against diverse circulating rotavirus strains in African infants: a randomized controlled trial

Directory of Open Access Journals (Sweden)

Steele Andrew

2012-09-01

Full Text Available Abstract Background Rotaviruses are the most important cause of severe acute gastroenteritis worldwide in children Rotarix™ significantly reduced severe rotavirus gastroenteritis episodes in a Phase III clinical trial conducted in infants in South Africa and Malawi. This paper examines rotavirus vaccine efficacy in preventing severe rotavirus gastroenteritis, during infancy, caused by the various G and P rotavirus types encountered during the first rotavirus-season. Methods Healthy infants aged 5–10 weeks were enrolled and randomized into three groups to receive either two (10 and 14 weeks or three doses of Rotarix™ (together forming the pooled Rotarix™ group or three doses of placebo at a 6,10,14-week schedule. Weekly home visits were conducted to identify gastroenteritis episodes. Rotaviruses were detected by ELISA and genotyped by RT-PCR and nucleotide sequencing. The percentage of infants with severe rotavirus gastroenteritis caused by the circulating G and P types from 2 weeks post-last dose until one year of age and the corresponding vaccine efficacy was calculated with 95% CI. Results Overall, 4939 infants were vaccinated and 4417 (pooled Rotarix™ = 2974; placebo = 1443 were included in the per protocol efficacy cohort. G1 wild-type was detected in 23 (1.6% severe rotavirus gastroenteritis episodes from the placebo group. This was followed in order of detection by G12 (15 [1%] in placebo and G8 types (15 [1%] in placebo. Vaccine efficacy against G1 wild-type, G12 and G8 types were 64.1% (95% CI: 29.9%; 82%, 51.5% (95% CI:-6.5%; 77.9% and 64.4% (95% CI: 17.1%; 85.2%, respectively. Genotype P[8] was the predominant circulating P type and was detected in 38 (2.6% severe rotavirus gastroenteritis cases in placebo group. The remaining circulating P types comprised of P[4] (20 [1.4%] in placebo and P[6] (13 [0.9%] in placebo. Vaccine efficacy against P[8] was 59.1% (95% CI: 32.8%; 75.3%, P[4] was 70.9% (95% CI: 37.5%; 87

Rotavirus specific maternal antibodies and immune response to RV3-BB neonatal rotavirus vaccine in New Zealand

Science.gov (United States)

Chen, Mee-Yew; Kirkwood, Carl D.; Bines, Julie; Cowley, Daniel; Pavlic, Daniel; Lee, Katherine J.; Orsini, Francesca; Watts, Emma; Barnes, Graeme; Danchin, Margaret

2017-01-01

ABSTRACT Background: Maternal antibodies, acquired passively via placenta and/or breast milk, may contribute to the reduced efficacy of oral rotavirus vaccines observed in children in developing countries. This study aimed to investigate the effect of rotavirus specific maternal antibodies on the serum IgA response or stool excretion of vaccine virus after any dose of an oral rotavirus vaccine, RV3-BB, in parallel to a Phase IIa clinical trial conducted at Dunedin Hospital, New Zealand. At the time of the study rotavirus vaccines had not been introduced in New Zealand and the burden of rotavirus disease was evident. Methods: Rotavirus specific IgG and serum neutralizing antibody (SNA) levels in cord blood and IgA levels in colostrum and breast milk samples collected ∼4 weeks, ∼20 weeks and ∼28 weeks after birth were measured. Infants were randomized to receive the first dose of vaccine at 0–5 d (neonatal schedule) or 8 weeks (infant schedule). Breast feeding was with-held for 30 minutes before and after vaccine administration. The relationship between rotavirus specific IgG and SNA levels in cord blood and IgA in colostrum and breast milk at the time of first active dose of RV3-BB vaccine and level of IgA response and stool excretion after 3 doses of vaccine was assessed using linear and logistic regression. Results: Forty infants received 3 doses of RV3-BB rotavirus vaccine and were included in the analysis of the neonatal and infant groups. Rotavirus specific IgA in colostrum (neonatal schedule group) and breast milk at 4 weeks (infant schedule group) was identified in 14/21 (67%) and 14/17 (82%) of infants respectively. There was little evidence of an association between IgA in colostrum or breast milk IgA at 4 weeks, or between cord IgG or SNA level, and IgA response or stool excretion after 3 doses of RV3-BB, or after one dose (neonatal schedule) (all p>0.05). Conclusions: The level of IgA in colostrum or breast milk and level of placental Ig

Rotavirus specific maternal antibodies and immune response to RV3-BB neonatal rotavirus vaccine in New Zealand.

Science.gov (United States)

Chen, Mee-Yew; Kirkwood, Carl D; Bines, Julie; Cowley, Daniel; Pavlic, Daniel; Lee, Katherine J; Orsini, Francesca; Watts, Emma; Barnes, Graeme; Danchin, Margaret

2017-05-04

Maternal antibodies, acquired passively via placenta and/or breast milk, may contribute to the reduced efficacy of oral rotavirus vaccines observed in children in developing countries. This study aimed to investigate the effect of rotavirus specific maternal antibodies on the serum IgA response or stool excretion of vaccine virus after any dose of an oral rotavirus vaccine, RV3-BB, in parallel to a Phase IIa clinical trial conducted at Dunedin Hospital, New Zealand. At the time of the study rotavirus vaccines had not been introduced in New Zealand and the burden of rotavirus disease was evident. Rotavirus specific IgG and serum neutralizing antibody (SNA) levels in cord blood and IgA levels in colostrum and breast milk samples collected ∼4 weeks, ∼20 weeks and ∼28 weeks after birth were measured. Infants were randomized to receive the first dose of vaccine at 0-5 d (neonatal schedule) or 8 weeks (infant schedule). Breast feeding was with-held for 30 minutes before and after vaccine administration. The relationship between rotavirus specific IgG and SNA levels in cord blood and IgA in colostrum and breast milk at the time of first active dose of RV3-BB vaccine and level of IgA response and stool excretion after 3 doses of vaccine was assessed using linear and logistic regression. Forty infants received 3 doses of RV3-BB rotavirus vaccine and were included in the analysis of the neonatal and infant groups. Rotavirus specific IgA in colostrum (neonatal schedule group) and breast milk at 4 weeks (infant schedule group) was identified in 14/21 (67%) and 14/17 (82%) of infants respectively. There was little evidence of an association between IgA in colostrum or breast milk IgA at 4 weeks, or between cord IgG or SNA level, and IgA response or stool excretion after 3 doses of RV3-BB, or after one dose (neonatal schedule) (all p>0.05). The level of IgA in colostrum or breast milk and level of placental IgG and SNA did not impact on the serum IgA response or

Acceso a la educación en salud y su potencial en la disminución de la incidencia de diarrea infantil en las poblaciones costeras de Yucatán, México

Directory of Open Access Journals (Sweden)

Rubén Solís

2015-01-01

Full Text Available Introducción: La educación en salud o pláticas en el ámbito institucional mitiga la incidencia de diarrea infantil. Yucatán es el estado con las mayores tasas de incidencia de diarreas a nivel nacional; el impacto de las pláticas, como parte de un programa de salud, en la incidencia de diarreas ha sido insuficientemente estudiado. Objetivo: Analizar el rol del acceso a las pláticas para prevenir la incidencia de diarreas infantiles. Metodología: Se utilizó el muestreo de encuestas en 151 hogares, se encontró a 187 niños menores de cinco años de edad. El estudio se realizó en tres segmentos muestrales de la zona costera, con diferentes condiciones ambientales: Progreso (puerto urbano concentrado, Celestún (reserva biosfera, turismo, urbanizada y Río Lagartos (turismo, reserva biosfera rural. Se estimó la tasa de prevalencia lápsica de diarrea, los casos fueron las diarreas ocurridas en los 15 días inmediatos previos a la encuesta. Se hizo análisis descriptivos, bivariados, estratificados y la regresión logística binaria. Resultados: Se registró una tasa de prevalencia lápsica de 13.37% (n=25 casos. El análisis logístico multivariado mostró el impacto protector significativo de las pláticas (B=-2.105; RM=0.163; y p= 0.018 con un efecto que equivale a 6.25 veces menos riesgo de presentar episodios diarreicos. Conclusión: Las pláticas, como política de salud, tienen impacto en la disminución de las diarreas; esto sucede en especial si se llevan a cabo entre los beneficiarios de los programas sociales.

Acceso a la educación en salud y su potencial en la disminución de la incidencia de diarrea infantil en las poblaciones costeras de Yucatán, México

Directory of Open Access Journals (Sweden)

Rubén Solís

2016-02-01

Full Text Available Introducción: La educación en salud o pláticas en el ámbito institucional mitiga la incidencia de diarrea infantil. Yucatán es el estado con las mayores tasas de incidencia de diarreas a nivel nacional; el impacto de las pláticas, como parte de un programa de salud, en la incidencia de diarreas ha sido insuficientemente estudiado. Objetivo: Analizar el rol del acceso a las pláticas para prevenir la incidencia de diarreas infantiles. Metodología: Se utilizó el muestreo de encuestas en 151 hogares, se encontró a 187 niños menores de cinco años de edad. El estudio se realizó en tres segmentos muestrales de la zona costera, con diferentes condiciones ambientales: Progreso (puerto urbano concentrado, Celestún (reserva biosfera, turismo, urbanizada y Río Lagartos (turismo, reserva biosfera rural. Se estimó la tasa de prevalencia lápsica de diarrea, los casos fueron las diarreas ocurridas en los 15 días inmediatos previos a la encuesta. Se hizo análisis descriptivos, bivariados, estratificados y la regresión logística binaria. Resultados: Se registró una tasa de prevalencia lápsica de 13.37% (n=25 casos. El análisis logístico multivariado mostró el impacto protector significativo de las pláticas (=-2.105; RM=0.163; y = 0.018 con un efecto que equivale a 6.25 veces menos riesgo de presentar episodios diarreicos. Conclusión: Las pláticas, como política de salud, tienen impacto en la disminución de las diarreas; esto sucede en especial si se llevan a cabo entre los beneficiarios de los programas sociales.

Estimating rotavirus gastroenteritis hospitalisations by using hospital episode statistics before and after the introduction of rotavirus vaccine in Australia.

Science.gov (United States)

Jayasinghe, Sanjay; Macartney, Kristine

2013-01-30

Hospital discharge records and laboratory data have shown a substantial early impact from the rotavirus vaccination program that commenced in 2007 in Australia. However, these assessments are affected by the validity and reliability of hospital discharge coding and stool testing to measure the true incidence of hospitalised disease. The aim of this study was to assess the validity of these data sources for disease estimation, both before and after, vaccine introduction. All hospitalisations at a major paediatric centre in children aged <5 years from 2000 to 2009 containing acute gastroenteritis (AGE) ICD 10 AM diagnosis codes were linked to hospital laboratory stool testing data. The validity of the rotavirus-specific diagnosis code (A08.0) and the incidence of hospitalisations attributable to rotavirus by both direct estimation and with adjustments for non-testing and miscoding were calculated for pre- and post-vaccination periods. A laboratory record of stool testing was available for 36% of all AGE hospitalisations (n=4948) the rotavirus code had high specificity (98.4%; 95% CI, 97.5-99.1%) and positive predictive value (96.8%; 94.8-98.3%), and modest sensitivity (61.6%; 58-65.1%). Of all rotavirus test positive hospitalisations only a third had a rotavirus code. The estimated annual average number of rotavirus hospitalisations, following adjustment for non-testing and miscoding was 5- and 6-fold higher than identified, respectively, from testing and coding alone. Direct and adjusted estimates yielded similar percentage reductions in annual average rotavirus hospitalisations of over 65%. Due to the limited use of stool testing and poor sensitivity of the rotavirus-specific diagnosis code routine hospital discharge and laboratory data substantially underestimate the true incidence of rotavirus hospitalisations and absolute vaccine impact. However, this data can still be used to monitor vaccine impact as the effects of miscoding and under-testing appear to be

Introduktion. Om rotavirus. Teknologi

DEFF Research Database (Denmark)

Wejse, Christian

2012-01-01

vil skyldes rotavirus. Typisk vil børnene få feber, opkastninger og/eller diarré. Sygdommen går sædvanligvis over af sig selv i løbet af 3 til 7 dage. Nogle børn får dog væske- og saltmangel i en sådan grad, at de må indlægges på hospital til behandling med drop og væske direkte ind i årerne. 85 – 90...... % af danske børn følger det danske børnevaccinationsprogram og bliver vaccineret mod en række infektioner. Der findes i Danmark to velafprøvede og godkendte vacciner mod rotavirus. Begge vacciner gives gennem munden og ikke gennem indsprøjtning i huden, som de øvrige vacciner i det danske...... børnevaccinationsprogram. Verdenssundhedsorganisation (WHO=World Health Organisation) samt nationale og europæiske faglige selskaber har anbefalet at vaccinere mod rotavirus. I en række europæiske lande er vaccination mod rotavirus indført i det nationale børnevaccinationsprogram. Andre europæiske lande har fravalgt...

Surveillance of Rotavirus Diarrhea in Hasan Sadikin Hospital Bandung

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Dwi Prasetyo

2010-12-01

Full Text Available The diarrhea morbidity in Indonesia has increased, however, all the reports had not been done carefully, so that accurate surveillance are essential for improving quality of morbidity data. To determine the prevalence and clinical manifestations of rotavirus diarrhea and to characterize the circulating rotavirus strains, children below 5 years old who were admitted to Hasan Sadikin Hospital, Bandung because of diarrhea, from January 2006 through March 2007 were enrolled in a surveillance study and had stool specimens tested for the presence of rotavirus using enzyme immunoassay (EIA. The strains of rotavirus were determined using reverse transcriptase-polymerase chain reaction (RT-PCR. Rotavirus were detected in 47.8% analyzed samples (87/184, G and P-genotype of rotavirus were G[1] (37.5% and P[6] (53.5%. Most subjects were males (56%, 6–11 months of age (35%. Most common clinical manifestations besides diarrhea were dehydration (72.7% and vomiting (50%. Subjects with positive rotavirus more common had dehydration (72% vs 28% and vomiting (61% vs 39%. In conclusion, vomiting and dehydration are the prominent clinical manifestations of diarrhea with positive rotavirus infection. G1 and P6 are the most common genotype of rotavirus.

Human rotavirus genotypes circulating in Brazil before and after a nationwide rotavirus vaccination program established in 2006

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Caruzo TAR

2011-04-01

Full Text Available Thabata AR CaruzoGenetics, Evolution and Bioagents Department, Institute of Biology, State University of Campinas, Campinas, São Paulo, BrazilAbstract: Accounting for an estimated 600,000 deaths worldwide each year, rotaviruses are recognized as the most important etiologic agents causing severe acute gastroenteritis among children under the age of five years. In Brazil, until rotavirus vaccination was established in the public health system in 2006, acute gastroenteritis striking children under five years and caused by these viruses was clearly associated with 3.5 million episodes of diarrhea, 650,000 visits to outpatient health care facilities, 92,000 hospitalizations, and 850 deaths each year. After the introduction of the rotavirus vaccine in Brazil in March 2006, studies all over the country have been comparing rotavirus genotypes circulating in the recent pre- and postvaccination era. Most of these studies have reported a high prevalence of the G2P[4] genotype and also a decrease in rotavirus detection all over Brazil after the introduction of the vaccine. So far, these are preliminary studies, as a longer period of time is necessary to establish if this high prevalence of G2P[4] is due to selective pressure by the vaccine on the circulating viruses or to a normal genotype fluctuation, and if it will have any impact on vaccine efficacy in the future. This review describes results from the most recent studies addressing this issue and on rotavirus genotypic variability in Brazil.Keywords: human rotavirus, vaccine, genotypes, prevalence, Brazil

CNS complications of rotavirus gastroenteritis

International Nuclear Information System (INIS)

Volosinova, D.

2010-01-01

Rotavirus infection may be accompanied by serious complications, e.g. disabilities central nervous system (CNS). Theory rotavirus penetration across the blood-brain barrier and subsequent rota-associated convulsions by the 2-year case-history of the patient. Rotavirosis minor gastrointestinal symptoms may lead to erroneous diagnosis. (author)

Uso de las enzimas digestivas en el tratamiento de la diarrea persistente

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Arnaldo Izquierdo Estévez

1998-03-01

Full Text Available Se realizó un estudio prospectivo de corte transversal, con el propósito de conocer la medida en que los fermentos pancreáticos totales administrados oralmente, favorecen la evolución de la enfermedad, en los niños menores de 1 año con diarrea persistente, ingresados en el Servicio de Gastroenterología del Hospital Pediátrico Docente "Ángel A. Aballí" en el período de enero a abril de 1996. Los resultados permiten afirmar la reducción del número de deposiciones y el incremento efectivo de peso al 3er. día de tratamiento, así como la mejoría de los síntomas asociados con la diarrea, sin efectos secundarios.A prospective cross-sectional study aimed at finding out to what extent the orally-administered total pancreatic fermets influence over the development of diarrhea disease in under one-year old children admitted with persistent diarrhea to the Gastroenterology Service Unit of «Ángel A. Aballí» Teaching Pediatric Hospital from January to April 1996 was performed. Results showed the reduction in the number of stools, the effective weight gain on the 3rd day of treatment as well as the improvement of diarrhea-related symptoms without side effects.

Bacterial pathogens associated with bloody diarrhea in Uruguayan children Patógenos bacterianos asociados a diarrea con sangre en niños uruguayos

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M. I. Mota

2010-06-01

Full Text Available Diarrheal disease continues to be a serious health problem, especially in developing countries. Bloody diarrhea represents approximately 20-30% of all cases and has higher morbidity and mortality. Treatment with antibiotics is beneficial in cases of Shigella, Campylobacter, Yersinia and Salmonella infection, principally in those children with a higher risk of invasive disease. The aims of this study were to detect the bacterial agents associated with bloody diarrhea in children and to determine their antimicrobial susceptibility patterns. Between June 2001 and January 2008, 249 children with bloody diarrhea were studied. Shigella and Shiga toxin-producing Escherichia coli (STEC were recovered from 48 (19.3% and 3 (1.2% of the total of cases, respectively. In 49 out of 249 children, in whom other enteropathogens were investigated, we recovered Campylobacter jejuni from 7 children (14.3%, Salmonella spp. from 2 (4.1% and Aeromonas spp. from 1 (2% in addition to Shigella from 7 children (14.3%. Thirty-four (70% Shigella isolates showed resistance to ampicillin and 13 (27% to trimethoprim-sulfamethoxazole. All Shigella isolates were susceptible to nalidixic acid, ciprofloxacin and ceftriaxone. Salmonella and STEC isolates were susceptible to all antibiotics assayed. Thus, the use of trimethoprim-sulfamethoxazole or ampicillin would not be appropriate for the empirical treatment of Shigella - associated diarrhea.La enfermedad diarreica es un problema de salud importante, especialmente en los países en desarrollo. La diarrea sanguinolenta representa el 20-30% del total de casos y determina una mayor morbimortalidad. La antibioticoterapia es beneficiosa en casos de infección por Shigella, Campylobacter, Yersinia y Salmonella, principalmente en niños con riesgo elevado de enfermedad invasora. Los objetivos del presente trabajo fueron conocer las bacterias asociadas a diarrea sanguinolenta y determinar su patrón de sensibilidad a los antimicrobianos

Severe Rotavirus gastroenteritis in a patient with infant leukemia

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Hatice Uygun

2011-03-01

Full Text Available Rotavirus is the most common cause of severe gastroenteritis in infants and young children. Reports about the clinical relevance of rotavirus in immunocompromised children are rare. We herein presented a case of life-threatening Rotavirus gastroenteritis in an infant with acute myeloblastic leukemia which could be prevented by recently recommended Rotavirus vaccination.

Outstanding challenges for rotavirus vaccine introduction in low-income countries

DEFF Research Database (Denmark)

Ustrup, Marte; Madsen, Lizell B; Bygbjerg, Ib C

2011-01-01

Rotavirus infections are the most common cause of severe diarrhoea in children worldwide. Two internationally licensed rotavirus vaccines have proven to be efficacious in middle and high-income countries and they could potentially be valuable tools for the prevention of rotavirus....... There is also a need for political commitment to prevent rotavirus infections as well as a need for an overall strengthening of the health systems in low-income countries. If these challenges were met, rotavirus vaccination could substantially improve child health and survival from rotavirus...

Detenga las infecciones por C. difficile (Stop C. difficile Infections)

Centers for Disease Control (CDC) Podcasts

2012-03-06

Este podcast se basa en la edición de marzo del 2012 del informe Vital Signs de los CDC. La Clostridium difficile es una bacteria que causa diarrea y está asociada a 14,000 muertes anuales en los Estados Unidos. Este podcast ayuda a los profesionales de la salud a saber cómo prevenir las infecciones por C. difficile.  Created: 3/6/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 3/6/2012.

Phase I trial of RV3-BB rotavirus vaccine: a human neonatal rotavirus vaccine.

Science.gov (United States)

Danchin, M; Kirkwood, C D; Lee, K J; Bishop, R F; Watts, E; Justice, F A; Clifford, V; Cowley, D; Buttery, J P; Bines, J E

2013-05-28

RV3 is a human neonatal rotavirus strain (G3P[6]) that has been associated with asymptomatic neonatal infection and replicates well in the infant gut. RV3-BB rotavirus vaccine has been developed as a rotavirus vaccine candidate for administration at birth. A single-centre, double-blind, randomised placebo-controlled Phase I study evaluated the safety and tolerability of a single oral dose of the second generation RV3-BB rotavirus vaccine (8.3×10(6)FFU/mL) in 20 adults, 20 children and 20 infants (10 vaccine and 10 placebo per age cohort). Vaccine take was defined as seroconversion (a 3-fold increase in serum anti-rotavirus IgA or serum neutralising antibody (SNA) from baseline at day 28 post-dose) or evidence of RV3-BB viral replication in the faeces by RT-PCR analysis 3-6 days post-vaccination. RV3-BB presence was confirmed by sequence analysis. The RV3-BB vaccine was well tolerated in all participants, with no pattern of adverse events shown to be associated with the study vaccine. In the infant cohort, vaccine take was demonstrated in 8/9 infants following a single dose of vaccine compared with 2/7 placebo recipients. In the infant vaccine group, 5/9 infants exhibited either IgA or SNA seroconversion and 7/9 infants had evidence of RV3-BB replication on days 3-6, compared with 2/7 infants who seroconverted and 0/10 infants with evidence of replication in the placebo group. Two infants in the placebo group had serological evidence of a rotavirus infection within the 28-day study period: one demonstrated an IgA and the other an SNA response, with wild-type virus replication detected in another infant. A single dose of RV3-BB rotavirus vaccine was well tolerated in adults, children and infants. Most infants (8/9) who received RV3-BB demonstrated vaccine take following a single dose. These data support progression of RV3-BB to Phase II immunogenicity and efficacy trials. Copyright © 2013 Elsevier Ltd. All rights reserved.

Inhibition of rotavirus replication by a non-neutralizing, rotavirus VP6–specific IgA mAb

Science.gov (United States)

Feng, Ningguo; Lawton, Jeffrey A.; Gilbert, Joana; Kuklin, Nelly; Vo, Phuoc; Prasad, B.V. Venkataram; Greenberg, Harry B.

2002-01-01

Rotaviruses are the leading cause of severe diarrheal disease in young children. Intestinal mucosal IgA responses play a critical role in protective immunity against rotavirus reinfection. Rotaviruses consist of three concentric capsid layers surrounding a genome of 11 segments of double-stranded RNA. The outer layer proteins, VP4 and VP7, which are responsible for viral attachment and entry, are targets for protective neutralizing antibodies. However, IgA mAb’s directed against the intermediate capsid protein VP6, which do not neutralize the virus, have also been shown to protect mice from rotavirus infection and clear chronic infection in SCID mice. We investigated whether the anti-VP6 IgA (7D9) mAb could inhibit rotavirus replication inside epithelial cells and found that 7D9 acted at an early stage of infection to neutralize rotavirus following antibody lipofection. Using electron cryomicroscopy, we determined the three-dimensional structure of the virus-antibody complex. The attachment of 7D9 IgA to VP6 introduces a conformational change in the VP6 trimer, rendering the particle transcriptionally incompetent and preventing the elongation of initiated transcripts. Based on these observations, we suggest that anti-VP6 IgA antibodies confers protection in vivo by inhibiting viral transcription at the start of the intracellular phase of the viral replication cycle. PMID:11994409

An evaluation of the Australian Rotavirus Surveillance Program.

Science.gov (United States)

Roberts-Witteveen, April R; Patel, Mahomed S; Roche, Paul W

2008-09-01

The Australian Rotavirus Serotyping Program (ARSP) serotypes rotavirus isolates obtained from stool samples sent from Australian laboratories. In collaboration with ARSP the Australian Government Department of Health and Ageing evaluated the program for its utility and capacity to monitor effectiveness of the rotavirus vaccines recently introduced into the Australian National Immunisation Program. The system was described using ARSP annual reports and staff interviews. The attributes of the system were assessed by adapting standard guidelines for evaluating a surveillance system. Email surveys or face to face interviews were conducted with staff of ARSP, participating laboratories, rotavirus vaccine manufacturing companies and representatives of the Communicable Diseases Network Australia. The ability of the ARSP to monitor changes in rotavirus serotype epidemiology was assessed. ARSP serotypes rotavirus isolates received from participating laboratories at least bi-annually, with results being reported at least as often. Serotype analyses have informed formulation of rotavirus vaccines and contributed to forecasting the extent of outbreaks caused by novel serotypes. The ARSP will be able to monitor changes in rotavirus serotype epidemiology and identify probable vaccination failures. Enhancement of the representativeness and sensitivity of the system are needed for the data to remain useful in the public health context. Methods for transferring data between the program and state and territory health departments need to be developed.

Rotavirus specific maternal antibodies and immune response to RV3-BB neonatal rotavirus vaccine in New Zealand

OpenAIRE

Chen, Mee-Yew; Kirkwood, Carl D.; Bines, Julie; Cowley, Daniel; Pavlic, Daniel; Lee, Katherine J.; Orsini, Francesca; Watts, Emma; Barnes, Graeme; Danchin, Margaret

2017-01-01

Background: Maternal antibodies, acquired passively via placenta and/or breast milk, may contribute to the reduced efficacy of oral rotavirus vaccines observed in children in developing countries. This study aimed to investigate the effect of rotavirus specific maternal antibodies on the serum IgA response or stool excretion of vaccine virus after any dose of an oral rotavirus vaccine, RV3-BB, in parallel to a Phase IIa clinical trial conducted at Dunedin Hospital, New Zealand. At the time o...

Rotavirus vaccination within the South African Expanded Programme on Immunisation.

Science.gov (United States)

Seheri, L Mapaseka; Page, Nicola A; Mawela, Mothahadini P B; Mphahlele, M Jeffrey; Steele, A Duncan

2012-09-07

Diarrhoeal diseases are ranked the third major cause of childhood mortality in South African children less than 5 years, where the majority of deaths are among black children. Acute severe dehydrating rotavirus diarrhoea remains an important contributor towards childhood mortality and morbidity and has been well documented in South Africa. As the preventive strategy to control rotavirus diarrhoea, South Africa became the first country in the WHO African Region to adopt the rotavirus vaccine in the national childhood immunisation programme in August 2009. The rotavirus vaccine in use, Rotarix, GSK Biologicals, is given at 6 and 14 weeks of age, along with other vaccines as part of Expanded Programme on Immunisation (EPI). Studies which facilitated the introduction of rotavirus vaccine in South Africa included the burden of rotavirus disease and strain surveillance, economic burden of rotavirus infection and clinical trials to assess the safety and efficacy of vaccine candidates. This paper reviews the epidemiology of rotavirus in South Africa, outlines some of the steps followed to introduce rotavirus vaccine in the EPI, and highlights the early positive impact of vaccination in reducing the rotavirus burden of disease based on the post-marketing surveillance studies at Dr George Mukhari hospital, a sentinel site at University of Limpopo teaching hospital in Pretoria, South Africa, which has conducted rotavirus surveillance for >20 years. Copyright © 2012 Elsevier Ltd. All rights reserved.

Household transmission of rotavirus in a community with rotavirus vaccination in Quininde, Ecuador.

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Ben Lopman

Full Text Available We studied the transmission of rotavirus infection in households in peri-urban Ecuador in the vaccination era.Stool samples were collected from household contacts of child rotavirus cases, diarrhea controls and healthy controls following presentation of the index child to health facilities. Rotavirus infection status of contacts was determined by RT-qPCR. We examined factors associated with transmissibility (index-case characteristics and susceptibility (household-contact characteristics.Amongst cases, diarrhea controls and healthy control household contacts, infection attack rates (iAR were 55%, 8% and 2%, (n = 137, 130, 137 respectively. iARs were higher from index cases with vomiting, and amongst siblings. Disease ARs were higher when the index child was <18 months and had vomiting, with household contact <10 years and those sharing a room with the index case being more susceptible. We found no evidence of asymptomatic infections leading to disease transmission.Transmission rates of rotavirus are high in households with an infected child, while background infections are rare. We have identified factors associated with transmission (vomiting/young age of index case and susceptibility (young age/sharing a room/being a sibling of the index case. Vaccination may lead to indirect benefits by averting episodes or reducing symptoms in vaccinees.

Rotavirus Viremia and Extraintestinal Viral Infection in the Neonatal Rat Model

Science.gov (United States)

Crawford, Sue E.; Patel, Dinesh G.; Cheng, Elly; Berkova, Zuzana; Hyser, Joseph M.; Ciarlet, Max; Finegold, Milton J.; Conner, Margaret E.; Estes, Mary K.

2006-01-01

Rotaviruses infect mature, differentiated enterocytes of the small intestine and, by an unknown mechanism, escape the gastrointestinal tract and cause viremia. The neonatal rat model of rotavirus infection was used to determine the kinetics of viremia, spread, and pathology of rotavirus in extraintestinal organs. Five-day-old rat pups were inoculated intragastrically with an animal (RRV) or human (HAL1166) rotavirus or phosphate-buffered saline. Blood was collected from a subset of rat pups, and following perfusion to remove residual blood, organs were removed and homogenized to analyze rotavirus-specific antigen by enzyme-linked immunosorbent assay and infectious rotavirus by fluorescent focus assay or fixed in formalin for histology and immunohistochemistry. Viremia was detected following rotavirus infection with RRV and HAL1166. The RRV 50% antigenemia dose was 1.8 × 103 PFU, and the 50% diarrhea dose was 7.7 × 105 PFU, indicating that infection and viremia occurred in the absence of diarrhea and that detecting rotavirus antigen in the blood was a more sensitive measure of infection than diarrhea. Rotavirus antigens and infectious virus were detected in multiple organs (stomach, intestines, liver, lungs, spleen, kidneys, pancreas, thymus, and bladder). Histopathological changes due to rotavirus infection included acute inflammation of the portal tract and bile duct, microsteatosis, necrosis, and inflammatory cell infiltrates in the parenchymas of the liver and lungs. Colocalization of structural and nonstructural proteins with histopathology in the liver and lungs indicated that the histological changes observed were due to rotavirus infection and replication. Replicating rotavirus was also detected in macrophages in the lungs and blood vessels, indicating a possible mechanism of rotavirus dissemination. Extraintestinal infectious rotavirus, but not diarrhea, was observed in the presence of passively or actively acquired rotavirus-specific antibody. These

Comparative analysis of pentavalent rotavirus vaccine strains and G8 rotaviruses identified during vaccine trial in Africa.

Science.gov (United States)

Heylen, Elisabeth; Zeller, Mark; Ciarlet, Max; Lawrence, Jody; Steele, Duncan; Van Ranst, Marc; Matthijnssens, Jelle

2015-10-06

RotaTeqTM is a pentavalent rotavirus vaccine based on a bovine rotavirus genetic backbone in vitro reassorted with human outer capsid genes. During clinical trials of RotaTeqTM in Sub-Saharan Africa, the vaccine efficacy over a 2-year follow-up was lower against the genotypes contained in the vaccine than against the heterotypic G8P[6] and G8P[1] rotavirus strains of which the former is highly prevalent in Africa. Complete genome analyses of 43 complete rotavirus genomes collected during phase III clinical trials of RotaTeqTM in Sub-Saharan Africa, were conducted to gain insight into the high level of cross-protection afforded by RotaTeqTM against these G8 strains. Phylogenetic analysis revealed the presence of a high number of bovine rotavirus gene segments in these human G8 strains. In addition, we performed an in depth analysis on the individual amino acid level which showed that G8 rotaviruses were more similar to the RotaTeqTM vaccine than non-G8 strains. Because RotaTeqTM possesses a bovine genetic backbone, the high vaccine efficacy against G8 strains might be partially explained by the fact that all these strains contain a complete or partial bovine-like backbone. Altogether, this study supports the hypothesis that gene segments other than VP7 and VP4 play a role in vaccine-induced immunity.

Effect of pentavalent rotavirus vaccine introduction on hospital admissions for diarrhoea and rotavirus in children in Rwanda: a time-series analysis.

Science.gov (United States)

Ngabo, Fidele; Tate, Jacqueline E; Gatera, Maurice; Rugambwa, Celse; Donnen, Philippe; Lepage, Philippe; Mwenda, Jason M; Binagwaho, Agnes; Parashar, Umesh D

2016-02-01

In May, 2012, Rwanda became the first low-income African country to introduce pentavalent rotavirus vaccine into its routine national immunisation programme. Although the potential health benefits of rotavirus vaccination are huge in low-income African countries that account for more than half the global deaths from rotavirus, concerns remain about the performance of oral rotavirus vaccines in these challenging settings. We conducted a time-series analysis to examine trends in admissions to hospital for non-bloody diarrhoea in children younger than 5 years in Rwanda between Jan 1, 2009, and Dec 31, 2014, using monthly discharge data from the Health Management Information System. Additionally, we reviewed the registries in the paediatric wards at six hospitals from 2009 to 2014 and abstracted the number of total admissions and admissions for diarrhoea in children younger than 5 years by admission month and age group. We studied trends in admissions specific to rotavirus at one hospital that had undertaken active rotavirus surveillance from 2011 to 2014. We assessed changes in rotavirus epidemiology by use of data from eight active surveillance hospitals. Compared with the 2009-11 prevaccine baseline, hospital admissions for non-bloody diarrhoea captured by the Health Management Information System fell by 17-29% from a pre-vaccine median of 4051 to 2881 in 2013 and 3371 in 2014, admissions for acute gastroenteritis captured in paediatric ward registries decreased by 48-49%, and admissions specific to rotavirus captured by active surveillance fell by 61-70%. The greatest effect was recorded in children age-eligible to be vaccinated, but we noted a decrease in the proportion of children with diarrhoea testing positive for rotavirus in almost every age group. The number of admissions to hospital for diarrhoea and rotavirus in Rwanda fell substantially after rotavirus vaccine implementation, including among older children age-ineligible for vaccination, suggesting

Hidratación oral continua o a dosis fraccionadas en niños deshidratados por diarrea aguda Oral rehydration in continuous administration or in fractionated doses in dehydrated children with acute diarrhea

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Felipe Mota-Hernández

2002-01-01

Full Text Available Objetivo. Evaluar la seguridad y efectividad de dos técnicas de hidratación oral. Material y métodos. Ensayo clínico aleatorio, hecho en el Servicio de Hidratación Oral del Hospital Infantil de México, Federico Gómez, entre septiembre de 1998 y junio de 1999. Cuarenta pacientes deshidratados por diarrea aguda, menores de cinco años, recibieron suero oral ad libitum (grupo AL y otros cuarenta lo recibieron en dosis fraccionada (grupo DF. Las características clínicas fueron similares en ambos grupos. Los resultados se presentan como promedio y desviación estándar o mediana, según la distribución de frecuencias simples y relativas. Resultados. El promedio de gasto fecal en el grupo AL fue 11.0±7.5 g/kg/h y en el grupo DF 7.1±7.4 (p=0.03. La ingesta de suero, el tiempo de hidratación y la diuresis promedio, fueron similares entre ambos grupos (p>0.05. Seis pacientes del grupo AL y cinco del DF tuvieron gasto fecal alto (>10 g/kg/hora, mejorando con la administración de atole de arroz. Un paciente del grupo AL y dos pacientes del DF tuvieron vómitos persistentes, mejorando con gastroclisis. Ningún paciente requirió rehidratación intravenosa. Conclusiones. Estos resultados sugieren que la administración de suero oral ad libitum, bajo supervisión, es tan segura y efectiva como la técnica de dosis fraccionada para el tratamiento de niños deshidratados por diarrea aguda.Objective. To evaluate the safety and effectiveness of two oral rehydration techniques. Material and Methods. A randomized clinical trial was conducted at the oral rehydration unit of Hospital Infantil de Mexico "Federico Gomez", between September 1998 and June 1999. Forty patients five-year old and younger children, dehydrated due to acute diarrhea, were given oral rehydration solution (ORS ad libitum (AL group; another forty patients received ORS in fractionated doses (FD group. Clinical characteristics were similar in both groups. Results are presented as

Impact of rotavirus vaccines in low and middle-income countries.

Science.gov (United States)

Sindhu, Kulandaipalayam Natarajan Chella; Babji, Sudhir; Ganesan, Santhosh Kumar

2017-10-01

Rotavirus vaccines are playing a pivotal role in improving lives of infants and young children in low and middle-income countries (LMICs). Many of these countries have adopted the vaccine into their routine immunization, whereas others are considering introduction. This article provides an update on the impact of rotavirus vaccines in LMICs on morbidity and mortality in children aged less than 5 years, and their cost-effectiveness. The WHO, in 2013, updated its recommendation to prioritize introduction of rotavirus vaccines in the routine immunization schedule, without age restrictions. Despite the decreased efficacy of the vaccines in LMICs, data from Sub-Saharan Africa have demonstrated a decrease in rotavirus-related morbidity, with some sites reporting an indirect protective effect on children age ineligible to receive the vaccine. Even with improvements in sanitation, nutritional status in children, and other health-related indices in LMICs, the use of rotavirus vaccines will play an important role in preventing rotavirus-related gastroenteritis. Economic models predict a reduction in economic burden because of rotavirus-related health costs, making vaccine introduction cost-effective in resource-constrained settings. Increasing evidence from impact studies shows the significant impact of rotavirus vaccination on hospitalizations and economic burden because of rotavirus gastroenteritis in LMICs. Universal rotavirus vaccination is recommended, and introductions should be monitored by robust surveillance systems to measure effectiveness and impact.

Rotavirus vaccines: safety, efficacy and public health impact.

Science.gov (United States)

Gray, J

2011-09-01

Rotaviruses are the cause of acute gastroenteritis, and disease is widespread amongst infants and young children throughout the world. Also, rotavirus is associated with significant mortality in developing countries with more than 500 000 children dying each year as a result of the severe dehydration associated with rotavirus disease. Efforts have been ongoing for more than 30 years to develop a safe and effective rotavirus vaccine. Currently, two vaccines, RotaRix and RotaTeq, have been licensed for use in many countries throughout the world following comprehensive safety and efficiency trials. Monitoring their effectiveness after licensure has confirmed that their incorporation into early childhood vaccination schedules can significantly prevent severe rotavirus diarrhoea, which would have resulted in hospitalizations, emergency room visits or increased diarrhoea-related mortality. Although the efficacy of both vaccines is lower at approximately 40-59% in developing countries, their use could significantly reduce the mortality associated with rotavirus disease that is concentrated in these countries. © 2011 The Association for the Publication of the Journal of Internal Medicine.

A systematic review of anti-rotavirus serum IgA antibody titer as a potential correlate of rotavirus vaccine efficacy.

Science.gov (United States)

Patel, Manish; Glass, Roger I; Jiang, Baoming; Santosham, Mathuram; Lopman, Ben; Parashar, Umesh

2013-07-15

Identifying an immunological correlate of protection for rotavirus vaccines (Rotarix [RV1] and RotaTeq [RV5]) would substantially facilitate testing of interventions for improving efficacy in developing countries and evaluating additional candidate rotavirus vaccines. We accessed PubMed and ClinicalTrials.gov to identify immunogenicity and efficacy trials for RV1 and RV5 to correlate anti-rotavirus serum immunoglobulin A (IgA) antibody titers vs efficacy in regions stratified by all-cause under-5 mortality rates (u5MR). We established a cutoff point for IgA geometric mean concentration or titer (GMC) that predicted lower efficacy and calculated pooled vaccine efficacy among countries with high vs low IgA titers. We observed an inverse correlation between u5MR and IgA titers for RV1 (r(2) = 0.72; P efficacy and IgA titers for both vaccines (r(2) = 0.56; P = .005). Postimmunization anti-rotavirus IgA GMC vaccine efficacy. Efficacy during first 2 years of life was significantly lower among countries with IgA GMC 90 (85%; 95% CI, 82-88). We observed a significant correlation between IgA titers and rotavirus vaccine efficacy and hypothesize that a critical level of IgA antibody titer is associated with a sufficient level of sustained protection after rotavirus vaccination.

Identification of the two rotavirus genes determining neutralization specificities

International Nuclear Information System (INIS)

Offit, P.A.; Blavat, G.

1986-01-01

Bovine rotavirus NCDV and simian rotavirus SA-11 represent two distinct rotavirus serotypes. A genetic approach was used to determine which viral gene segments segregated with serotype-specific viral neutralization. There were 16 reassortant rotarviruses derived by coinfection of MA-104 cells in vitro with the SA-11 and NCDV strains. The parental origin of reassortant rotavirus double-stranded RNA segments was determined by gene segment mobility in polyacrylamide gels and by hybridization with radioactively labeled parental viral transcripts. The authors found that two rotavirus gene segments found previously to code for outer capsid proteins vp3 and vp7 cosegreated with virus neutralization specificities

Identification of the two rotavirus genes determining neutralization specificities

Energy Technology Data Exchange (ETDEWEB)

Offit, P.A.; Blavat, G.

1986-01-01

Bovine rotavirus NCDV and simian rotavirus SA-11 represent two distinct rotavirus serotypes. A genetic approach was used to determine which viral gene segments segregated with serotype-specific viral neutralization. There were 16 reassortant rotarviruses derived by coinfection of MA-104 cells in vitro with the SA-11 and NCDV strains. The parental origin of reassortant rotavirus double-stranded RNA segments was determined by gene segment mobility in polyacrylamide gels and by hybridization with radioactively labeled parental viral transcripts. The authors found that two rotavirus gene segments found previously to code for outer capsid proteins vp3 and vp7 cosegreated with virus neutralization specificities.

Performance of rotavirus vaccines in developed and developing countries

OpenAIRE

Jiang, Victoria; Jiang, Baoming; Tate, Jacqueline; Parashar, Umesh D; Patel, Manish M

2010-01-01

The World Health Organization estimates that rotavirus diarrhea results in approximately half a million deaths and approximately 2.4 million hospitalizations in developing countries each year. Two live oral rotavirus vaccines, RotaTeq® (RV 5; Merck) and Rotarix® (RV 1; GlaxoSmithKline) with good efficacy against severe rotavirus disease and a reassuring safety profile could substantially impact the burden of rotavirus disease. In April 2009, WHO provided a recommendation for global introducti...

Determinants of Rotavirus Transmission: A Lag Nonlinear Time Series Analysis.

Science.gov (United States)

van Gaalen, Rolina D; van de Kassteele, Jan; Hahné, Susan J M; Bruijning-Verhagen, Patricia; Wallinga, Jacco

2017-07-01

Rotavirus is a common viral infection among young children. As in many countries, the infection dynamics of rotavirus in the Netherlands are characterized by an annual winter peak, which was notably low in 2014. Previous study suggested an association between weather factors and both rotavirus transmission and incidence. From epidemic theory, we know that the proportion of susceptible individuals can affect disease transmission. We investigated how these factors are associated with rotavirus transmission in the Netherlands, and their impact on rotavirus transmission in 2014. We used available data on birth rates and rotavirus laboratory reports to estimate rotavirus transmission and the proportion of individuals susceptible to primary infection. Weather data were directly available from a central meteorological station. We developed an approach for detecting determinants of seasonal rotavirus transmission by assessing nonlinear, delayed associations between each factor and rotavirus transmission. We explored relationships by applying a distributed lag nonlinear regression model with seasonal terms. We corrected for residual serial correlation using autoregressive moving average errors. We inferred the relationship between different factors and the effective reproduction number from the most parsimonious model with low residual autocorrelation. Higher proportions of susceptible individuals and lower temperatures were associated with increases in rotavirus transmission. For 2014, our findings suggest that relatively mild temperatures combined with the low proportion of susceptible individuals contributed to lower rotavirus transmission in the Netherlands. However, our model, which overestimated the magnitude of the peak, suggested that other factors were likely instrumental in reducing the incidence that year.

electropherotypes and subgroups of group a rotaviruses circulating ...

African Journals Online (AJOL)

Emmanuel Ameh

diarrhea caused by rotaviruses. The virus is a double stranded RNA (dsRNA) virus with 11 segments. Group A rotaviruses show a characteristic 4-2-3-2 pattern following electrophoresis. The VP6 subgroups, I and II exist. This work was carried out to study the prevalence of rotavirus infection among children 0-5 years with ...

Atypical rotavirus among diarrhoeic children living in Belém, Brazil Rotavírus atípicos detectados em crianças diarréicas, em Belém, Brasil

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Yvone B. Gabbay

1989-03-01

Full Text Available Atypical rotaviruses were detected in faeces from two diarrhoeic children living in Belém, Pará, Brazil. Rotavirus particles were detected by electron microscopy and the RNA electrophoresis showed patterns which were compatible with group C rotaviruses. Tests for the presence of group A antigen by enzyme-linked-immunosorbent assay (ELISA were negative. The two children had three successive rotavirus infection and in both cases the atypical strains were excreted at the time of the third infection, causing a mild and short-lasting disease.Rotavírus atípicos foram detectados nas fezes de duas crianças diarreícas residentes em Belém, Brasil. Partículas de rotavírus foram visualizadas por microscopia eletrônica nos espécimes fecais de ambos os pacientes, tendo a eletroforese do ácido ribonucleico (ARN exibido padrões compatíveis com rotavírus do grupo C. Testes imunoenzimáticos (ELISA foram negativos quanto à presença de antígenos do grupo A. As duas crianças apresentaram três infecções sucessivas por esse agente, sendo que, em ambos os casos, os rotavírus atípicos foram excretados por ocasião da terceira infecção, produzindo sintomas brandos e de pouca duração.

Utilidad del estudio de las heces para el diagnóstico y manejo de lactantes y prescolares con diarrea aguda Stool work-up protocol in infants and preschool children with acute diarrhea: is it useful for diagnosis and treatment

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Alfredo Larrosa-Haro

2002-07-01

Full Text Available Objetivo. Analizar los resultados de un protocolo de estudio de las heces en una serie de lactantes y prescolares con diarrea aguda. Material y métodos. Estudio transversal descriptivo efectuado entre abril de 1999 y marzo de 2000 en una muestra de 288 prescolares y lactantes, atendidos en un consultorio pediátrico no institucional de la ciudad de Guadalajara, México. La edad promedio fue de 23.1±13.9 meses. El 43% fueron niñas. Se tomaron datos generales sociodemográficos y clínicos. Las heces se estudiaron con frotis en fresco, tinciones de azul de metileno y Kinyoun. Se analizaron pH y sustancias reductoras. Se hizo coprocultivo en casos con ³3 leucocitos/campo y el antígeno de rotavirus se midió en casos seleccionados. Se empleó estadística descriptiva, ji², RM e intervalo de confianza de 95%. Resultados. Agentes identificados (% del total de muestras estudiadas: Rotavirus 47.1, Campylobacter jejuni 27.4, Salmonella spp. 5.1,Shigella spp. 4.3, Cryptosporidium parvum 2.8, Giardia lamblia 2.4, Blastocystis hominis 1.4, Entamoeba histolytica 0.7. La RM para aislamiento de bacterias enteropatógenas en presencia de leucocitos fue de 5.7. Intolerancia a la lactosa en 19.1% de la muestra. La frecuencia de rotavirus e intolerancia a la lactosa fue mayor en lactantes; la RM para intolerancia a la lactosa en casos con rotavirus fue de 21. La presencia de moco y sangre se asoció con agentes bacterianos y con Cryptosporidium parvum. Conclusiones. Con el protocolo aplicado fue posible identificar en forma inmediata agentes parasitarios, rotavirus e intolerancia a hidratos de carbono. La presencia de leucocitos en las heces se asoció con el aislamiento de bacterias enteroinvasoras. La frecuencia de agentes patógenos identificados fue similar a la de otras series nacionales. Este algoritmo puede limitar la prescripción de fármacos y la manipulación dietética exclusivamente a las indicaciones universalmente aceptadas.Objective. To

Effectiveness and impact of rotavirus vaccines in Europe, 2006-2014.

Science.gov (United States)

Karafillakis, Emilie; Hassounah, Sondus; Atchison, Christina

2015-04-27

Prior to the introduction of rotavirus vaccines in 2006, rotavirus was the leading cause of severe gastroenteritis among European children rotavirus vaccines in Europe following the first eight years of routine use. Four publication databases were searched, yielding 276 unique citations from February 1st, 2006 to July 31st, 2014. Twenty four studies on effectiveness (n=9) and impact (n=15) met the inclusion criteria. Across Europe, vaccine effectiveness against rotavirus-related healthcare utilisation ranged from 68% to 98%, consistent with efficacy data from clinical trials. Reductions in rotavirus hospitalisations ranged from 65% to 84%, consistent with findings from post-marketing studies from the US and Latin America. We confirm the significant public health benefit of rotavirus vaccination in Europe and provide further evidence to support implementation of universal rotavirus vaccination in all European countries. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Brote por Salmonella enteritidis en trabajadores de un hospital

OpenAIRE

Chávez-de la Peña Ma. Eugenia; Higuera-Iglesias Anjarath L.; Huertas-Jiménez Martha A.; Báez-Martínez Rosa; Morales-de León Josefina; Arteaga-Cabello Fernando; Rangel-Frausto Sigfrido; Ponce de León-Rosales Samuel

2001-01-01

Objetivo. Describir y determinar las causas de un brote de enfermedad gastrointestinal por Salmonella enteritidis, ocurrido en junio de 1998, entre el personal trabajador de la salud (TS) que labora en un hospital de tercer nivel de atención, en la ciudad de México. Material y métodos. Se incluyó a todo aquel empleado que presentó diarrea o fiebre asociada a síntomas gastrointestinales, a partir del día 8 de junio de ese año, posterior a la ingestión de alimentos en el comedor del hospital (c...

Effectiveness of rotavirus vaccines against hospitalisations in Japan.

Science.gov (United States)

Fujii, Yoshiyuki; Noguchi, Atsuko; Miura, Shinobu; Ishii, Haruka; Nakagomi, Toyoko; Nakagomi, Osamu; Takahashi, Tsutomu

2017-07-11

In Japan, rotavirus hospitalisation occurs at a rate from 2.8 to 13.7 per 1000 child-years among children age less than 5 years, and it imposes a substantial burden to the healthcare system in the country. While both monovalent (RV1) and pentavalent (RV5) rotavirus vaccines are licensed in Japan, neither has been incorporated in the national infant immunization programme. In this study, we estimated vaccine effectiveness (VE) in Japan. This study was conducted in Yuri-Kumiai General Hospital located in a city in the north-western part of Japan. Age-eligible children for rotavirus vaccination were enrolled if they were hospitalized for rotavirus gastroenteritis between September 2013 and August 2016. Rotavirus gastroenteritis was defined by the detection of rotavirus antigen by immunochromatography. "Vaccinated" was defined as infant inoculated with at least one dose of either RV1 or RV5. A conditional logistic regression analysis was performed by modelling the year of birth, year of admission, residence of the children and vaccination status, and by matching the age of cases with that of test-negative controls. The adjusted odds ratio of the vaccinated over unvaccinated was then used to calculate VE in the formula of (1 - adjusted odds ratio) × 100. Out of the 244 patients enrolled, rotavirus antigen was detected in 55 (22.5%) of whom 10 (18.2%) were vaccinated, whereas 94 (49.7%) of 189 test-negative controls were vaccinated. During the study period, the vaccine uptake rate in the controls increased from 36.2% to 61.8%. On the other hand, the vaccination coverage over the three years was 64.2% in Yuri-Honjo city (three quarters of the catchment), and 91.4% in Nikaho city (one quarter of the catchment). The VE was calculated to be 70.4% (95% confidence interval: 36.0-86.4%, P = 0.002). The point estimate of the VE was lower but its 95% confidence interval overlaps those of the efficacies obtained from clinical trials in Japan. The rotavirus vaccine was

Estimating the herd immunity effect of rotavirus vaccine.

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Pollard, Suzanne L; Malpica-Llanos, Tanya; Friberg, Ingrid K; Fischer-Walker, Christa; Ashraf, Sania; Walker, Neff

2015-07-31

Diarrhea is one of the leading causes of death in children under 5, and an estimated 39% of these deaths are attributable to rotavirus. Currently two live, oral rotavirus vaccines have been introduced on the market; however, the herd immunity effect associated with rotavirus vaccine has not yet been quantified. The purpose of this meta-analysis was to estimate the herd immunity effects associated with rotavirus vaccines. We performed a systematic literature review of articles published between 2008 and 2014 that measured the impact of rotavirus vaccine on severe gastroenteritis (GE) morbidity or mortality. We assessed the quality of published studies using a standard protocol and conducted meta-analyses to estimate the herd immunity effect in children less than one year of age across all years presented in the studies. We conducted these analyses separately for studies reporting a rotavirus-specific GE outcome and those reporting an all-cause GE outcome. In studies reporting a rotavirus-specific GE outcome, four of five of which were conducted in the United States, the median herd effect across all study years was 22% [19-25%]. In studies reporting an all-cause GE outcome, all of which were conducted in Latin America, the median herd effect was 24.9% [11-30%]. There is evidence that rotavirus vaccination confers a herd immunity effect in children under one year of age in the United States and Latin American countries. Given the high variability in vaccine efficacy across regions, more studies are needed to better examine herd immunity effects in high mortality regions. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Vacinas contra rotavírus e papilomavírus humano (HPV Vaccines against rotavirus and human papillomavirus (HPV

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Alexandre C. Linhares

2006-07-01

-se que a implementação de vacinas de elevada eficácia na prevenção de tumores benignos e malignos causados por alguns tipos de HPV leve a uma queda acentuada das taxas desses tumores, os quais afetam milhões de pessoas em todo o mundo.OBJECTIVE: To briefly review strategies aimed at the development of rotavirus and HPV vaccines, with emphasis on the current status of studies assessing the safety, reactogenicity, immunogenicity and efficacy of recently developed vaccines. SOURCES OF DATA: This review focuses on articles published from 1996 to 2006, mainly those from the last five years, with special emphasis on data obtained from recently completed studies involving a new live attenuated human rotavirus vaccine and a virus-like particle (HPV vaccine. SUMMARY OF THE FINDINGS: Strategies for developing rotavirus vaccines ranged from Jennerian approaches to the new human-derived rotavirus vaccine. Currently, two rotavirus vaccines are recognized as both efficacious and safe: a pentavalent human-bovine reassortant vaccine and a vaccine derived from an attenuated rotavirus of human origin. The second of these has been evaluated in more than 70,000 infants all over the world. Prophylactic vaccines against HPV have been tested in more than 25,000 young individuals around the world. Results from phase II and III clinical studies indicate that such vaccines against the most common types of HPV, those linked to both genital warts and 70% of cervical cancers, are safe and highly efficacious. CONCLUSIONS: A future rotavirus immunization program covering 60 to 80% of infants worldwide is likely to reduce by at least 50% the number of rotavirus-associated hospitalizations and deaths. It is also reasonable to expect that implementation of HPV prophylactic vaccines will reduce the burden of the HPV-related diseases that presently impact millions of people around the world.

Zooanthroponotic transmission of rotavirus in Haryana State of Northern India.

Science.gov (United States)

Choudhary, P; Minakshi, P; Ranjan, K; Basanti, B

Rotaviruses are the major cause of severe gastroenteritis and mortality in young children and animals. Due to segmented nature of dsRNA genome and wide host range, vast genetic and antigenic diversity exists amongst different isolates of rotaviruses. A total of 230 fecal ovine and caprine samples collected from organized farms and villages in Haryana were screened for rotavirus detection. Samples were screened by latex agglutination test and RNA-PAGE followed by RT-PCR and nucleic acid sequencing. The latex agglutination test showed 25 newborn lamb and 4 kid fecal samples positive for rotavirus. However, RNA-PAGE showed only 9 lamb fecal samples positive for rotavirus. All the samples were subjected to RT-PCR employing vp4 and vp7 gene specific primers of group A rotavirus of ovine, bovine and human origin. Only two samples from lamb (Sheep18/Hisar/2013 and Sheep22/Hisar/2013) showed vp4 and vp7 gene specific amplification with human group A rotavirus (GAR) specific primer. However, they did not show any amplification with ovine and bovine rotavirus specific primers. The nucleotide as well as deduced amino acid sequence analysis of vp4 gene of these isolates showed >98/97% and vp7 gene >95/94% nt/aa identity with human GAR from different regions of the world. Based on nucleotide similarity search, Sheep18/Hisar/2013 and Sheep22/Hisar/2013 isolates were genotyped as G1P[8] and G1P[4]. Phylogenetic analysis also confirmed that these isolates were clustered closely with human rotaviruses from different regions of the world. Earlier, higher prevalence of human rotaviruses was reported from the sample collecting area. The amplification of ovine samples with human rotavirus gene specific primers, sequence identity and phylogenetic analysis strongly suggests the zoonotic transmission of human GAR to sheep.

Rotavirus Vaccines: a story of success with challenges ahead

Science.gov (United States)

O’Ryan, Miguel

2017-01-01

Approximately 40 years have passed since the discovery of the rotavirus and 10 years since the introduction and progressive dissemination of rotavirus vaccines worldwide. Currently, 92 countries have introduced rotavirus vaccines into national or subnational programs with evident impact in disease reduction. Two vaccines have been widely used, and four additional vaccines have been licensed and are being used in defined regions. In this context, one main issue that remains unsolved is the lower vaccine efficacy/effectiveness in low-income countries. An additional partially answered issue relates to rotavirus strain circulation in vaccinated populations. These issues are discussed in this review. The most imperative challenge ahead is to fulfill the WHO’s recommendation to introduce rotavirus vaccines in all countries. PMID:28928954

Rotaviruses

Centers for Disease Control (CDC) Podcasts

2009-01-06

CDC's Dr. Jon Gentsch discusses rotaviruses, the most important cause of severe gastroenteritis in children less than five years of age. Essentially, all children around the world get the disease during the first few years of life.  Created: 1/6/2009 by Emerging Infectious Diseases.   Date Released: 1/6/2009.

Cryptosporidium spp. and rotavirus gastroenteritis and change of incidence after rotavirus vaccination among children in Raparin Pediatrics Hospital, Erbil, Iraq

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Sally S. Azeez

2017-11-01

Full Text Available Background: Watery diarrhea is the most common medical problem among infants and young children, caused by different microbial etiology including Cryptosporidium spp. and rotavirus, which are usually misdiagnosed in conventional stool test. This study aimed to investigate the incidence of Cryptosporidium and rotavirus gastroenteritis among children in Erbil as well as evaluate the efficacy of rotavirus vaccination procedure applied in Erbil.Methods: Fecal specimens were collected from 400 children (boys and girls, aged one month to five years old, who attended Raparin Pediatrics Hospital in Erbil complaining from diarrhea, between January to August 2014. Modified Ziehl Neelsen technique and nested PCR were used for detection of cryptosporidiosis while rotavirus infection was detected by rapid CerTest.Results: Rate of detection of cryptosporidiosis was remarkably higher using PCR than Ziehl-Neelsen stain (0% versus 6%, and the infection was slightly higher among boys (6.25% vs 5.55% and children ≤2 years (11.7%. The peak of infection reached during spring season (March and April (9.5%. The detection rate of rotavirus was 32.0%, which was slightly higher among males (34.4% vs 30.0% and in children between one to three years old (39.3%. The highest detection rate (38.6% was recorded during winter season (January and February. The infection was significantly higher among non-vaccinated children (65.9% vs 14.1%; p<0.05.Conclusion: The incidence of cryptosporidiosis is declining. However, rotavirus gastroenteritis was relatively high among young children in Erbil. Rotateq vaccine significantly reduced the incidence of rotavirus infection.

Effectiveness of Pentavalent Rotavirus Vaccine Under Conditions of Routine Use in Rwanda.

Science.gov (United States)

Tate, Jacqueline E; Ngabo, Fidele; Donnen, Philippe; Gatera, Maurice; Uwimana, Jeannine; Rugambwa, Celse; Mwenda, Jason M; Parashar, Umesh D

2016-05-01

Rotavirus vaccine efficacy is lower in low-income countries than in high-income countries. Rwanda was one of the first low-income countries in sub-Saharan Africa to introduce rotavirus vaccine into its national immunization program. We sought to evaluate rotavirus vaccine effectiveness (VE) in this setting. VE was assessed using a case-control design. Cases and test-negative controls were children who presented with a diarrheal illness to 1 of 8 sentinel district hospitals and 10 associated health centers and had a stool specimen that tested positive (cases) or negative (controls) for rotavirus by enzyme immunoassay. Due to high vaccine coverage almost immediately after vaccine introduction, the analysis was restricted to children 7-18 weeks of age at time of rotavirus vaccine introduction. VE was calculated as (1 - odds ratio) × 100, where the odds ratio was the adjusted odds ratio for the rotavirus vaccination rate among case-patients compared with controls. Forty-eight rotavirus-positive and 152 rotavirus-negative children were enrolled. Rotavirus-positive children were significantly less likely to have received rotavirus vaccine (33/44 [73%] unvaccinated) compared with rotavirus-negative children (81/136 [59%] unvaccinated) (P= .002). A full 3-dose series was 75% (95% confidence interval [CI], 31%-91%) effective against rotavirus gastroenteritis requiring hospitalization or a health center visit and was 65% (95% CI, -80% to 93%) in children 6-11 months of age and 81% (95% CI, 25%-95%) in children ≥12 months of age. Rotavirus vaccine is effective in preventing rotavirus disease in Rwandan children who began their rotavirus vaccine series from 7 to 18 weeks of age. Protection from vaccination was sustained after the first year of life. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Rotavirus Infection in the Auckland Region After the Implementation of Universal Infant Rotavirus Vaccination: Impact on Hospitalizations and Laboratory Implications.

Science.gov (United States)

McAuliffe, Gary N; Taylor, Susan L; Drinković, Dragana; Roberts, Sally A; Wilson, Elizabeth M; Best, Emma J

2018-01-01

In July 2014, New Zealand introduced universal infant vaccination with RotaTeq (Merk & Co.) administered as 3 doses at 6 weeks, 3 and 5 months of age. We sought to assess the impact of rotavirus vaccination on gastroenteritis (GE) hospitalizations in the greater Auckland region and analyze changes in rotavirus testing in the period around vaccine introduction. Hospitalizations, laboratory testing rates and methods were compared between the pre-vaccine period (2009-2013), post-vaccine period (January 2015 to December 2015) and year of vaccine introduction (2014). There was a 68% decline in rotavirus hospitalizations of children Auckland region. However, continued rotavirus testing at pre-vaccine rates risks generating false positive results. Laboratories and clinicians should consider reviewing their testing algorithms before vaccine introduction.

Group A Rotavirus Associated with Encephalitis in Red Fox.

Science.gov (United States)

Busi, Chiara; Martella, Vito; Papetti, Alice; Sabelli, Cristiano; Lelli, Davide; Alborali, G Loris; Gibelli, Lucia; Gelmetti, Daniela; Lavazza, Antonio; Cordioli, Paolo; Boniotti, M Beatrice

2017-09-01

In 2011, a group A rotavirus was isolated from the brain of a fox with encephalitis and neurologic signs, detected by rabies surveillance in Italy. Intracerebral inoculation of fox brain homogenates into mice was fatal. Genome sequencing revealed a heterologous rotavirus of avian origin, which could provide a model for investigating rotavirus neurovirulence.

[Seasonality of rotavirus infection in Venezuela: relationship between monthly rotavirus incidence and rainfall rates].

Science.gov (United States)

González Chávez, Rosabel

2015-09-01

In general, it has been reported that rotavirus infection was detected year round in tropical countries. However, studies in Venezuela and Brazil suggest a seasonal behavior of the infection. On the other hand, some studies link infection with climatic variables such as rainfall. This study analyzes the pattern of behavior of the rotavirus infection in Carabobo-Venezuela (2001-2005), associates the seasonality of the infection with rainfall, and according to the seasonal pattern, estimates the age of greatest risk for infection. The analysis of the rotavirus temporal series and accumulated precipitation was performed with the software SPSS. The infection showed two periods: high incidence (November-April) and low incidence (May-October). Accumulated precipitation presents an opposite behavior. The highest frequency of events (73.8% 573/779) for those born in the period with a low incidence of the virus was recorded at an earlier age (mean age 6.5 +/- 2.0 months) when compared with those born in the station of high incidence (63.5% 568/870, mean age 11.7 +/- 2.2 months). Seasonality of the infection and the inverse relationship between virus incidence and rainfall was demonstrated. In addition, it was found that the period of birth determines the age and risk of infection. This information generated during the preaccine period will be helpful to measure the impact of the vaccine against the rotavirus.

Effect of UV-irradiation on rotavirus

International Nuclear Information System (INIS)

Smirnov, Y.A.; Kapitulets, S.P.; Kaverin, N.V.; Amitina, N.N.; Ginevskaya, V.A.

1991-01-01

The effect of UV-irradiation on the infectivity of the SAll rotavirus was examined. The time behavior of the inactivation of infectivity generally exhibited the one-hit pattern. The effect was studied with respect to two phenomena, viz. the RNA-protein linkage and the formation of uracil dimers. To determine the number of the latter, purified 3 H-uridine-labelled rotavirus was exposed to UV radiation, and the RNA was extracted and analyzed by paper chromatography in the ascending mode. The formation of photodimers was found to be an important mechanism in the rotavirus inactivation on conventional irradiation, whereas RNA-protein linkages were observed on the application of high doses only. (author). 3 figs., 10 refs

75 FR 48706 - Proposed Vaccine Information Materials for Rotavirus Vaccine

Science.gov (United States)

2010-08-11

... Vaccine Information Materials for Rotavirus Vaccine AGENCY: Centers for Disease Control and Prevention... information materials for rotavirus vaccine. DATES: Written comments are invited and must be received on or... (chickenpox), pneumococcal conjugate, rotavirus, hepatitis A, meningococcal, human papillomavirus (HPV), and...

Recombinant monovalent llama-derived antibody fragments (VHH) to rotavirus VP6 protect neonatal gnotobiotic piglets against human rotavirus-induced diarrhea.

Science.gov (United States)

Vega, Celina G; Bok, Marina; Vlasova, Anastasia N; Chattha, Kuldeep S; Gómez-Sebastián, Silvia; Nuñez, Carmen; Alvarado, Carmen; Lasa, Rodrigo; Escribano, José M; Garaicoechea, Lorena L; Fernandez, Fernando; Bok, Karin; Wigdorovitz, Andrés; Saif, Linda J; Parreño, Viviana

2013-01-01

Group A Rotavirus (RVA) is the leading cause of severe diarrhea in children. The aims of the present study were to determine the neutralizing activity of VP6-specific llama-derived single domain nanoantibodies (VHH nanoAbs) against different RVA strains in vitro and to evaluate the ability of G6P[1] VP6-specific llama-derived single domain nanoantibodies (VHH) to protect against human rotavirus in gnotobiotic (Gn) piglets experimentally inoculated with virulent Wa G1P[8] rotavirus. Supplementation of the daily milk diet with 3B2 VHH clone produced using a baculovirus vector expression system (final ELISA antibody -Ab- titer of 4096; virus neutralization -VN- titer of 256) for 9 days conferred full protection against rotavirus associated diarrhea and significantly reduced virus shedding. The administration of comparable levels of porcine IgG Abs only protected 4 out of 6 of the animals from human RVA diarrhea but significantly reduced virus shedding. In contrast, G6P[1]-VP6 rotavirus-specific IgY Abs purified from eggs of hyperimmunized hens failed to protect piglets against human RVA-induced diarrhea or virus shedding when administering similar quantities of Abs. The oral administration of VHH nanoAb neither interfered with the host's isotype profiles of the Ab secreting cell responses to rotavirus, nor induced detectable host Ab responses to the treatment in serum or intestinal contents. This study shows that the oral administration of rotavirus VP6-VHH nanoAb is a broadly reactive and effective treatment against rotavirus-induced diarrhea in neonatal pigs. Our findings highlight the potential value of a broad neutralizing VP6-specific VHH nanoAb as a treatment that can complement or be used as an alternative to the current strain-specific RVA vaccines. Nanobodies could also be scaled-up to develop pediatric medication or functional food like infant milk formulas that might help treat RVA diarrhea.

Recombinant monovalent llama-derived antibody fragments (VHH to rotavirus VP6 protect neonatal gnotobiotic piglets against human rotavirus-induced diarrhea.

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Celina G Vega

Full Text Available Group A Rotavirus (RVA is the leading cause of severe diarrhea in children. The aims of the present study were to determine the neutralizing activity of VP6-specific llama-derived single domain nanoantibodies (VHH nanoAbs against different RVA strains in vitro and to evaluate the ability of G6P[1] VP6-specific llama-derived single domain nanoantibodies (VHH to protect against human rotavirus in gnotobiotic (Gn piglets experimentally inoculated with virulent Wa G1P[8] rotavirus. Supplementation of the daily milk diet with 3B2 VHH clone produced using a baculovirus vector expression system (final ELISA antibody -Ab- titer of 4096; virus neutralization -VN- titer of 256 for 9 days conferred full protection against rotavirus associated diarrhea and significantly reduced virus shedding. The administration of comparable levels of porcine IgG Abs only protected 4 out of 6 of the animals from human RVA diarrhea but significantly reduced virus shedding. In contrast, G6P[1]-VP6 rotavirus-specific IgY Abs purified from eggs of hyperimmunized hens failed to protect piglets against human RVA-induced diarrhea or virus shedding when administering similar quantities of Abs. The oral administration of VHH nanoAb neither interfered with the host's isotype profiles of the Ab secreting cell responses to rotavirus, nor induced detectable host Ab responses to the treatment in serum or intestinal contents. This study shows that the oral administration of rotavirus VP6-VHH nanoAb is a broadly reactive and effective treatment against rotavirus-induced diarrhea in neonatal pigs. Our findings highlight the potential value of a broad neutralizing VP6-specific VHH nanoAb as a treatment that can complement or be used as an alternative to the current strain-specific RVA vaccines. Nanobodies could also be scaled-up to develop pediatric medication or functional food like infant milk formulas that might help treat RVA diarrhea.

An update of “Cost-effectiveness of rotavirus vaccination in the Netherlands: the results of a Consensus Rotavirus Vaccine model”

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Tu Hong Anh T

2013-01-01

Full Text Available Abstract Background To update a cost-effectiveness analysis of rotavirus vaccination in the Netherlands previously published in 2011. Methods The rotavirus burden of disease and the indirect protection of older children and young adults (herd protection were updated. Results When updated data was used, routine infant rotavirus vaccination in the Netherlands would potentially become an even more cost-effective strategy than previously estimated with the incremental cost per QALY at only €3,000-4,000. Break-even total vaccination costs were indicated at €92–122, depending on the applied threshold. Conclusions We concluded that the results on potentially favourable cost-effectiveness in the previous study remained valid, however, the new data suggested that previous results might represent an underestimation of the economic attractiveness of rotavirus vaccination.

Molecular Epidemiology of Rotavirus in Cats in the United Kingdom

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Iturriza-Gómara, M.; Dove, W.; Sandrasegaram, M.; Nakagomi, T.; Nakagomi, O.; Cunliffe, N.; Radford, A. D.; Morgan, K. L.

2014-01-01

Rotaviruses are leading causes of gastroenteritis in the young of many species. Molecular epidemiological studies in children suggest that interspecies transmission contributes to rotavirus strain diversity in people. However, population-based studies of rotaviruses in animals are few. We investigated the prevalence, risk factors for infection, and genetic diversity of rotavirus A in a cross-sectional survey of cats housed within 25 rescue catteries across the United Kingdom. Morning litter tray fecal samples were collected during the winter and summer in 2012 from all pens containing kittens and a random sample of those housing adult cats. Group A rotavirus RNA was detected by real-time reverse transcription-PCR, and positive samples were G and P genotyped using nested VP4 and VP7 PCR assays. A total of 1,727 fecal samples were collected from 1,105 pens. Overall, the prevalence of rotavirus was 3.0% (95% confidence interval [CI], 1.2 to 4.9%). Thirteen out of 25 (52%; 95% CI, 31.3 to 72.2%) centers housed at least one rotavirus-positive cat. The prevalence of rotavirus was associated with season (odds ratio, 14.8 [95% CI, 1.1 to 200.4]; P = 0.04) but not age or diarrhea. It was higher during the summer (4.7%; 95% CI, 1.2 to 8.3%) than in winter (0.8%; 95% CI, 0.2 to 1.5%). Asymptomatic epidemics of infection were detected in two centers. G genotypes were characterized for 19 (33.3%) of the 57 rotavirus-positive samples and P genotypes for 36 (59.7%). Two rotavirus genotypes were identified, G3P[9] and G6P[9]. This is the first population-based study of rotavirus in cats and the first report of feline G6P[9], which questions the previous belief that G6P[9] in people is of bovine origin. PMID:25411173

Burden of paediatric Rotavirus Gastroenteritis (RVGE and potential benefits of a universal Rotavirus vaccination programme with a pentavalent vaccine in Spain

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Diez-Domingo Javier

2010-08-01

Full Text Available Abstract Background Rotavirus is the most common cause of gastroenteritis in young children worldwide. The aim of the study was to assess the health outcomes and the economic impact of a universal rotavirus vaccination programme with RotaTeq, the pentavalent rotavirus vaccine, versus no vaccination programme in Spain. Methods A birth cohort was followed up to the age of 5 using a cohort model. Epidemiological parameters were taken from the REVEAL study (a prospective epidemiological study conducted in Spain, 2004-2005 and from the literature. Direct and indirect costs were assessed from the national healthcare payer and societal perspectives by combining health care resource utilisation collected in REVEAL study and unit costs from official sources. RotaTeq per protocol efficacy data was taken from a large worldwide rotavirus clinical trial (70,000 children. Health outcomes included home care cases, General Practioner (GP/Paediatrician, emergency department visits, hospitalisations and nosocomial infections. Results The model estimates that the introduction of a universal rotavirus vaccination programme with RotaTeq (90% coverage rate would reduce the rotavirus gastroenteritis (RVGE burden by 75% in Spain; 53,692 home care cases, 35,187 GP/Paediatrician visits, 34,287 emergency department visits, 10,987 hospitalisations and 2,053 nosocomial infections would be avoided. The introduction of RotaTeq would avoid about 76% of RVGE-related costs from both perspectives: €22 million from the national health system perspective and €38 million from the societal perspective. Conclusions A rotavirus vaccination programme with RotaTeq would reduce significantly the important medical and economic burden of RVGE in Spain.

Options for improving effectiveness of rotavirus vaccines in developing countries.

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Tissera, Marion S; Cowley, Daniel; Bogdanovic-Sakran, Nada; Hutton, Melanie L; Lyras, Dena; Kirkwood, Carl D; Buttery, Jim P

2017-04-03

Rotavirus gastroenteritis is a leading global cause of mortality and morbidity in young children due to diarrhea and dehydration. Over 85% of deaths occur in developing countries. In industrialised countries, 2 live oral rotavirus vaccines licensed in 2006 quickly demonstrated high effectiveness, dramatically reducing severe rotavirus gastroenteritis admissions in many settings by more than 90%. In contrast, the same vaccines reduced severe rotavirus gastroenteritis by only 30-60% in developing countries, but have been proven life-saving. Bridging this "efficacy gap" offers the possibility to save many more lives of children under the age of 5. The reduced efficacy of rotavirus vaccines in developing settings may be related to differences in transmission dynamics, as well as host luminal, mucosal and immune factors. This review will examine strategies currently under study to target the issue of reduced efficacy and effectiveness of oral rotavirus vaccines in developing settings.

A gastrointestinal rotavirus infection mouse model for immune modulation studies

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van Amerongen Geert

2011-03-01

Full Text Available Abstract Background Rotaviruses are the single most important cause of severe diarrhea in young children worldwide. The current study was conducted to assess whether colostrum containing rotavirus-specific antibodies (Gastrogard-R® could protect against rotavirus infection. In addition, this illness model was used to study modulatory effects of intervention on several immune parameters after re-infection. Methods BALB/c mice were treated by gavage once daily with Gastrogard-R® from the age of 4 to 10 days, and were inoculated with rhesus rotavirus (RRV at 7 days of age. A secondary inoculation with epizootic-diarrhea infant-mouse (EDIM virus was administered at 17 days of age. Disease symptoms were scored daily and viral shedding was measured in fecal samples during the post-inoculation periods. Rotavirus-specific IgM, IgG and IgG subclasses in serum, T cell proliferation and rotavirus-specific delayed-type hypersensitivity (DTH responses were also measured. Results Primary inoculation with RRV induced a mild but consistent level of diarrhea during 3-4 days post-inoculation. All mice receiving Gastrogard-R® were 100% protected against rotavirus-induced diarrhea. Mice receiving both RRV and EDIM inoculation had a lower faecal-viral load following EDIM inoculation then mice receiving EDIM alone or Gastrogard-R®. Mice receiving Gastrogard-R® however displayed an enhanced rotavirus-specific T-cell proliferation whereas rotavirus-specific antibody subtypes were not affected. Conclusions Preventing RRV-induced diarrhea by Gastrogard-R® early in life showed a diminished protection against EDIM re-infection, but a rotavirus-specific immune response was developed including both B cell and T cell responses. In general, this intervention model can be used for studying clinical symptoms as well as the immune responses required for protection against viral re-infection.

Diarrheal Diseases Hospitalization in Yemen before and after Rotavirus Vaccination

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Mohammed Amood AL-Kamarany

2016-01-01

Full Text Available The study aims to assess the impact of rotavirus vaccine introduction on diarrheal diseases hospitalization and to identify the rotavirus genotypes most prevalent before and after vaccine introduction among children ≤ 5 years of age. Rotarix™ ® rotavirus vaccine is currently licensed for infants in Yemen and was introduced in 2012. The vaccination course consists of two doses. The first dose is administrated at 6 weeks of age and the second dose is completed by 10 weeks. Based on a longitudinal observational study, we assessed the impact of vaccination on rotavirus hospitalization before and after vaccination among children ≤ 5 years of age at the Yemeni-Swedish Hospital (YSH in Taiz, Yemen. Prevaccination covered January 2009–July 2012 during which 2335 fecal samples were collected from children ≤ 5 years old. Postvaccination covered January 2013–December 2014 during which 1114 fecal samples were collected. Rotavirus was detected by Enzyme Linkage Immunosorbent Assay (ELISA. The incidence of rotavirus hospitalization decreased from 43.79% in 2009 to 10.54% in 2014. Hospitalization due to rotavirus diarrhea was reduced by 75.93%. Vaccine coverage increased from 23% in 2012 to 72% in 2014. Also, the results showed that the most predominant genotypes in prevaccination period were G2P[4] (55.0%, followed by G1P[8] (15.0%, while in postvaccination period G1P[8] (31% was the predominant genotype, followed by G9P[8] (27.5%. In conclusion, rotavirus vaccination in Yemen resulted in sharp reduction in diarrheal hospitalization. A successful rotavirus vaccination program in Yemen will rely upon efficient vaccine delivery systems and sustained vaccine efficacy against diverse and evolving rotavirus strains.

Bovine rotavirus pentavalent vaccine development in India.

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Zade, Jagdish K; Kulkarni, Prasad S; Desai, Sajjad A; Sabale, Rajendra N; Naik, Sameer P; Dhere, Rajeev M

2014-08-11

A bovine rotavirus pentavalent vaccine (BRV-PV) containing rotavirus human-bovine (UK) reassortant strains of serotype G1, G2, G3, G4 and G9 has been developed by the Serum Institute of India Ltd, in collaboration with the National Institute of Allergy and Infectious Diseases (NIAID), USA. The vaccine underwent animal toxicity studies and Phase I and II studies in adults, toddlers and infants. It has been found safe and immunogenic and will undergo a large Phase III study to assess efficacy against severe rotavirus gastroenteritis. Copyright © 2014. Published by Elsevier Ltd.

Rotavirus vaccine and diarrhea mortality: quantifying regional variation in effect size

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Black Robert E

2011-04-01

Full Text Available Abstract Background Diarrhea mortality remains a leading cause of child death and rotavirus vaccine an effective tool for preventing severe rotavirus diarrhea. New data suggest vaccine efficacy may vary by region. Methods We reviewed published vaccine efficacy trials to estimate a regional-specific effect of vaccine efficacy on severe rotavirus diarrhea and hospitalizations. We assessed the quality of evidence using a standard protocol and conducted meta-analyses where more than 1 data point was available. Results Rotavirus vaccine prevented severe rotavirus episodes in all regions; 81% of episodes in Latin America, 42.7% of episodes in high-mortality Asia, 50% of episodes in sub-Saharan Africa, 88% of episodes low-mortality Asia and North Africa, and 91% of episodes in developed countries. The effect sizes observed for preventing severe rotavirus diarrhea will be used in LiST as the effect size for rotavirus vaccine on rotavirus-specific diarrhea mortality. Conclusions Vaccine trials have not measured the effect of vaccine on diarrhea mortality. The overall quality of the evidence and consistency observed across studies suggests that estimating mortality based on a severe morbidity reduction is highly plausible.

Human rotavirus genotypes causing acute watery diarrhea among ...

African Journals Online (AJOL)

2014-06-17

Jun 17, 2014 ... vaccine with strains peculiar to this environment should be introduced. ..... Safety and efficacy of an attenuated vaccine against severe rotavirus ... prevalence of adenovirus serotypes 40 and 41, astrovirus, and rotavirus.

Global Impact of Rotavirus Vaccination on Childhood Hospitalizations and Mortality From Diarrhea.

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Burnett, Eleanor; Jonesteller, Christine L; Tate, Jacqueline E; Yen, Catherine; Parashar, Umesh D

2017-06-01

In 2006, 2 rotavirus vaccines were licensed. We summarize the impact of rotavirus vaccination on hospitalizations and deaths from rotavirus and all-cause acute gastroenteritis (AGE) during the first 10 years since vaccine licensure, including recent evidence from countries with high child mortality. We used standardized guidelines (PRISMA) to identify observational evaluations of rotavirus vaccine impact among children rotavirus AGE were reduced by a median of 67% overall and 71%, 59%, and 60% in countries with low, medium, and high child mortality, respectively. Implementation of rotavirus vaccines has substantially decreased hospitalizations from rotavirus and all-cause AGE. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Impact and cost-effectiveness of rotavirus vaccination in Bangladesh.

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Pecenka, Clint; Parashar, Umesh; Tate, Jacqueline E; Khan, Jahangir A M; Groman, Devin; Chacko, Stephen; Shamsuzzaman, Md; Clark, Andrew; Atherly, Deborah

2017-07-13

Diarrheal disease is a leading cause of child mortality globally, and rotavirus is responsible for more than a third of those deaths. Despite substantial decreases, the number of rotavirus deaths in children under five was 215,000 per year in 2013. Of these deaths, approximately 41% occurred in Asia and 3% of those in Bangladesh. While Bangladesh has yet to introduce rotavirus vaccination, the country applied for Gavi support and plans to introduce it in 2018. This analysis evaluates the impact and cost-effectiveness of rotavirus vaccination in Bangladesh and provides estimates of the costs of the vaccination program to help inform decision-makers and international partners. This analysis used Pan American Health Organization's TRIVAC model (version 2.0) to examine nationwide introduction of two-dose rotavirus vaccination in 2017, compared to no vaccination. Three mortality scenarios (low, high, and midpoint) were assessed. Benefits and costs were examined from the societal perspective over ten successive birth cohorts with a 3% discount rate. Model inputs were locally acquired and complemented by internationally validated estimates. Over ten years, rotavirus vaccination would prevent 4000 deaths, nearly 500,000 hospitalizations and 3 million outpatient visits in the base scenario. With a Gavi subsidy, cost/disability adjusted life year (DALY) ratios ranged from $58/DALY to $142/DALY averted. Without a Gavi subsidy and a vaccine price of $2.19 per dose, cost/DALY ratios ranged from $615/DALY to $1514/DALY averted. The discounted cost per DALY averted was less than the GDP per capita for nearly all scenarios considered, indicating that a routine rotavirus vaccination program is highly likely to be cost-effective. Even in a low mortality setting with no Gavi subsidy, rotavirus vaccination would be cost-effective. These estimates exclude the herd immunity benefits of vaccination, so represent a conservative estimate of the cost-effectiveness of rotavirus vaccination

Epidemiology of rotavirus diarrhea in children under 5 years in ...

African Journals Online (AJOL)

Background: Rotavirus still remains the major cause of diarrhea in children below 5 years. No data on rotavirus epidemiology is available in the Northern regions of Cameroon. We aimed to determine the prevalence of group A rotavirus (RVA) in children below 5 years with diarrhea in two regions of Northern Cameroon ...

Clinical characteristics of rotavirus diarrhea in hospitalized Romanian infants.

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Lesanu, Gabriela; Becheanu, Cristina Adriana; Vlad, Raluca Maria; Pacurar, Daniela; Tincu, Iulia Florentina; Smadeanu, Roxana Elena

2013-01-01

Clinical characteristics of rotavirus enteritis were evaluated by comparison with acute diarrhea of other etiologies. We reviewed the medical records of children (aged 0-12 months) admitted with acute diarrhea in our hospital between January and December 2011. Of the 839 patients, 49.3% had rotavirus diarrhea. The incidence of severe disease was significantly higher for rotavirus diarrhea (65.2%, P < 0.01) than for other types of diarrheal disease.

Effectiveness of Monovalent and Pentavalent Rotavirus Vaccines in Guatemala.

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Gastañaduy, Paul A; Contreras-Roldán, Ingrid; Bernart, Chris; López, Beatriz; Benoit, Stephen R; Xuya, Marvin; Muñoz, Fredy; Desai, Rishi; Quaye, Osbourne; Tam, Ka Ian; Evans-Bowen, Diana K; Parashar, Umesh D; Patel, Manish; McCracken, John P

2016-05-01

Concerns remain about lower effectiveness and waning immunity of rotavirus vaccines in resource-poor populations. We assessed vaccine effectiveness against rotavirus in Guatemala, where both the monovalent (RV1; 2-dose series) and pentavalent (RV5; 3-dose series) vaccines were introduced in 2010. A case-control evaluation was conducted in 4 hospitals from January 2012 to August 2013. Vaccine status was compared between case patients (children with laboratory-confirmed rotavirus diarrhea) and 2 sets of controls: nondiarrhea "hospital" controls (matched by birth date and site) and nonrotavirus "test-negative" diarrhea controls (adjusted for age, birth month/year, and site). Vaccine effectiveness ([1 - odds ratio of vaccination] × 100%) was computed using logistic regression models. We evaluated 213 case patients, 657 hospital controls, and 334 test-negative controls. Effectiveness of 2-3 doses of a rotavirus vaccine against rotavirus requiring emergency department visit or hospitalization was 74% (95% confidence interval [CI], 58%-84%) with hospital controls, and 52% (95% CI, 26%-69%) with test-negative controls. Using hospital controls, no significant difference in effectiveness was observed between infants 6-11 months (74% [95% CI, 18%-92%]) and children ≥12 months of age (71% [95% CI, 44%-85%]) (P= .85), nor between complete courses of RV1 (63% [95% CI, 23%-82%]) and RV5 (69% [95% CI, 29%-87%]) (P= .96). An uncommon G12P[8] strain, partially heterotypic to strains in both vaccines, was identified in 89% of cases. RV1 and RV5 were similarly effective against severe rotavirus diarrhea caused by a heterotypic strain in Guatemala. This supports broader implementation of rotavirus vaccination in low-income countries where >90% global deaths from rotavirus occur. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Study on the relationship between infant rotavirus enteritis and breast feeding

International Nuclear Information System (INIS)

Chen Yanping; Liu Hui; Sun Xuerong; Wei Tao; Wang Bin

2005-01-01

Objective: To study the relationship between infant rotavirus enteritis and breast feeding, with emphasis on early immuno-protection provided by breast feeding as well as later possible hazards with rotavirus carrier mothers. Methods: Stool specimens from 520 infants with diarrhea were screened for rotavirus with colloid gold method. Positive specimens were confirmed with RT-PCR. Results: In local (Qingdao) infants with enteritis, the over-all incidence of rotavirus infection was 31.2%. Positive rate in breast-feeding infants was only 26.8%, being significantly lower than that in bottle-feeding ones (45.2%). The virus infectivity rate in both groups of breast- feeding infants (below 6 months and 7-12 months) was lower than the corresponding rate in the bottle feeding group. However, infant fed from rotavirus carriers had significantly higher fecal positive rate of rotavirus than that in infants fed from non-carriers. Conclusion: (1) At beginning, especially below 6 months, breast-feeding provided important protection again rotavirus enteritis in the infants. (2) certain infections could be transmitted through breast feedings, which deserved closer observation. (authors)

Epidemiological investigation of rotavirus infection in buffalo calves in Bangladesh

International Nuclear Information System (INIS)

Samad, M.A.; Ahmed, M.W.

1990-01-01

A study on rotavirus infection in buffalo calves in Bangladesh was carried out to detect its association with diarrhoea. An overall 28% incidence of diarrhoeal diseases was recorded in rural buffalo calves. Rotavirus was detected in faecal samples from both diarrhoeic (12%) and non-diarrhoeic (3%) calves by enzyme linked immunosorbent assay. An association between diarrhoea and rotavirus infection was recorded in buffalo calves below 1 month of age in both diarrhoeic (27%) and non-diarrhoeic (7%) calves. Rotavirus infection in diarrhoeic buffalo calves was found to be highest in winter (16.7%), followed by summer (9.1%) and lowest in the rainy season (7.7%). Further studies on the epidemiological and prophylactic aspects of rotavirus infection should be conducted to control this infection in Bangladesh. (author). 21 refs, 2 tabs

Inactivation of human and simian rotaviruses by ozone

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Vaughn, J.M.; Chen, Y.S.; Lindburg, K.; Morales, D.

1987-09-01

The inactivation of simian rotavirus Sa-11 and human rotavirus type 2 (Wa) by ozone was compared at 4/sup 0/C by using single-particle virus stocks. Although the human strain was clearly more sensitive, both virus types were rapidly inactivated by ozone concentrations of 0.25 mg/liter or greater at all pH levels tested. Comparison of the virucidal activity of ozone with that of chlorine in identical experiments indicated little significant difference in rotavirus-inactivating efficiencies when the disinfectants were used at concentrations of 0.25 mg/liter or greater.

Modulation of rotavirus severe gastroenteritis by the combination of probiotics and prebiotics.

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Gonzalez-Ochoa, Guadalupe; Flores-Mendoza, Lilian K; Icedo-Garcia, Ramona; Gomez-Flores, Ricardo; Tamez-Guerra, Patricia

2017-09-01

Annual mortality rates due to infectious diarrhea are about 2.2 million; children are the most vulnerable age group to severe gastroenteritis, representing group A rotaviruses as the main cause of disease. One of the main factors of rotavirus pathogenesis is the NSP4 protein, which has been characterized as a viral toxin involved in triggering several cellular responses leading to diarrhea. Furthermore, the rotavirus protein NSP1 has been associated with interferon production inhibition by inducing the degradation of interferon regulatory factors IRF3, IRF5, and IRF7. On the other hand, probiotics such as Bifidobacterium and Lactobacillus species in combination with prebiotics such as inulin, HMO, scGOS, lcFOS have been associated with improved generalized antiviral response and anti-rotavirus effect by the reduction of rotavirus infectivity and viral shedding, decreased expression of NSP4 and increased levels of specific anti-rotavirus IgAs. Moreover, these probiotics and prebiotics have been related to shorter duration and severity of rotavirus diarrhea, to the prevention of infection and reduced incidence of reinfections. In this review we will discuss in detail about the rotavirus pathogenesis and immunity, and how probiotics such as Lactobacillus and Bifidobacterium species in combination with prebiotics have been associated with the prevention or modulation of rotavirus severe gastroenteritis.

Inactivated rotavirus vaccine induces protective immunity in gnotobiotic piglets.

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Wang, Yuhuan; Azevedo, Marli; Saif, Linda J; Gentsch, Jon R; Glass, Roger I; Jiang, Baoming

2010-07-26

Live oral rotavirus vaccines that are effective in middle and high income countries have been much less immunogenic and effective among infants in resource-limited settings. Several hypotheses might explain this difference, including neutralization of the vaccine by high levels of maternal antibody in serum and breast milk, severe malnutrition, and interference by other flora and viruses in the gut. We have pursued development of an alternative parenteral rotavirus vaccine with the goal of inducing comparable levels of immunogenicity and efficacy in populations throughout the world regardless of their income levels. In the present study, we assessed the immunogenicity and protection of a candidate inactivated rotavirus vaccine (IRV), the human strain CDC-9 (G1P[8]) formulated with aluminum phosphate, against rotavirus infection in gnotobiotic piglets. Three doses of IRV induced high titers of rotavirus-specific IgG and neutralizing activity in the sera of gnotobiotic piglets and protection against shedding of rotavirus antigen following oral challenge with a homologous virulent human strain Wa (G1P[8]). Our findings demonstrate the proof of concept for an IRV in a large animal model and provide evidence and justification for further clinical development as an alternative candidate vaccine. Published by Elsevier Ltd.

Rotavirus epidemiology and vaccine demand: considering Bangladesh chapter through the book of global disease burden.

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Mahmud-Al-Rafat, Abdullah; Muktadir, Abdul; Muktadir, Hasneen; Karim, Mahbubul; Maheshwari, Arpan; Ahasan, Mohammad Mainul

2018-02-01

Rotavirus is the major cause of gastroenteritis in children throughout the world. Every year, a large number of children aged rotavirus-related diarrhoeal diseases. Though these infections are vaccine-preventable, the vast majority of children in low-income countries suffer from the infection. The situation leads to severe economic loss and constitutes a major public health problem. We searched electronic databases including PubMed and Google scholar using the following words: "features of rotavirus," "epidemiology of rotavirus," "rotavirus serotypes," "rotavirus in Bangladesh," "disease burden of rotavirus," "rotavirus vaccine," "low efficacy of rotavirus vaccine," "inactivated rotavirus vaccine". Publications until July 2017 have been considered for this work. Currently, two live attenuated vaccines are available throughout the world. Many countries have included rotavirus vaccines in national immunization program to reduce the disease burden. However, due to low efficacy of the available vaccines, satisfactory outcome has not yet been achieved in developing countries such as Bangladesh. Poor economic, public health, treatment, and sanitation status of the low-income countries necessitate the need for the most effective rotavirus vaccines. Therefore, the present scenario demands the development of a highly effective rotavirus vaccine. In this regard, inactivated rotavirus vaccine concept holds much promise for reducing the current disease burden. Recent advancements in developing an inactivated rotavirus vaccine indicate a significant progress towards disease prophylaxis and control.

Characteristics of Rotavirus Diarrhea in Hospitalized Children in Kosovo

OpenAIRE

Ismaili-Jaha, Vlora; Shala, Muje; Azemi, Mehmedali; Hoxha-Kamberi, Teuta; Avdiu, Muharrem; Spahiu, Shqipe; Jaha, Luan

2014-01-01

Background: Diarrhea is a leading cause of child mortality worldwide. Rotavirus is one of the most common causes of severe diarrhea and dehydration in children. Authors reviewed epidemiological and clinical data of the rotavirus diarrhea in Kosovo. Methods: This is a prospective study carried between January 1st and December 31st 2011. All data, comprising demographics, nutrition, clinical presentation, laboratory findings, management and outcome of the rotavirus diarrhea are collected on the...

Rotavirus vaccination and herd immunity: an evidence-based review

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Seybolt LM

2012-06-01

Full Text Available Lorna M Seybolt, Rodolfo E BéguéDepartment of Pediatrics, Division of Infectious Diseases, Louisiana State University Health Sciences Center, New Orleans, LA, USAAbstract: Until recently, rotavirus was the most common cause of diarrhea in infants and young children with over 100 million cases and 400,000 deaths every year worldwide. Yet, its epidemiology is changing rapidly with the introduction of two rotavirus vaccines in the mid 2000s. Both vaccines were shown to be highly efficacious in prelicensure studies to reduce severe rotavirus disease; the efficacy being more pronounced in high- and middle-income countries than in low-income countries. Herd immunity – the indirect protection of unimmunized individuals as a result of others being immunized – was not expected to be a benefit of rotavirus vaccination programs since the vaccines were thought to reduce severe disease but not to decrease virus transmission significantly. Postlicensure studies, however, have suggested that this assumption may need reassessment. Studies in a variety of settings have shown evidence of greater than expected declines in rotavirus disease. While these studies were not designed specifically to detect herd immunity – and few failed to detect this phenomenon – the consistency of the evidence is compelling. These studies are reviewed and described here. While further work is needed, clarifying the presence of herd immunity is not just an academic exercise but an important issue for rotavirus control, especially in lower income countries where the incidence of the disease is highest and the direct protection of the vaccines is lower.Keywords: rotavirus, vaccine, herd immunity, efficacy

Cytokines in the management of rotavirus infection: A systematic review of in vivo studies.

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Gandhi, Gopalsamy Rajiv; Santos, Victor Santana; Denadai, Marina; da Silva Calisto, Valdete Kaliane; de Souza Siqueira Quintans, Jullyana; de Oliveira E Silva, Ana Mara; de Souza Araújo, Adriano Antunes; Narain, Narendra; Cuevas, Luis Eduardo; Júnior, Lucindo José Quintans; Gurgel, Ricardo Queiroz

2017-08-01

Rotavirus is a leading cause of childhood diarrhoea. Rotavirus vaccines are effective against severe rotavirus gastroenteritis, but have lower efficacy in low income countries in Africa. Anti-rotavirus treatment is not available. This study reviews the literature of animal studies evaluating whether cytokine mediated pathways of immune activation could improve rotavirus therapy. We performed a systematic review of articles in English published from 2010 to 2016 reporting agents with in vivo antirotavirus activity for the management of rotavirus infection. The search was carried in PubMed, EMBASE, Scopus and Web of Science. Animal experiments where cytokines were investigated to assess the outcome of rotavirus therapy were included. A total of 869 publications were identified. Of these, 19 pertained the objectives of the review, and 11 articles described the effect of probiotics/commensals on rotavirus infection and immune responses in animals. Eight further in vivo studies evaluated the immunomodulating effects of herbs, secondary metabolites and food-derived products on cytokine responses of rotavirus-infected animals. Studies extensively reported the regulatory roles for T-helper (Th)1 (interferon gamma (IFN-γ), interleukin (IL)-2, IL-12) and Th2 (IL-4, IL-6, IL-10) cytokines responses to rotavirus pathogenesis and immunity, inhibiting rotavirus infection through suppression of inflammation by viral inhibition. Th1 and Th2 cytokines stimulate the immune system, inhibiting rotavirus binding and/or replication in animal models. Th1/Th2 cytokine responses have optimal immunomodulating effects to reduce rotavirus diarrhoea and enhance immune responses in experimental rotavirus infection. Copyright © 2017 Elsevier Ltd. All rights reserved.

Diarrea persistente: algunos factores de riesgo

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Lyliam Díaz Fernández

1999-03-01

Full Text Available Se realizó un estudio descriptivo-longitudinal, con el propósito de evaluar algunos aspectos socioculturales en 75 niños menores de 2 años, que con diagnóstico de diarrea persistente, ingresaron en el Servicio de Enfermedades Diarreicas del Hospital Pediátrico Docente "Dr. Angel A. Aballí" de Ciudad de La Habana, de julio de 1995 a marzo de 1996, ambos inclusive. Los resultados permiten afirmar que la mayoría de estos episodios acontecieron en lactantes y que el elevado índice de hacinamiento, malas condiciones higiénico-sanitarias de la vivienda y padres con nivel escolar medio, dominaron los antecedentes sociales de los niños estudiados.A descriptive-longitudinal study was conducted aimed at evaluating some sociocultural aspects in 75 children under 2 that due to persistent diarrhea were admitted in the Service of Diarrheal Diseases of the «Dr. Angel A. Aballí» Pediatric Teaching Hospital, in Havana City, from July, 1995, to March, 1996, including both. The results allow to assure that most of these episodes occurred in infants and that the high index of heaping, bad hygienic and sanitary conditions of the houses and parents with middle educational level predominated in the social background of the studied children.

Effect of human rotavirus vaccine on severe diarrhea in African infants

OpenAIRE

Madhi, Shabir A; Cunliffe, Nigel A; Steele, Duncan; Witte, Desirée; Kirsten, Mari; Louw, Cheryl; Ngwira, Bagrey; Victor, John C; Gillard, Paul H; Cheuvart, Brigitte B; Han, Htay H; Neuzil, Kathleen M

2016-01-01

: Rotavirus is the most common cause of severe gastroenteritis among young children worldwide. Data are needed to assess the efficacy of the rotavirus vaccine in African children. : We conducted a randomized, placebo-controlled, multicenter trial in South Africa (3166 infants; 64.1% of the total) and Malawi (1773 infants; 35.9% of the total) to evaluate the efficacy of a live, oral rotavirus vaccine in preventing severe rotavirus gastroenteritis. Healthy infants were randomly assigned in a 1:...

Cost-Effectiveness of Rotavirus Vaccination in France-Accounting for Indirect Protection.

Science.gov (United States)

Yamin, Dan; Atkins, Katherine E; Remy, Vanessa; Galvani, Alison P

Vaccination against rotavirus has shown great potential for reducing the primary cause of severe childhood gastroenteritis. Previous economic evaluations of rotavirus vaccination in France have not modeled the potential impact of vaccines on disease burden via reduced transmission. To determine the cost-effectiveness of the introduction of pentavalent rotavirus vaccination into the French infant vaccination schedule. We developed an age-structured model of rotavirus transmission calibrated to 6 years of French gastroenteritis incidence and vaccine clinical trial data. We evaluated the cost-effectiveness of pentavalent rotavirus vaccination considering that 75% of infants would receive the three-dose vaccine course. Our model predicts that rotavirus vaccination will decrease rotavirus gastroenteritis incidence and associated clinical outcomes in vaccinated and unvaccinated individuals, delay the seasonal peak of infection, and increase the age of infection. From the societal perspective, our base-case scenario predicts that vaccination coverage would be cost-effective at €115 or €135 per vaccine course at €28,500 and €39,500/quality-adjusted life-year (QALY) gained, respectively, and suggests that almost 95% of the financial benefits will be recouped within the first 5 years following vaccination implementation. From the third-party payer perspective, incremental cost-effectiveness ratios ranged from €12,500 to €20,000/QALY, respectively. Our uncertainty analysis suggests that findings were sensitive to various assumptions including the number of hospitalizations, outpatient visits, and the extent of QALY losses per rotavirus episode. Introducing pentavalent rotavirus vaccination into the French infant vaccination schedule would significantly reduce the burden of rotavirus disease in children, and could be cost-effective under plausible conditions. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by

Suspected zoonotic transmission of rotavirus group A in Danish adults

DEFF Research Database (Denmark)

Midgley, S. E.; Hjulsager, Charlotte Kristiane; Larsen, Lars Erik

2012-01-01

Group A rotaviruses infect humans and a variety of animals. In July 2006 a rare rotavirus strain with G8P[14] specificity was identified in the stool samples of two adult patients with diarrheoa, who lived in the same geographical area in Denmark. Nucleotide sequences of the VP7, VP4, VP6, and NSP4...... genes of the identified strains were identical. Phylogenetic analyses showed that both Danish G8P[14] strains clustered with rotaviruses of animal, mainly, bovine and caprine, origin. The high genetic relatedness to animal rotaviruses and the atypical epidemiological features suggest that these human G8...

Biennial pattern of rotavirus gastroenteritis in the Netherlands and a shifting age distribution following a low rotavirus season, 2010-2016.

NARCIS (Netherlands)

Verberk, J.D.M.; Pijnacker, R.; Bruijning-Verhagen, P.; Franz, E.; Vennema, H.; Hooiveld, M.; Hahné, S.J.M.; Melker, H.E. de

2017-01-01

A hyper-endemic rotavirus season was expected after a low-endemic 2014 season in the Netherlands. Rotavirus detections were however similar in 2015 and lower in 2016 compared with 2010-2013. Gastroenteritis consultations rates were also similar in 2015, but the age-distribution shifted to older

Determinants of rotavirus transmission : a lag non-linear time series analysis

NARCIS (Netherlands)

van Gaalen, Rolina D; van de Kassteele, Jan; Hahné, Susan J M; Bruijning-Verhagen, Patricia; Wallinga, Jacco

Rotavirus is a common viral infection among young children. As in many countries, the infection dynamics of rotavirus in the Netherlands are characterized by an annual winter peak, which was notably low in 2014. Previous work suggested an association between weather factors and both rotavirus

Rotavirus in Ireland: national estimates of disease burden, 1997 to 1998.

LENUS (Irish Health Repository)

Lynch, M

2012-02-03

BACKGROUND: We estimated the disease burden caused by rotavirus hospitalizations in the Republic of Ireland by using national data on the number of hospitalizations for diarrhea in children and laboratory surveillance of confirmed rotavirus detections. METHODS: We examined trends in diarrheal hospitalizations among children <5 years old as coded by ICD-9-CM for the period January, 1997, to December, 1998. We collated data on laboratory-confirmed rotavirus detections nationally for the same period among children <2 years old. We calculated the overall contribution of rotavirus to laboratory-confirmed intestinal disease in children <5 years old from INFOSCAN, a disease bulletin for one-third of the population. We compared data from all sources and estimated the proportion of diarrheal hospitalizations that are likely the result of rotavirus in children <5 years old. RESULTS: In children <5 years old, 9% of all hospitalizations are for diarrheal illness. In this age group 1 in 8 are hospitalized for a diarrheal illness, and 1 in 17 are hospitalized for rotavirus by 5 years of age. In hospitalized children <2 years old, 1 in 38 have a laboratory confirmed rotavirus infection. CONCLUSIONS: The disease burden of rotavirus hospitalizations is higher than in other industrialized countries. Access to comprehensive national databases may have contributed to the high hospitalization rates, as well as a greater tendency to hospitalize children with diarrhea in Ireland.

Simian rhesus rotavirus is a unique heterologous (non-lapine) rotavirus strain capable of productive replication and horizontal transmission in rabbits.

Science.gov (United States)

Ciarlet, M; Estes, M K; Conner, M E

2000-05-01

Simian rhesus rotavirus (RRV) is the only identified heterologous (non-lapine) rotavirus strain capable of productive replication at a high inoculum dose of virus (>10(8) p.f.u.) in rabbits. To evaluate whether lower doses of RRV would productively infect rabbits and to obtain an estimate of the 50% infectious dose, rotavirus antibody-free rabbits were inoculated orally with RRV at inoculum doses of 10(3), 10(5) or 10(7) p.f.u. Based on faecal virus antigen or infectious virus shedding, RRV replication was observed with inoculum doses of 10(7) and 10(5) p.f.u., but not 10(3) p.f.u. Horizontal transmission of RRV to one of three mock-inoculated rabbits occurred 4-5 days after onset of virus antigen shedding in RRV-infected rabbits. Rabbits infected at 10(7) and 10(5), but not 10(3), p.f.u. of RRV developed rotavirus-specific immune responses and were completely (100%) protected from lapine ALA rotavirus challenge. These data confirm that RRV can replicate productively and spread horizontally in rabbits. In attempts to elucidate the genetic basis of the unusual replication efficacy of RRV in rabbits, the sequence of the gene encoding the lapine non-structural protein NSP1 was determined. Sequence analysis of the NSP1 of three lapine rotaviruses revealed a high degree of amino acid identity (85-88%) with RRV. Since RRV and lapine strains also share similar VP7s (96-97%) and VP4s (69-70%), RRV might replicate efficiently in rabbits because of the high relatedness of these three gene products, each implicated in host range restriction.

A systematic review of genetic diversity of human rotavirus circulating in South Korea.

Science.gov (United States)

Than, Van Thai; Jeong, Sunyoung; Kim, Wonyong

2014-12-01

Rotavirus infections continue to be the leading cause of severe diarrhea in young Korean children. Rotavirus data acquired from uninterrupted surveillance studies between 1989 and 2009 in South Korea were analyzed to better understand the genetic diversity and evolution. The relationship between rotaviruses and the currently licensed rotavirus vaccine viruses was also examined. The most prevalent rotavirus strains, with genotype G1P[8], followed by G3P[8], G4P[6], and G2P[4], accounted for approximately 76.7% of the total identified strains, and more recently, rotavirus G9P[8] has significance increased to be the fifth most common genotype. Phylogenetic analyses underscored the heterogeneity between viral populations within each genotype, with different lineages and sub-lineages. Although the currently licensed rotavirus vaccines are effective, safe, and economical, additional data from rotavirus monitoring is necessary to evaluate the efficacy of these vaccines for their sustained use in South Korea. The present study provides comprehensive and up-to-date information regarding the epidemiology, genetic diversity, and evolution of the circulating rotaviruses in South Korea. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

Unexpectedly high burden of rotavirus gastroenteritis in very young infants

Directory of Open Access Journals (Sweden)

Reilly Megan

2010-06-01

Full Text Available Abstract 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 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

Caregiver knowledge, attitudes, and practices regarding childhood diarrhea and dehydration in Kingston, Jamaica Conocimientos, actitudes y prácticas de los cuidadores hacia la diarrea infantil y la deshidratación en Kingston, Jamaica

Directory of Open Access Journals (Sweden)

Lela Rose Bachrach

2002-07-01

diarrea infantil y la deshidratación en Kingston, Jamaica, con el fin de determinar si sus escasos conocimientos sobre la prevención y el tratamiento de la diarrea y la deshidratación hacen que los niños corran mayor riesgo de hospitalización por estos problemas. Métodos. Se realizó un estudio observacional de casos y controles entre febrero y mayo de 1997 en el Hospital Infantil Bustamante de Kingston. Se usó una muestra de conveniencia de niños de menos de 5 años y los datos fueron recogidos mediante entrevistas personales con los cuidadores de los dos grupos de niños. Un grupo estaba formado por 117 niños con gastroenteritis aguda, y el otro por 98 niños con problemas agudos no relacionados con la gastroenteritis. De los 215 cuidadores entrevistados, 197 eran las madres, 9 eran tutores, 5 eran los padres y 4 eran las abuelas. Resultados. La media etaria de los cuidadores, su nivel educacional y su estatus socioeconómico eran similares en los dos grupos. Los cuidadores del grupo de niños con gastroenteritis tenían niños más pequeños y menos acceso al agua corriente y a frigoríficos. Los niños cuyos cuidadores nunca habían oído hablar de la rehidratación oral tenían mayor riesgo de presentar gastroenteritis y deshidratación [razón de posibilidades (odds ratio: OR: 4,6; intervalo de confianza del 95% (IC95: 1,8-11,7], al igual que los niños cuyos cuidadores tenían escasos conocimientos sobre la prevención y el tratamiento de la diarrea y la deshidratación (OR: 3,7; IC95: 1,6-8,8. Otro factor de riesgo independiente fue la poca confianza del cuidador en su propia capacidad para tratar la diarrea del niño (OR: 2,3; IC95: 1,1-4,9. Conclusiones. Estos resultados destacan la necesidad de incrementar los esfuerzos informativos que les permitan a los cuidadores proteger a los niños de la morbilidad y la mortalidad relacionadas con la diarrea.

Diarrea del viajero asociada a Aeromonas hydrophila Traveller's diarrohea caused by Aeromonas hydrophila

Directory of Open Access Journals (Sweden)

M. L. Pita Toledo

2001-06-01

Full Text Available Aeromonas hydrophila es una bacteria que se encuentra frecuentemente en aguas dulces y salobres. Desde hace varios años se conoce que determinadas cepas de la especie pueden causar enfermedad en pescados y en anfibios, existiendo cierta controversia sobre su patogeneicidad en humanos. No obstante, puede dar lugar a infección en personas, que la adquieren bien a través de heridas abiertas o bien por ingestión de alimentos o agua contaminados. Sin embargo, en prácticamente la totalidad de las publicaciones se hace referencia a casos aislados más que a brotes producidos por esta bacteria. Generalmente la infección por A. hydrophila da lugar a gastroenteritis en personas sanas, pudiendo generar una septicemia en individuos inmunodeprimidos.En 1998 se produjo una alarma en el sector hotelero por un incremento considerable de los casos de gastroenteritis entre los turistas que acudían durante sus vacaciones a determinadas zonas costeras de la isla de Tenerife.Tras tener conocimiento de la situación, la Dirección General de Salud Pública inició una investigación epidemiológica con el objetivo de conocer la magnitud real del problema detectado e identificar los factores asociados a la misma, para poner en marcha las medidas correctoras y de control necesarias. El análisis inicial permitió determinar que se trataba de un proceso de gran magnitud en su extensión aunque de carácter leve, que afectaba únicamente a los turistas en una zona costera en concreto, compatible por lo tanto con la diarrea del viajero, planteándose un origen probablemente hídrico.Aeromonas hydrophila is a bacteria frequently found in fresh water and saline water. Certain strains of the species have been known to cause disease in fish and amphibians for several years, although some controversy exists about its ability to cause illness in humans. Nevertheless, either through open wounds or contaminated food or water, it can give rise to infection. However, almost

Rotavirus I in feces of a cat with diarrhea.

Science.gov (United States)

Phan, Tung G; Leutenegger, Christian M; Chan, Roxanne; Delwart, Eric

2017-06-01

A divergent rotavirus I was detected using viral metagenomics in the feces of a cat with diarrhea. The eleven segments of rotavirus I strain Felis catus encoded non-structural and structural proteins with amino acid identities ranging from 25 to 79% to the only two currently sequenced members of that viral species both derived from canine feces. No other eukaryotic viral sequences nor bacterial and protozoan pathogens were detected in this fecal sample suggesting the involvement of rotavirus I in feline diarrhea.

molecular identification of rotavirus strains associated with diarrhea

African Journals Online (AJOL)

DR. AMINU

ABSTRACT. The study was carried out to determine the molecular characteristics of the rotavirus strains associated with diarrhea among children in Kwara state, Nigeria. A total of 150 stool samples were collected from diarrheic children. The stool samples were screened for rotavirus,using Enzyme linked Immunosorbent ...

Molecular identification of rotavirus strains associated with diarrhea ...

African Journals Online (AJOL)

The study was carried out to determine the molecular characteristics of the rotavirus strains associated with diarrhea among children in Kwara state, Nigeria. A total of 150 stool samples were collected from diarrheic children. The stool samples were screened for rotavirus,using Enzyme linked Immunosorbent assay (ELISA).

The clinical appearance of neonatal rotavirus infection: Association ...

African Journals Online (AJOL)

BackgroundRotavirus is the most important aetiological agent causing severe gastroenteritis in children <2 years of age in South Africa and worldwide. Most endemic neonatal nursery strains are thought to be asymptomatic. However, serious conditions have been reported to be associated with rotavirus infection, such as ...

Implementation of Rotavirus Surveillance and Vaccine Introduction - World Health Organization African Region, 2007-2016.

Science.gov (United States)

Mwenda, Jason M; Burke, Rachel M; Shaba, Keith; Mihigo, Richard; Tevi-Benissan, Mable Carole; Mumba, Mutale; Biey, Joseph Nsiari-Muzeyi; Cheikh, Dah; Poy MSc, Alain; Zawaira, Felicitas R; Aliabadi, Negar; Tate, Jacqueline E; Hyde, Terri; Cohen, Adam L; Parashar, Umesh D

2017-11-03

Rotavirus is a leading cause of severe pediatric diarrhea globally, estimated to have caused 120,000 deaths among children aged rotavirus vaccination for all infants worldwide (2). Two rotavirus vaccines are currently licensed globally: the monovalent Rotarix vaccine (RV1, GlaxoSmithKline; 2-dose series) and the pentavalent RotaTeq vaccine (RV5, Merck; 3-dose series). This report describes progress of rotavirus vaccine introduction (3), coverage (using estimates from WHO and the United Nations Children's Fund [UNICEF]) (4), and impact on pediatric diarrhea hospitalizations in the WHO African Region. By December 2016, 31 (66%) of 47 countries in the WHO African Region had introduced rotavirus vaccine, including 26 that introduced RV1 and five that introduced RV5. Among these countries, rotavirus vaccination coverage (completed series) was 77%, according to WHO/UNICEF population-weighted estimates. In 12 countries with surveillance data available before and after vaccine introduction, the proportion of pediatric diarrhea hospitalizations that were rotavirus-positive declined 33%, from 39% preintroduction to 26% following rotavirus vaccine introduction. These results support introduction of rotavirus vaccine in the remaining countries in the region and continuation of rotavirus surveillance to monitor impact.

Survival and detection of rotaviruses on environmental surfaces in day care centers.

Science.gov (United States)

Keswick, B H; Pickering, L K; DuPont, H L; Woodward, W E

1983-01-01

Previously, we demonstrated that children in day care centers commonly experience diarrhea due to rotavirus, giardia, and bacterial pathogens. Multiple agents frequently coexist, and the environment is heavily contaminated with enteric bacteria during outbreaks. A study of environmental surface contamination with rotavirus was performed during three non-outbreak periods. Of 25 samples collected from environmental surfaces and teachers hands at a day care center, 4 (16%) were positive for rotavirus antigen when a fluorescence assay was used. We also examined the survival of two animal viruses, rotavirus SA-11 and poliovirus type 1, and bacteriophage 12 on similar environmental surfaces in a laboratory. Poliovirus type 1 and bacteriophage f2 were more resistant to drying than rotavirus SA-11 and could be recovered after a 90-min exposure on a dry surface. Rotavirus SA-11 could be detected for 30 min. All three viruses survived longer when they were suspended in fecal material than when they were suspended in distilled water. These data suggest that several agents, including rotavirus, can remain viable on contaminated surfaces long enough to be transmitted to susceptible children. This finding helps explain why rotavirus shows a mode of spread like that of parasitic and bacterial agents within day care center settings. PMID:6314896

Report of the 5th European expert meeting on rotavirus vaccination (EEROVAC).

Science.gov (United States)

de Hoog, Marieke L A; Vesikari, Timo; Giaquinto, Carlo; Huppertz, Hans-Iko; Martinon-Torres, Federico; Bruijning-Verhagen, Patricia

2018-04-03

The Fifth European Expert Meeting on Rotavirus Vaccination was convened in Utrecht, The Netherlands, in March 2017. The 2-day meeting included invited lectures as well as original oral and poster presentations and brought together experts from 21 countries. Summary findings of the meeting include: Rotavirus vaccination programmes in Europe have resulted in reductions of 60-90% in rotavirus outpatient visits and hospitalizations. Long term trends indicate this impact is sustained over the years. Herd effects, protecting unvaccinated children and neonates too young to be vaccinated have been observed in many European countries. Early evidence now also suggests that rotavirus vaccination may be instrumental in the prevention of celiac disease. Special attention should be given to preterm infants, who may age out of the vaccination window before hospital discharge and to HIV infected children who are at increased risk of severe rotavirus AGE. There is a small but increased risk of IS following rotavirus vaccination and parents should therefore be informed about possible signs and symptoms of IS. New insights in rotavirus genetic susceptibility and interactions with microbiome may open opportunities for interventions to improve protection by vaccination, in particular in LMIC. The development of several novel rotavirus vaccines discussed at the meeting is also promising in this respect.

Human rotavirus genotypes causing acute watery diarrhea among ...

African Journals Online (AJOL)

Background: Diarrhea is a major cause of childhood morbidity and mortality in the developing countries. Rotavirus is a major cause of acute watery diarrhea. Aim: This study aims at characterizing the prevalent rotavirus G-genotypes among under.five children presenting with acute watery diarrhea in Benin City, Nigeria.

epidemiology of rotavirus and astrovirus infections in children

African Journals Online (AJOL)

Emmanuel Ameh

Abstract. Background: Recent estimates attribute 527 000 deaths in children less than five years of age to rotavirus diarrhea annually, with 145 000 occurring in sub-Saharan Africa. Human astroviruses have been identified as one of the most frequent causes of infantile diarrhea, second in incidence only to rotavirus.

The incidence and clinical presentation of infantile rotavirus ...

African Journals Online (AJOL)

Objectives. An effective vaccine is needed to protect against severe rotavirus disease, an important cause of gastroenteritis. Since there are no data on the incidence and antigenic diversity of rotavirus infection in Sierra Leone, we studied its epidemiology to enable an effective vaccine strategy to be designed. Methods.

Human rotavirus group a serotypes causing gastroenteritis in ...

African Journals Online (AJOL)

Background: Rotavirus remains a leading cause of acute gastroenteritis in children worldwide with an estimated 2000 deaths each day in developing countries. Due to HIV/AIDS scourge in Kenya, it is possible that rotavirus-related gastroenteritis has been aggravated in adults. The Global Alliance for Immunizations has ...

Pharmacoeconomic spotlight on rotavirus vaccine RIX4414 (Rotarix™) in developed countries.

Science.gov (United States)

Plosker, Greg L

2012-12-01

The most common cause of severe diarrhea in infants and young children is rotavirus gastroenteritis (RVGE), which is associated with significant morbidity, healthcare resource use, and direct and indirect costs in industrialized nations. The monovalent rotavirus vaccine RIX4414 (Rotarix™) is administered as a two-dose oral series in infants and has demonstrated protective efficacy against RVGE in clinical trials conducted in developed countries. In addition, various naturalistic studies have demonstrated 'real-world' effectiveness after the introduction of widespread rotavirus vaccination programs in the community setting. Numerous cost-effectiveness analyses have been conducted in developed countries in which a universal rotavirus vaccination program using RIX4414 was compared with no universal rotavirus vaccination program. There was a high degree of variability in base-case results across studies even when the studies were conducted in the same country, often reflecting differences in the selection of data sources or assumptions used to populate the models. In addition, results were sensitive to plausible changes in a number of key input parameters. As such, it is not possible to definitively state whether a universal rotavirus vaccination program with RIX4414 is cost effective in developed countries, although results of some analyses in some countries suggest this is the case. In addition, international guidelines advocate universal vaccination of infants and children against rotavirus. It is also difficult to draw conclusions regarding the cost effectiveness of rotavirus vaccine RIX4414 relative to that of the pentavalent rotavirus vaccine, which is administered as a three-dose oral series. Although indirect comparisons in cost-effectiveness analyses indicate that RIX4414 provided more favorable incremental cost-effectiveness ratios when each vaccine was compared with no universal rotavirus vaccination program, results were generally sensitive to vaccine

Epidemiology of rotavirus-associated hospital admissions in the province of Ferrara, Italy.

Science.gov (United States)

Marsella, Maria; Raimondi, Licia; Bergamini, Mauro; Sprocati, Monica; Bigi, Ettore; De Sanctis, Vincenzo; Borgna-Pignatti, Caterina; Gabutti, Giovanni

2009-12-01

Hospital discharge forms with specific codes for rotavirus gastroenteritis in children 0 to 14 years of age were reviewed in the period 2003-2005 in the province of Ferrara. A total of 4,238 children were admitted to the pediatric departments; 151 patients were diagnosed with rotavirus gastroenteritis. The average annual rate of hospitalization for rotavirus gastroenteritis was 1.54/1,000 children Italy and underline the potential impact of rotavirus vaccination in our province.

Efficacy of pentavalent rotavirus vaccine against severe rotavirus gastroenteritis in infants in developing countries in sub-Saharan Africa: a randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Armah, George E; Sow, Samba O; Breiman, Robert F; Dallas, Michael J; Tapia, Milagritos D; Feikin, Daniel R; Binka, Fred N; Steele, A Duncan; Laserson, Kayla F; Ansah, Nana A; Levine, Myron M; Lewis, Kristen; Coia, Michele L; Attah-Poku, Margaret; Ojwando, Joel; Rivers, Stephen B; Victor, John C; Nyambane, Geoffrey; Hodgson, Abraham; Schödel, Florian; Ciarlet, Max; Neuzil, Kathleen M

2010-08-21

Rotavirus gastroenteritis causes many deaths in infants in sub-Saharan Africa. Because rotavirus vaccines have proven effective in developed countries but had not been tested in developing countries, we assessed efficacy of a pentavalent rotavirus vaccine against severe disease in Ghana, Kenya, and Mali between April, 2007, and March, 2009. In our multicentre, double-blind, placebo-controlled trial, undertaken in rural areas of Ghana and Kenya and an urban area of Mali, we randomly assigned infants aged 4-12 weeks without symptoms of gastrointestinal disorders in a 1:1 ratio to receive three oral doses of pentavalent rotavirus vaccine 2 mL or placebo at around 6 weeks, 10 weeks, and 14 weeks of age. Infants with HIV infection were not excluded. Randomisation was done by computer-generated randomisation sequence in blocks of six. We obtained data for gastrointestinal symptoms from parents on presentation to health-care facilities and clinical data were obtained prospectively by clinicians. The primary endpoint was severe rotavirus gastroenteritis (Vesikari score >or=11), detected by enzyme immunoassay, arising 14 days or more after the third dose of placebo or vaccine to end of study (March 31, 2009; around 21 months of age). Analysis was per protocol; infants who received scheduled doses of vaccine or placebo without intervening laboratory-confirmed naturally occurring rotavirus disease earlier than 14 days after the third dose and had complete clinical and laboratory results were included in the analysis. This study is registered with ClinicalTrials.gov, number NCT00362648. 5468 infants were randomly assigned to receive pentavalent rotavirus vaccine (n=2733) or placebo (n=2735). 2357 infants assigned to vaccine and 2348 assigned to placebo were included in the per-protocol analysis. 79 cases of severe rotavirus gastroenteritis were reported in 2610.6 person-years in the vaccine group, compared with 129 cases in 2585.9 person-years in the placebo group, resulting

Reduction in Diarrhea- and Rotavirus-related Healthcare Visits Among Children Introduction in Zimbabwe.

Science.gov (United States)

Mujuru, Hilda A; Yen, Catherine; Nathoo, Kusum J; Gonah, Nhamo A; Ticklay, Ismail; Mukaratirwa, Arnold; Berejena, Chipo; Tapfumanei, Ottias; Chindedza, Kenneth; Rupfutse, Maxwell; Weldegebriel, Goitom; Mwenda, Jason M; Burnett, Eleanor; Tate, Jacqueline E; Parashar, Umesh D; Manangazira, Portia

2017-10-01

In Zimbabwe, rotavirus accounted for 41%-56% of acute diarrhea hospitalizations before rotavirus vaccine introduction in 2014. We evaluated rotavirus vaccination impact on acute diarrhea- and rotavirus-related healthcare visits in children. We examined monthly and annual acute diarrhea and rotavirus test-positive hospitalizations and Accident and Emergency Department visits among children introduction (2012-2013) with postvaccine introduction (2015 and 2016) data for 2 of the hospitals. We examined monthly acute diarrhea hospitalizations by year and age group for 2013-2016 from surveillance hospital registers and monthly acute diarrhea outpatient visits reported to the Ministry of Health and Child Care during 2012-2016. Active surveillance data showed winter seasonal peaks in diarrhea- and rotavirus-related visits among children introduction; the percentage of rotavirus test-positive visits followed a similar seasonal pattern and decrease. Hospital register data showed similar pre-introduction seasonal variation and post-introduction declines in diarrhea hospitalizations among children 0-11 and 12-23 months of age. Monthly variation in outpatient diarrhea-related visits mirrored active surveillance data patterns. At 2 surveillance hospitals, the percentage of rotavirus-positive visits declined by 40% and 43% among children 0-11 months of age and by 21% and 33% among children 12-23 months of age in 2015 and 2016, respectively. Initial reductions in diarrheal illness among children introduction are encouraging. These early results provide evidence to support continued rotavirus vaccination and rotavirus surveillance in Zimbabwe.

Experimental reproduction of rotavirus and Salmonella pullorum ...

African Journals Online (AJOL)

Group A chicks were inoculated with 1 X 106 pfu/ml of rotavirus, group B chicks were inoculated with 1 X 106 cfu/ml of Salmonella pullorum, group C chicks were inoculated with 1 X 106 pfu/ml of rotavirus and 1 X 106 cfu/ml of Salmonella pullorum, while group D birds were given 1ml of PBS alone. Birds in all groups were ...

Estimates of economic burden of providing inpatient care in childhood rotavirus gastroenteritis from Malaysia.

Science.gov (United States)

Lee, Way Seah; Poo, Muhammad Izzuddin; Nagaraj, Shyamala

2007-12-01

To estimate the cost of an episode of inpatient care and the economic burden of hospitalisation for childhood rotavirus gastroenteritis (GE) in Malaysia. A 12-month prospective, hospital-based study on children less than 14 years of age with rotavirus GE, admitted to University of Malaya Medical Centre, Kuala Lumpur, was conducted in 2002. Data on human resource expenditure, costs of investigations, treatment and consumables were collected. Published estimates on rotavirus disease incidence in Malaysia were searched. Economic burden of hospital care for rotavirus GE in Malaysia was estimated by multiplying the cost of each episode of hospital admission for rotavirus GE with national rotavirus incidence in Malaysia. In 2002, the per capita health expenditure by Malaysian Government was US$71.47. Rotavirus was positive in 85 (22%) of the 393 patients with acute GE admitted during the study period. The median cost of providing inpatient care for an episode of rotavirus GE was US$211.91 (range US$68.50-880.60). The estimated average cases of children hospitalised for rotavirus GE in Malaysia (1999-2000) was 8571 annually. The financial burden of providing inpatient care for rotavirus GE in Malaysian children was estimated to be US$1.8 million (range US$0.6 million-7.5 million) annually. The cost of providing inpatient care for childhood rotavirus GE in Malaysia was estimated to be US$1.8 million annually. The financial burden of rotavirus disease would be higher if cost of outpatient visits, non-medical and societal costs are included.

Expression and characterization of a novel truncated rotavirus VP4 for the development of a recombinant rotavirus vaccine.

Science.gov (United States)

Li, Yijian; Xue, Miaoge; Yu, Linqi; Luo, Guoxing; Yang, Han; Jia, Lianzhi; Zeng, Yuanjun; Li, Tingdong; Ge, Shengxiang; Xia, Ningshao

2018-04-12

The outer capsid protein VP4 is an important target for the development of a recombinant rotavirus vaccine because it mediates the attachment and penetration of rotavirus. Due to the poor solubility of full-length VP4, VP8 was explored as candidate rotavirus vaccines in the past years. In previous studies, it has been found that the N-terminal truncated VP8 protein, VP8-1 (aa26-231), could be expressed in soluble form with improved immunogenicity compared to the core of VP8 (aa65-223). However, this protein stimulated only a weak immune response when aluminum hydroxide was used as an adjuvant. In addition, it should be noted that the protective efficacy of VP4 was higher than that of VP8 and VP5. In this study, it was found that when the N-terminal 25 amino acids were deleted, the truncated VP4 ∗ (aa26-476) containing VP8 and the stalk domain of VP5 could be expressed in soluble form in E. coli and purified to homogeneous trimers. Furthermore, the truncated VP4 could induce high titers of neutralizing antibodies when aluminum adjuvant was used and conferred high protective efficacy in reducing the severity of diarrhea and rotavirus shedding in stools in animal models. The immunogenicity of the truncated VP4 was significantly higher than that of VP8 ∗ and VP5 ∗ alone. Taken together, the truncated VP4 ∗ (aa26-476), with enhanced immunogenicity and immunoprotectivity, could be considered as a viable candidate for further development and has the potential to become a parenterally administered rotavirus vaccine. Copyright © 2018 Elsevier Ltd. All rights reserved.

Characteristics of Rotavirus Diarrhea in Hospitalized Children in Kosovo

Science.gov (United States)

Ismaili-Jaha, Vlora; Shala, Muje; Azemi, Mehmedali; Hoxha-Kamberi, Teuta; Avdiu, Muharrem; Spahiu, Shqipe; Jaha, Luan

2014-01-01

Background: Diarrhea is a leading cause of child mortality worldwide. Rotavirus is one of the most common causes of severe diarrhea and dehydration in children. Authors reviewed epidemiological and clinical data of the rotavirus diarrhea in Kosovo. Methods: This is a prospective study carried between January 1st and December 31st 2011. All data, comprising demographics, nutrition, clinical presentation, laboratory findings, management and outcome of the rotavirus diarrhea are collected on the specially designed form. Results: 116 children with rotavirus diarrhea are included in the study. The majority boys (74.4%) and children aged 0 – 12 months (82.75%). Mean age of children in the study was 16.38 months. Almost every third child in the study was hypotrophic (29.2%). More than half of the infants (55.2%) were on mixed food, somewhat more than every third was breast feeding (36.45%), and every twelfth (8.33%) was on artificial milk (animal or formula). Apart from diarrhea, present in all patients, vomiting (97.41%) and fever (43.96%) were characteristics of the clinical presentation of the diarrhea. Two thirds of the children had mild grade dehydration (70.7%). All patients recovered with no sequels. Conclusion: Rotavirus continues to be responsible for a significant portion of acute diarrhea in Kosovo. Clinical features, epidemiological data and the agglutination test are safe enough to establish the diagnosis. Treated correctly rotavirus diarrhea has a favorable outcome. PMID:25568634

Cost-effectiveness of rotavirus vaccination in Albania.

Science.gov (United States)

Ahmeti, Albana; Preza, Iria; Simaku, Artan; Nelaj, Erida; Clark, Andrew David; Felix Garcia, Ana Gabriela; Lara, Carlos; Hoestlandt, Céline; Blau, Julia; Bino, Silvia

2015-05-07

Rotavirus vaccines have been introduced in several European countries but can represent a considerable cost, particularly for countries that do not qualify for any external financial support. This study aimed to evaluate the cost-effectiveness of introducing rotavirus vaccination into Albania's national immunization program and to inform national decision-making by improving national capacity to conduct economic evaluations of new vaccines. The TRIVAC model was used to assess vaccine impact and cost-effectiveness. The model estimated health and economic outcomes attributed to 10 successive vaccinated birth cohorts (2013-2022) from a government and societal perspective. Epidemiological and economic data used in the model were based on national cost studies, and surveillance data, as well as estimates from the scientific literature. Cost-effectiveness was estimated for both the monovalent (RV1) and pentavalent vaccines (RV5). A multivariate scenario analysis (SA) was performed to evaluate the uncertainty around the incremental cost-effectiveness ratios (ICERs). With 3% discounting of costs and health benefits over the period 2013-2022, rotavirus vaccination in Albania could avert 51,172 outpatient visits, 14,200 hospitalizations, 27 deaths, 950 disability-adjusted life-years (DALYs), and gain 801 life-years. When both vaccines were compared to no vaccination, the discounted cost per DALY averted was US$ 2008 for RV1 and US$ 5047 for RV5 from a government perspective. From the societal perspective the values were US$ 517 and US$ 3556, respectively. From both the perspectives, the introduction of rotavirus vaccine to the Albanian immunization schedule is either cost-effective or highly cost-effective for a range of plausible scenarios. In most scenarios, including the base-case scenario, the discounted cost per DALY averted was less than three times the gross domestic product (GDP) per capita. However, rotavirus vaccination was not cost-effective when rotavirus cases

Human rotavirus strain Wa downregulates NHE1 and NHE6 expressions in rotavirus-infected Caco-2 cells.

Science.gov (United States)

Chen, Honglang; Song, Lijun; Li, Guixian; Chen, Wenfeng; Zhao, Shumin; Zhou, Ruoxia; Shi, Xiaoying; Peng, Zhenying; Zhao, Wenchang

2017-06-01

Rotavirus (RV) is the most common cause of severe gastroenteritis and fatal dehydration in human infants and neonates of different species. However, the pathogenesis of rotavirus-induced diarrhea is poorly understood. Secretory diarrhea caused by rotavirus may lead to a combination of excessive secretion of fluid and electrolytes into the intestinal lumen. Fluid absorption in the small intestine is driven by Na + -coupled transport mechanisms at the luminal membrane, including Na + /H + exchanger (NHE). Here, we performed qRT-PCR to detect the transcription of NHEs. Western blotting was employed for protein detection. Furthermore, immunocytochemistry was used to validate the NHE's protein expression. Finally, intracellular Ca 2+ concentration was detected by confocal laser scanning microscopy. The results demonstrated that the NHE6 mRNA and protein expressed in the human colon adenocarcinoma cell line (Caco-2). Furthermore, RV-Wa induced decreased expression of the NHE1 and NHE6 in Caco-2 cell in a time-dependent manner. In addition, intracellular Ca 2+ concentration in RV-Wa-infected Caco-2 cells was higher than that in the mock-infected cells. Furthermore, RV-Wa also can downregulate the expression of calmodulin (CaM) and calmodulin kinase II (CaMKII) in Caco-2 cells. These findings provides important insights into the mechanisms of rotavirus-induced diarrhea. Further studies on the underlying pathophysiological mechanisms that downregulate NHEs in RV-induced diarrhea are required.

Diversity and zoonotic potential of rotaviruses in swine and cattle across Europe

DEFF Research Database (Denmark)

Midgley, Sofie E.; Bányai, Krisztián; Buesa, Javier

2012-01-01

Group A rotaviruses can infect both humans and animals. Individual rotavirus strains can occasionally cross species barriers and might hereby contribute to the emergence of new genotypes in heterologous hosts. The incidence and impact of zoonotic rotavirus are not well defined, and one reason...... for this is a lack of data about strains circulating in suspected reservoir animal hosts. In this study we report the incidence, genetic diversity, and molecular epidemiology of rotaviruses detected in domestic cattle and swine in 6 European countries. From 2003 to 2007, 1101 and more than 2000 faecal specimens were...... collected from swine and cattle, both healthy and diarrhoeic, and tested for rotaviruses. Viruses from positive stools were genotyped and a subset of strains was characterized by nucleotide sequencing and phylogenetic analysis of the VP7 (G) and VP4 (P) genes. Rotaviruses were detected in 43% of bovine...

Immunogenicity and protective efficacy of yeast extracts containing rotavirus-like particles: a potential veterinary vaccine.

Science.gov (United States)

Rodríguez-Limas, William A; Pastor, Ana Ruth; Esquivel-Soto, Ernesto; Esquivel-Guadarrama, Fernando; Ramírez, Octavio T; Palomares, Laura A

2014-05-19

Rotavirus is the most common cause of severe diarrhea in many animal species of economic interest. A simple, safe and cost-effective vaccine is required for the control and prevention of rotavirus in animals. In this study, we evaluated the use of Saccharomyces cerevisiae extracts containing rotavirus-like particles (RLP) as a vaccine candidate in an adult mice model. Two doses of 1mg of yeast extract containing rotavirus proteins (between 0.3 and 3 μg) resulted in an immunological response capable of reducing the replication of rotavirus after infection. Viral shedding in all mice groups diminished in comparison with the control group when challenged with 100 50% diarrhea doses (DD50) of murine rotavirus strain EDIM. Interestingly, when immunizing intranasally protection against rotavirus infection was observed even when no increase in rotavirus-specific antibody titers was evident, suggesting that cellular responses were responsible of protection. Our results indicate that raw yeast extracts containing rotavirus proteins and RLP are a simple, cost-effective alternative for veterinary vaccines against rotavirus. Copyright © 2014 Elsevier Ltd. All rights reserved.

Molecular characterization of a human G20P[28] rotavirus a strain with multiple genes related to bat rotaviruses.

Science.gov (United States)

Esona, Mathew D; Roy, Sunando; Rungsrisuriyachai, Kunchala; Gautam, Rashi; Hermelijn, Sandra; Rey-Benito, Gloria; Bowen, Michael D

2018-01-01

Group A rotaviruses are the major cause of severe gastroenteritis in the young of mammals and birds. This report describes characterization of an unusual G20P[28] rotavirus strain detected in a 24month old child from Suriname. Genomic sequence analyses revealed that the genotype constellation of the Suriname strain RVA/Human-wt/SUR/2014735512/2013/G20P[28] was G20-P[28]-I13-R13-C13-M12-A23-N13-T15-E20-H15. Genes VP1, VP2, VP3, NSP1, NSP2, NSP3, NSP4 and NSP5 were recently assigned novel genotypes by the Rotavirus Classification Working Group (RCWG). Three of the 11 gene segments (VP7, VP4, VP6) were similar to cognate gene sequences of bat-like human rotavirus strain Ecu534 from Ecuador and the VP7, NSP3 and NSP5 gene segments of strain RVA/Human-wt/SUR/2014735512/2013/G20P[28] were found to be closely related to gene sequences of bat rotavirus strain 3081/BRA detected in Brazil. Although distantly related, the VP1 gene of the study strain and bat strain BatLi09 detected in Cameroon in 2014 are monophyletic. The NSP1 gene was found to be most closely related to human strain QUI-35-F5 from Brazil. These findings suggest that strain RVA/Human-wt/SUR/2014735512/2013/G20P[28] represents a zoonotic infection from a bat host. Published by Elsevier B.V.

NEW PREVENTION OPPORTUNITIES OF INFECTIOUS DISEASES. VACCINATION AGAINST ROTAVIRUS

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T. A. Grechukha

2013-01-01

Full Text Available The article covers the problem of the burden of rotavirus disease. Rotavirus infection is the leading cause of mortality among children under 5 years of age and is a major problem for a public healthcare. The world is actively engaged in the prevention of rotavirus infection since 2005. There is a lot of data on the efficacy and safety of this vaccine. Different foreign investigations have shown the herd immunity of the vaccine. The authors present data about the effectiveness and safety of vaccines, established during clinical studies of the foreign scientists.

Effects of wastewater sludge and its detergents on the stability of rotavirus

Energy Technology Data Exchange (ETDEWEB)

Ward, R.L. (Sandia Labs., Albuquerque, NM); Ashley, C.S.

1980-06-01

Wastewater sludge reduced the heat required to inactivate rotavirus SA-11, and ionic detergents were identified as the sludge components responsible for this effect. A similar result was found previously with reovirus. The quantitative effects of individual ionic detergents on rotavirus and reovirus were very different, and rotavirus was found to be extremely sensitive to several of these detergents. However, neither virus was destabilized by nonionic detergents. On the contrary, rotavirus was stabilized by a nonionic detergent against the potent destabilizing effects of the ionic detergent sodium dodecyl sulfate. The destabilizing effects of both cationic and anionic detergents on rotavirus were greatly altered by changes in the pH of the medium.

Identification of Rotavirus VP6-Specific CD4+ T Cell Epitopes in a G1P[8] Human Rotavirus-Infected Rhesus Macaque

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Wei Zhao

2008-01-01

Full Text Available A non-human primate model was used to evaluate its potential for identification of rotavirus viral protein 6 (VP6 CD4+ T cell epitopes. Four juvenile rhesus macaques were inoculated with a mixed inoculum (G1P[8] and G9P[8] of human rotaviruses. Infection accompanied by G1P[8] shedding was achieved in the two macaques that had no rotavirus immunoglobulin A (IgA in plasma. To measure the interferon gamma (IFN-γ and tumor necrosis factor (TNF anti-viral cytokines produced by peripheral CD4+ cells that recognize VP6 epitopes, whole blood cells from one infected macaque were stimulated in vitro with VP6 peptides. Stimulation with peptide pools derived from the simian rotavirus VP6 161–395 region revealed reactivity of CD4+ T cells with the VP6 281–331 domain. A VP6 301–315 region was identified as the epitope responsible for IFN-γ production while a broader VP6 293–327 domain was linked to TNF production. These results suggest that human rotavirus-infected macaques can be used for identification of additional epitopes and domains to address specific questions related to the development of pediatric vaccines.

Rotavirus Vaccine Response Correlates with the Infant Gut Microbiota Composition in Pakistan

NARCIS (Netherlands)

Harris, Vanessa; Ali, Asad; Fuentes, Susana; Korpela, Katri; Kazi, Momin; Tate, Jacqueline; Parashar, Umesh; Wiersinga, W. Joost; Giaquinto, Carlo; de Weerth, Carolina; de Vos, Willem M.

2017-01-01

Background Rotavirus (RV) is the leading cause of diarrhea-related death in children worldwide, and ninety-five percent of rotavirus deaths occur in Africa and Asia. Rotavirus vaccines (RVV) can dramatically reduce RV deaths, but have low efficacy in low-income settings where they are most needed.

ROTAVIRUS INFECTION. HOW TO REALLY PROTECT CHILDREN FROM SEVERE GASTROENTERITIS?

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T. A. Grechukha

2013-01-01

Full Text Available According to the statistics of the recent 5 years, the share of rotavirus gastroenterites is 44-47% of all acute intestinal infections in children under 5 years of age in the Russian Federation. Up to 5% of mortality rate in children under 5 years of age is connected with rotavirus gastroenteritis. Rotavirus gastroenteritis takes an especially severe course in children of 6-24 months of age. The only reliable method of preventing this infection is vaccination. The authors present information on the rotavirus strains dominant in Russia and abroad, efficacy and safety of immunization with a pentavalent vaccine and the recommended schemes of its administration. This vaccine is registered in the Russian Federation; it is to be first used in the nearest future.

Hospitalizations due to rotavirus gastroenteritis in Catalonia, Spain, 2003-2008

Science.gov (United States)

2011-01-01

Background Rotavirus is the most common cause of severe gastroenteritis among young children in Spain and worldwide. We evaluated hospitalizations due to community and hospital-acquired rotavirus gastroenteritis (RVGE) and estimated related costs in children under 5 years old in Catalonia, Spain. Results We analyzed hospital discharge data from the Catalan Health Services regarding hospital admissions coded as infectious gastroenteritis in children under 5 for the period 2003-2008. In order to estimate admission incidence, we used population estimates for each study year published by the Statistic Institut of Catalonia (Idescat). The costs associated with hospital admissions due to rotavirus diarrhea were estimated for the same years. A decision tree model was used to estimate the threshold cost of rotavirus vaccine to achieve cost savings from the healthcare system perspective in Catalonia. From 2003 through 2008, 10655 children under 5 years old were admitted with infectious gastroenteritis (IGE). Twenty-two percent of these admissions were coded as RVGE, yielding an estimated average annual incidence of 104 RVGE hospitalizations per 100000 children in Catalonia. Eighty seven percent of admissions for RVGE occurred during December through March. The mean hospital stay was 3.7 days, 0.6 days longer than for other IGE. An additional 892 cases of presumed nosocomial RVGE were detected, yielding an incidence of 2.5 cases per 1000 child admissions. Total rotavirus hospitalization costs due to community acquired RVGE for the years 2003 and 2008 were 431,593 and 809,224 €, respectively. According to the estimated incidence and hospitalization costs, immunization would result in health system cost savings if the cost of the vaccine was 1.93 € or less. At a vaccine cost of 187 € the incremental cost per hospitalization prevented is 195,388 € (CI 95% 159,300; 238,400). Conclusions The burden of hospitalizations attributable to rotavirus appeared to be lower in

Influence of oral polio vaccines on performance of the monovalent and pentavalent rotavirus vaccines.

Science.gov (United States)

Patel, Manish; Steele, A Duncan; Parashar, Umesh D

2012-04-27

In recent years, two live, oral rotavirus vaccines have been successfully tested in developing and industrialized countries, and both vaccines are now recommended by the World Health Organization for all children worldwide. Both immunogenicity and efficacy of these rotavirus vaccines has been lower in developing compared to industrialized settings. We reviewed the data on the effect of trivalent OPV on the immunogenicity and efficacy of two rotavirus vaccines currently recommended by the WHO. While rotavirus vaccines have not affected immune responses to OPV, in general, the immune responses (i.e., antibody levels) to rotavirus vaccination were lower when rotavirus vaccines were co-administered with OPV. Limited data suggests that the interference is greater after the first dose of OPV, presumably because the first dose is associated with greatest intestinal replication of vaccine polio virus strains, and this interference is largely overcome with subsequent rotavirus vaccine doses. Despite the lower immunogenicity, one large efficacy study in middle income Latin American countries showed no decrease in protective efficacy of rotavirus vaccine in infants receiving concurrent OPV. While these data are encouraging and support simultaneous administration of rotavirus vaccines and OPV, additional evidence should be gathered as rotavirus vaccines are used more widely in developing country settings, where OPV is routinely used, rather than inactivated polio vaccine. Published by Elsevier Ltd.

Prevalence of Rotavirus in shellfish from Southern Kerala

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Vysakh Mohan

2014-10-01

Full Text Available Aim: To study the prevalence of Rotavirus in shellfish from Southern Kerala. Materials and Methods: The shellfish samples after processing was concentrated using proteinase K. RNA was isolated from the concentrated samples using phenol chloroform method. Rota viral RNA was detected using reverse transcriptionpolymerase chain reaction. Results: A low prevalence of 2.5% (5/200 was obtained during the study. Rotavirus was detected in 2 out of 60 brown mussels (3.33%, 2 out of 70 yellow clams (2.86% and 1 out of 70 black clams (1.43%. Conclusion: Low prevalence of Rotavirus was obtained in our study. A more extensive study need to be conducted to estimate the prevalence of enteric virus in shellfish.

Rotavirus vaccine response correlates with the infant gut microbiota composition in Pakistan

NARCIS (Netherlands)

Harris, Vanessa C.; Ali, Asad; Fuentes, Susana; Korpela, Katri; Kazi, Momin; Tate, Jacqueline; Parashar, Umesh; Wiersinga, W.J.; Giaquinto, Carlo; Weerth, de Carolina; Vos, de Willem M.

2017-01-01

Rotavirus (RV) is the leading cause of diarrhea-related death in children worldwide and ninety-five percent of rotavirus deaths occur in Africa and Asia. Rotavirus vaccines (RVV) can dramatically reduce RV deaths, but have low efficacy in low-income settings where they are most needed. The

Health and economic impact of rotavirus vaccination in GAVI-eligible countries

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Slichter David

2010-05-01

Full Text Available Abstract Background Rotavirus infection is responsible for about 500,000 deaths annually, and the disease burden is disproportionately borne by children in low-income countries. Recently the World Health Organization (WHO has released a global recommendation that all countries include infant rotavirus vaccination in their national immunization programs. Our objective was to provide information on the expected health, economic and financial consequences of rotavirus vaccines in the 72 GAVI support-eligible countries. Methods We synthesized population-level data from various sources (primarily from global-level databases for the 72 countries eligible for the support by the GAVI Alliance (GAVI-eligible countries in order to estimate the health and economic impact associated with rotavirus vaccination programs. The primary outcome measure was incremental cost (in 2005 international dollars [I$] per disability-adjusted life year (DALY averted. We also projected the expected reduction in rotavirus disease burden and financial resources required associated with a variety of scale-up scenarios. Results Under the base-case assumptions (70% coverage, vaccinating one single birth cohort would prevent about 55% of rotavirus associated deaths in the 72 GAVI-eligible countries. Assuming I$25 per vaccinated child (~$5 per dose, the number of countries with the incremental cost per DALY averted less than I$200 was 47. Using the WHO's cost-effectiveness threshold based on per capita GDP, the vaccines were considered cost-effective in 68 of the 72 countries (~94%. A 10-year routine rotavirus vaccination would prevent 0.9-2.8 million rotavirus associated deaths among children under age 5 in the poorest parts of the world, depending on vaccine scale-up scenarios. Over the same intervention period, rotavirus vaccination programs would also prevent 4.5-13.3 million estimated cases of hospitalization and 41-107 million cases of outpatient clinic visits in the same

Probióticos para la prevención de la diarrea asociada al clostridium difficile en adultos y niños

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2014-05-01

Resultados principales: Sobre la base de esta revisión sistemática y del metanálisis de 23 ensayos controlados aleatorios con 4213 pacientes, las pruebas de calidad moderada indican que los probióticos son tanto seguros como efectivos para prevenir la diarrea asociada al Clostridium difficile.

Rotavirus mortality confirmed by etiologic identification in Venezuelan children with diarrhea.

Science.gov (United States)

Pérez-Schael, Irene; Salinas, Belén; González, Rosabel; Salas, Hans; Ludert, Juan Ernesto; Escalona, Marisol; Alcalá, Ana; Rosas, María Alejandra; Materán, Mercedes

2007-05-01

Hospital-based studies to determine the etiology of deaths from diarrhea are scarce. In this study, we specifically analyzed deaths due to rotavirus to assess the rotavirus impact on diarrhea mortality. To determine the rotavirus proportion contributing to mortality due to diarrhea, we analyzed data obtained from a hospital-based mortality surveillance, conducted over 7 years, in the Ciudad Hospitalaria Dr. Enrique Tejera, Valencia, Venezuela. Rotavirus was identified in stool samples collected from children who died of diarrhea, by a confirmatory ELISA and/or reverse transcription polymerase chain reaction. Our results show that rotavirus (21%; 21/100) is the leading cause of death due to diarrhea among children causes in this age group. Shigella spp. (19%; 13/69) was the second most important cause of death, followed by calicivirus (6%; 3/53). Furthermore, this study documents a seasonal pattern in the deaths due to rotavirus (odds ratio 3.28; 95% confidence interval 1.13-9.76). For Venezuela, it is estimated that approximately 300 children cause of death due to diarrhea, which supports previous estimations. This is the first study to present data of cause-specific mortality due to diarrhea based on hospital surveillance of diarrhea etiologies.

Frequency of Rotavirus Infection among Children with Diarrhea in ...

African Journals Online (AJOL)

Background: Rotaviruses are the major cause of gastroenteritis and diarrhea in infants and young children worldwide. Basic epidemiological data concerning rotaviruses among infants and children are necessary for health planners and care providers in Sudan. Method: Cross-sectional study was conducted at Omdurman ...

Rotavirus disease course among immunocompromised patients : 5-year observations from a tertiary care medical centre

NARCIS (Netherlands)

Bruijning-Verhagen, P; Nipshagen, M D; Graaf, H.; Bonten, M J M

2017-01-01

Rotavirus (RV) is highly endemic inside and outside hospital-settings. Immunocompromised children and adults are at risk of complicated rotavirus gastroenteritis (RVGE), but general rotavirus disease severity in this group remains poorly described and rotavirus testing is not routinely performed

Dynamic modeling of cost-effectiveness of rotavirus vaccination, Kazakhstan.

Science.gov (United States)

Freiesleben de Blasio, Birgitte; Flem, Elmira; Latipov, Renat; Kuatbaeva, Ajnagul; Kristiansen, Ivar Sønbø

2014-01-01

The government of Kazakhstan, a middle-income country in Central Asia, is considering the introduction of rotavirus vaccination into its national immunization program. We performed a cost-effectiveness analysis of rotavirus vaccination spanning 20 years by using a synthesis of dynamic transmission models accounting for herd protection. We found that a vaccination program with 90% coverage would prevent ≈880 rotavirus deaths and save an average of 54,784 life-years for children vaccine cost at vaccination program costs would be entirely offset. To further evaluate efficacy of a vaccine program, benefits of indirect protection conferred by vaccination warrant further study.

Sunlight-induced inactivation of human Wa and porcine OSU rotaviruses in the presence of exogenous photosensitizers

KAUST Repository

Romero-Maraccini, Ofelia C.

2013-10-01

Human rotavirus Wa and porcine rotavirus OSU solutions were irradiated with simulated solar UV and visible light in the presence of different photosensitizers dissolved in buffered solutions. For human rotavirus, the exogenous effects were greater than the endogenous effects under irradiation with full spectrum and UVA and visible light at 25 C. For porcine rotavirus, the exogenous effects with UVA and visible light irradiation were only observed at high temperatures, >40 C. The results from dark experiments conducted at different temperatures suggest that porcine rotavirus has higher thermostability than human rotavirus. Concentrations of 3′-MAP excited triplet states of 1.8 fM and above resulted in significant human rotavirus inactivation. The measured excited triplet state concentrations of ≤0.45 fM produced by UVA and visible light irradiation of natural dissolved organic matter solutions were likely not directly responsible for rotavirus inactivation. Instead, the linear correlation for human rotavirus inactivation rate constant (kobs) with the phenol degradation rate constant (kexp) found in both 1 mM NaHCO3 and 1 mM phosphate-buffered solutions suggested that OH radical was a major reactive species for the exogenous inactivation of rotaviruses. Linear correlations between rotavirus kobs and specific UV254 nm absorbance of two river-dissolved organic matter and two effluent organic matter isolates indicated that organic matter aromaticity may help predict formation of radicals responsible for rotavirus inactivation. The results from this study also suggested that the differences in rotavirus strains should be considered when predicting solar inactivation of rotavirus in sunlit surface waters. © 2013 American Chemical Society.

Gene-Specific-Candidate-Driven Study to decipher Genetic Predisposition to Rotavirus Infection

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Kshitija Rane-Yadav

2017-10-01

Full Text Available Recent report of WHO shows 113000 children in India succumb to death due to Rotavirus diarrhea. Lack of knowledge about pathogenesis of virus has led to lack of therapy for severely infected patients. Previous studies have found that, animal rotavirus requires sialyl glycan moieties on cell surface for pathogenesis. Present study states that human rotaviruses also follows same path and this specificity of virus leads to host genetic predisposition for the infection as well as the disease. Two hundred children less than 5 years of age clinically suspected of viral diarrhea were screened for rotavirus infection. EDTA blood was processed for analyzing DNA sequences of various fucosyltransferase genes. Lewis antigens which are secretory form of ABO Histo Blood Group Antigens were correlated with the genotype of patient. Genetics of HBGA secretion, particularly, basis of Leb expression manifested by fucosyltransferase-2 enzyme was studied in healthy individuals and was compared in cases of rotavirus positive and negative diarrhea. Positive clinical isolates with various genotypes were purified from stool samples and gene for VP4 - surface spike protein was sequenced. Using Bioinformatics interphase, three dimensional protein structures were modeled and their functional domains were analyzed. All these modeled proteins were docked with Leb HBGA (Lewis-b Histo Blood Group Antigens using molecular docking software. In present study, to investigate possible association of the rotavirus with host genome, we screened highly suspected genes involved in expression of glycoproteins on enterocytes. This study performed for prevalent Indian strains of rotaviruses provides possible evidence that, VP8 domain of VP4 spike protein utilizes Leb surface antigen for attachment and entry to enterocytes in the intestine. The FUT2 and FUT3 gene has been found to show significant association with the rotavirus infection hence can serve as a biomarker for genetic

Rotavirus vaccine effectiveness in low-income settings: An evaluation of the test-negative design.

Science.gov (United States)

Schwartz, Lauren M; Halloran, M Elizabeth; Rowhani-Rahbar, Ali; Neuzil, Kathleen M; Victor, John C

2017-01-03

The test-negative design (TND), an epidemiologic method currently used to measure rotavirus vaccine (RV) effectiveness, compares the vaccination status of rotavirus-positive cases and rotavirus-negative controls meeting a pre-defined case definition for acute gastroenteritis. Despite the use of this study design in low-income settings, the TND has not been evaluated to measure rotavirus vaccine effectiveness. This study builds upon prior methods to evaluate the use of the TND for influenza vaccine using a randomized controlled clinical trial database. Test-negative vaccine effectiveness (VE-TND) estimates were derived from three large randomized placebo-controlled trials (RCTs) of monovalent (RV1) and pentavalent (RV5) rotavirus vaccines in sub-Saharan Africa and Asia. Derived VE-TND estimates were compared to the original RCT vaccine efficacy estimates (VE-RCTs). The core assumption of the TND (i.e., rotavirus vaccine has no effect on rotavirus-negative diarrhea) was also assessed. TND vaccine effectiveness estimates were nearly equivalent to original RCT vaccine efficacy estimates. Neither RV had a substantial effect on rotavirus-negative diarrhea. This study supports the TND as an appropriate epidemiologic study design to measure rotavirus vaccine effectiveness in low-income settings. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Hospitalization of childhood rotavirus infection from Kuala Lumpur, Malaysia.

Science.gov (United States)

Lee, W S; Veerasingam, P D; Goh, A Y T; Chua, K B

2003-01-01

To determine the epidemiology of rotavirus gastroenteritis in children admitted to an urban hospital in a developing country from South-East Asia. Retrospective review of cases of acute gastroenteritis admitted to the children's ward of the University of Malaya Medical Centre, Kuala Lumpur, Malaysia, between 1996 and 1999. During the study period, 333 cases (24%) of 1362 stool samples, obtained from children admitted with acute diarrhoea, were positive for rotavirus. Acute gastroenteritis constituted 8.2%, and rotavirus infection 1.6% of all the paediatric admissions each year. Of the 271 cases analysed, 72% of the affected population were less than 2 years of age. Peak incidence of admissions was between January to March, and September to October. Dehydration was common (92%) but electrolyte disturbances, lactose intolerance (5.2%), prolonged diarrhoea (2.6%) and cow's milk protein intolerance was uncommon. No deaths were recorded. Rotavirus infection was a common cause of childhood diarrhoea that required hospital admission in an urban setting in Malaysia.

Dynamic Modeling of Cost-effectiveness of Rotavirus Vaccination, Kazakhstan

Science.gov (United States)

Flem, Elmira; Latipov, Renat; Kuatbaeva, Ajnagul; Kristiansen, Ivar Sønbø

2014-01-01

The government of Kazakhstan, a middle-income country in Central Asia, is considering the introduction of rotavirus vaccination into its national immunization program. We performed a cost-effectiveness analysis of rotavirus vaccination spanning 20 years by using a synthesis of dynamic transmission models accounting for herd protection. We found that a vaccination program with 90% coverage would prevent ≈880 rotavirus deaths and save an average of 54,784 life-years for children <5 years of age. Indirect protection accounted for 40% and 60% reduction in severe and mild rotavirus gastroenteritis, respectively. Cost per life year gained was US $18,044 from a societal perspective and US $23,892 from a health care perspective. Comparing the 2 key parameters of cost-effectiveness, mortality rates and vaccine cost at

Zoonotic transmission of rotavirus in Denmark; a case report

DEFF Research Database (Denmark)

Midgley, Sofie; Gram, N.; Hjulsager, Charlotte Kristiane

Rotavirus type A infection is a common cause of hospitalisation of children. In addition, almost 30% of diagnosed persons in Denmark are adults. Rotavirus type A infection can also occur in a range of animals, including domestic dogs, cats, cattle, horses, and birds. There is some data suggesting...... direct transmission between animals and humans. Rotavirus genotyping is carried out in Denmark as part of the EUROTAnet vaccine study. In 2006 a total of 180 samples were successfully typed, and to date 85 samples from 2007 have been typed. 19 samples from pigs and 31 samples from cattle (from 2006...... and 2007) have also been typed. For the human samples all common human G types (1-4 and 9), as well the emerging G12 were identified, and were found in combination with the common P types ([4], [6], and [8]). Two samples contained a G8 P[goat] rotavirus (G8 98% identical to bovine G8, 96% identical to goat...

The Control of Rotavirus Gastroenteritis in The United States

Science.gov (United States)

Glass, Roger I.; Parashar, Umesh; Patel, Manish; Tate, Jacqueline; Jiang, Baoming; Gentsch, Jon

2012-01-01

Since 2006, two new vaccines have been licensed to prevent rotavirus, the cause of 20% to 50% of severe acute gastroenteritis in young children worldwide. These vaccines have been implemented in national immunization programs in about 30 high- and middle-income countries, including the United States, and vaccine use has led to substantial decreases in diarrhea-related health care visits. In addition to reductions in diarrhea burden in vaccinated children, decreases have been observed in older, unvaccinated age groups in many settings, suggesting indirect benefits (i.e., herd immunity) from vaccination. Although the efficacy of these oral rotavirus vaccines is expectedly lower in developing countries in Asia and Africa, the public health benefits of vaccination in these settings, where more than 90% of the estimated 453,000 annual deaths from rotavirus occur, are likely to be substantial. Efforts continue to develop alternative rotavirus vaccines that could have a better efficacy and safety profile and may be less expensive. PMID:23303967

Delayed Dosing of Oral Rotavirus Vaccine Demonstrates Decreased Risk of Rotavirus Gastroenteritis Associated With Serum Zinc: A Randomized Controlled Trial.

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Colgate, E Ross; Haque, Rashidul; Dickson, Dorothy M; Carmolli, Marya P; Mychaleckyj, Josyf C; Nayak, Uma; Qadri, Firdausi; Alam, Masud; Walsh, Mary Claire; Diehl, Sean A; Zaman, K; Petri, William A; Kirkpatrick, Beth D

2016-09-01

Rotavirus is the world's leading cause of childhood diarrheal death. Despite successes, oral rotavirus vaccines are less effective in developing countries. In an urban slum of Dhaka, we performed active diarrhea surveillance to evaluate monovalent G1P[8] rotavirus vaccine (RV1) efficacy and understand variables contributing to risk of rotavirus diarrhea (RVD). We performed a randomized controlled trial of monovalent oral rotavirus vaccine (RV1). Seven hundred healthy infants received RV1 or no RV1 (1:1) using delayed dosing (10 and 17 weeks) and were followed for 1 year. Intensive diarrhea surveillance was performed. The primary outcome was ≥1 episode of RVD. Nutritional, socioeconomic, and immunologic factors were assessed by logistic regression best-subsets analysis for association with risk of RVD and interactions with vaccine arm. Incidence of all RVD was 38.3 cases per 100 person-years. Per-protocol RV1 efficacy was 73.5% (95% confidence interval [CI], 45.8%-87.0%) against severe RVD and 51% (95% CI, 33.8%-63.7%) against all RVD. Serum zinc level (odds ratio [OR], 0.77; P = .002) and lack of rotavirus immunoglobulin A (IgA) seroconversion (OR, 1.95; P = .018) were associated with risk of RVD, independent of vaccination status. Water treatment and exclusive breastfeeding were of borderline significance. Factors not associated with RVD included height for age at 10 weeks, vitamin D, retinol binding protein, maternal education, household income, and sex. In an urban slum with high incidence of RVD, the efficacy of RV1 against severe RVD was higher than anticipated in the setting of delayed dosing. Lower serum zinc level and lack of IgA seroconversion were associated with increased risk of RVD independent of vaccination. NCT01375647. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Modern Views on Rotavirus Infection in Children: Epidemiological and Clinicopathogenetic Features

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G.O. Lezhenko

2014-04-01

Full Text Available Based on the analysis of epidemiological, clinical and laboratory data characterizing the course of rotavirus infection in children of Zaporizhya region, there are provided the modern features of the disease. The authors marked dynamic changes in clinical and laboratory parameters of lactase deficiency, which occur during rotavirus infection in infants. The efficiency of Saccharomyces boulardii in complex treatment of rotavirus infection in children is shown.

Characterization of rotavirus strains detected among children and adults with acute gastroenteritis in Ganozan, Saudi Arabia

International Nuclear Information System (INIS)

Kheyami, Ali M.; Dove, W.; Cunliffe, Nigel A.; Hart, C.A.; Areeshi, Mohammed Y.; Nakagomi, O.

2008-01-01

Objective was to assess the circulating rotavirus strains among hospitalized children and adults in Gizan City. This cross-sectional study was based in 5 hospitals in the Gizan area. Stool samples were collected between November 2004 and March 2005 from sequential patients with acute dehydrating diarrhea. Rotavirus antigen was detected in stool by enzyme-linked immunosorbent assay. The diversity of rotavirus strains was investigated using electropherotyping and reverse transcription-polymerase chain reaction amplification of the VP7 and VP4 genes (G and P genotyping). Rotavirus was detected in 54 of 454 (12%) subjects. The ages of those infected with rotavirus ranged from 15 days to 20 years, with a median age of 36 months. The highest rotavirus detection rate (24%) occurred in children in aged 48-59 months. Overall, 50 (93%) of strains could be assigned both a G- and P- type; G1P (8) was the most frequently detected strain type (n=48, 89%) with one rotavirus each of G2P (4) and G9P (8). Rotavirus strains circulating in Gizan would be well covered by current rotavirus vaccines. Rotavirus serotype G9 has been detected in Saudi Arabia for the first time. Continued surveillance of rotavirus strains is required. (author)

Milk Oligosaccharides Inhibit Human Rotavirus Infectivity in MA104 Cells.

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Laucirica, Daniel R; Triantis, Vassilis; Schoemaker, Ruud; Estes, Mary K; Ramani, Sasirekha

2017-09-01

Background: Oligosaccharides in milk act as soluble decoy receptors and prevent pathogen adhesion to the infant gut. Milk oligosaccharides reduce infectivity of a porcine rotavirus strain; however, the effects on human rotaviruses are less well understood. Objective: In this study, we determined the effect of specific and abundant milk oligosaccharides on the infectivity of 2 globally dominant human rotavirus strains. Methods: Four milk oligosaccharides-2'-fucosyllactose (2'FL), 3'-sialyllactose (3'SL), 6'-sialyllactose (6'SL), and galacto-oligosaccharides-were tested for their effects on the infectivity of human rotaviruses G1P[8] and G2P[4] through fluorescent focus assays on African green monkey kidney epithelial cells (MA104 cells). Oligosaccharides were added at different time points in the infectivity assays. Infections in the absence of oligosaccharides served as controls. Results: When compared with infections in the absence of glycans, all oligosaccharides substantially reduced the infectivity of both human rotavirus strains in vitro; however, virus strain-specific differences in effects were observed. Compared with control infections, the maximum reduction in G1P[8] infectivity was seen with 2'FL when added after the onset of infection (62% reduction, P rotaviruses in MA104 cells, primarily through an effect on the virus. Although breastfed infants are directly protected, the addition of specific oligosaccharides to infant formula may confer these benefits to formula-fed infants. © 2017 American Society for Nutrition.

Heterogeneity of Rotavirus Vaccine Efficacy Among Infants in Developing Countries.

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Gruber, Joann F; Hille, Darcy A; Liu, G Frank; Kaplan, Susan S; Nelson, Micki; Goveia, Michelle G; Mast, T Christopher

2017-01-01

Rotavirus is the leading cause of severe diarrhea worldwide in young children. Although rotavirus vaccine efficacy is high in developed countries, efficacy is lower in developing countries. Here, we investigated heterogeneity of rotavirus vaccine efficacy by infant characteristics in developing countries. An exploratory, post hoc analysis was conducted using randomized controlled trial data of the pentavalent rotavirus vaccine (RV5) conducted in Africa and Asia (NCT00362648). Infants received either 3 doses of vaccine/placebo and were followed for up to 2 years. Within subgroups, vaccine efficacies and 95% confidence intervals (CIs) against rotavirus gastroenteritis (RVGE) were estimated using Poisson regression. We assessed heterogeneity of efficacy by age at first dose, gender, breastfeeding status and nutrition status. African children receiving the first dose at efficacy (23.7%; 95% CI: -8.2%-46.3%) than those vaccinated at ≥8 weeks (59.1%; 95% CI: 34.0%-74.6%). Marginally statistically significant differences were observed by age at first dose, gender and underweight status in Ghana and gender in Asian countries. Heterogeneity of efficacy was observed for age at first dose in African countries. This was an exploratory analysis; additional studies are needed to validate these results.

Rotavirus vaccine and diarrhea mortality: quantifying regional variation in effect size

OpenAIRE

Fischer Walker, Christa L; Black, Robert E

2011-01-01

Abstract Background Diarrhea mortality remains a leading cause of child death and rotavirus vaccine an effective tool for preventing severe rotavirus diarrhea. New data suggest vaccine efficacy may vary by region. Methods We reviewed published vaccine efficacy trials to estimate a regional-specific effect of vaccine efficacy on severe rotavirus diarrhea and hospitalizations. We assessed the quality of evidence using a standard protocol and conducted meta-analyses where more than 1 data point ...

Rotavirus vaccines in Israel: Uptake and impact.

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Muhsen, Khitam; Cohen, Daniel

2017-07-03

We present an overview of the impact of universal rotavirus immunization with the pentavalent vaccine, RotaTeq, which was introduced in Israel in 2010. The vaccine is given free of charge at age 2, 4 and 6 months, with an 80% coverage that was shortly achieved during the universal immunization period. Compared to pre-universal immunization years (2008-2010), a reduction of 66-68% in the incidence of rotavirus gastroenteritis (RVGE) hospitalizations was observed in 2011-2015 among children aged 0-23 months in central and northern Israel. In southern Israel a reduction of 80-88% in RVGE hospital visit rate was found among Jewish children aged 0-23 months in 2011-2013. Among Bedouins, the respective decline was 62-75%. A significant reduction of 59% was also observed in RVGE clinic visits, presumably representing less severe illness. Indirect benefit was evident in children aged 24-59 months who were ineligible for universal immunization. Vaccine effectiveness against RVGE hospitalization was estimated at 86% in children aged 6-23 months. Changes in the circulating rotavirus genotypes occurred but the contribution of vaccine induced immune pressure is unclear. Universal rotavirus immunization was followed by an impressive decrease in the burden of RVGE in young children in Israel, likely attributed to good vaccine coverage and effectiveness.

MAVS protein is attenuated by rotavirus nonstructural protein 1.

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Satabdi Nandi

Full Text Available Rotavirus is the single, most important agent of infantile gastroenteritis in many animal species, including humans. In developing countries, rotavirus infection attributes approximately 500,000 deaths annually. Like other viruses it establishes an intimate and complex interaction with the host cell to counteract the antiviral responses elicited by the cell. Among various pattern recognition receptors (PAMPs of the host, the cytosolic RNA helicases interact with viral RNA to activate the Mitochondrial Antiviral Signaling protein (MAVS, which regulates cellular interferon response. With an aim to identify the role of different PAMPs in rotavirus infected cell, MAVS was found to degrade in a time dependent and strain independent manner. Rotavirus non-structural protein 1 (NSP1 which is a known IFN antagonist, interacted with MAVS and degraded it in a strain independent manner, resulting in a complete loss of RNA sensing machinery in the infected cell. To best of our knowledge, this is the first report on NSP1 functionality where a signaling protein is targeted unanimously in all strains. In addition NSP1 inhibited the formation of detergent resistant MAVS aggregates, thereby averting the antiviral signaling cascade. The present study highlights the multifunctional role of rotavirus NSP1 and reinforces the fact that the virus orchestrates the cellular antiviral response to its own benefit by various back up strategies.

History of rotavirus research in children in Malawi: the pursuit of a killer

African Journals Online (AJOL)

Rotavirus gastroenteritis is a major health problem among Malawian children. Studies spanning 20 years have described the importance, epidemiology and viral characteristics of rotavirus infections in the country. Despite a wide diversity of circulating rotavirus strains causing severe disease in young infants, a clinical trial ...

Engineering and expression of a human rotavirus candidate vaccine in Nicotiana benthamiana.

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Pêra, Francisco F P G; Mutepfa, David L R; Khan, Ayesha M; Els, Johann H; Mbewana, Sandiswa; van Dijk, Alberdina A A; Rybicki, Edward P; Hitzeroth, Inga I

2015-12-02

Human rotaviruses are the main cause of severe gastroenteritis in children and are responsible for over 500 000 deaths annually. There are two live rotavirus vaccines currently available, one based on human rotavirus serotype G1P[8], and the other a G1-G4 P[8] pentavalent vaccine. However, the recent emergence of the G9 and other novel rotavirus serotypes in Africa and Asia has prompted fears that current vaccines might not be fully effective against these new varieties. We report an effort to develop an affordable candidate rotavirus vaccine against the new emerging G9P[6] (RVA/Human-wt/ZAF/GR10924/1999/G9P[6]) strain. The vaccine is based on virus-like particles which are both highly immunogenic and safe. The vaccine candidate was produced in Nicotiana benthamiana by transient expression, as plants allow rapid production of antigens at lower costs, without the risk of contamination by animal pathogens. Western blot analysis of plant extracts confirmed the successful expression of two rotavirus capsid proteins, VP2 and VP6. These proteins assembled into VLPs resembling native rotavirus particles when analysed by transmission electron microscopy (TEM). Expression of the rotavirus glycoprotein VP7 and the spike protein VP4 was also tried. However, VP7 expression caused plant wilting during the course of the time trial and expression could never be detected for either protein. We therefore created three fusion proteins adding the antigenic part of VP4 (VP8*) to VP6 in an attempt to produce more appropriately immunogenic particles. Fusion protein expression in tobacco plants was detected by western blot using anti-VP6 and anti-VP4 antibodies, but no regular particles were observed by TEM, even when co-expressed with VP2. Our results suggest that the rotavirus proteins produced in N. benthamiana are candidates for a subunit vaccine specifically for the G9P[6] rotavirus strain. This could be more effective in developing countries, thereby possibly providing a higher

Rotavirus - Global research density equalizing mapping and gender analysis.

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Köster, Corinna; Klingelhöfer, Doris; Groneberg, David A; Schwarzer, Mario

2016-01-02

Rotaviruses are the leading reason for dehydration and severe diarrheal disease and in infants and young children worldwide. An increasing number of related publications cause a crucial challenge to determine the relevant scientific output. Therefore, scientometric analyses are helpful to evaluate quantity as well as quality of the worldwide research activities on Rotavirus. Up to now, no in-depth global scientometric analysis relating to Rotavirus publications has been carried out. This study used scientometric tools and the method of density equalizing mapping to visualize the differences of the worldwide research effort referring to Rotavirus. The aim of the study was to compare scientific output geographically and over time by using an in-depth data analysis and New quality and quantity indices in science (NewQIS) tools. Furthermore, a gender analysis was part of the data interpretation. We retrieved all Rotavirus-related articles, which were published on "Rotavirus" during the time period from 1900 to 2013, from the Web of Science by a defined search term. These items were analyzed regarding quantitative and qualitative aspects, and visualized with the help of bibliometric methods and the technique of density equalizing mapping to show the differences of the worldwide research efforts. This work aimed to extend the current NewQIS platform. The 5906 Rotavirus associated articles were published in 138 countries from 1900 to 2013. The USA authored 2037 articles that equaled 34.5% of all published items followed by Japan with 576 articles and the United Kingdom - as the most productive representative of the European countries - with 495 articles. Furthermore, the USA established the most cooperations with other countries and was found to be in the center of an international collaborative network. We performed a gender analysis of authors per country (threshold was set at a publishing output of more than 100 articles by more than 50 authors whose names could be

Cost-effectiveness of rotavirus immunization in Vietnam: Results and challenges

NARCIS (Netherlands)

Tu, H.A.T.; Rozenbaum, M.; Coyte, P.C.; Li, S.C.; Postma, M.J.

2011-01-01

OBJECTIVES: To assess the cost-effectiveness of universal rotavirus immunization, explicitly the use of Rotateq® and affordability of implementing rotavirus immunization based on the Global Alliance for Vaccines and Immunization (GAVI)-subsidized vaccine price in the context of Vietnamese health

Identification of co-infection by rotavirus and parvovirus in dogs with gastroenteritis in Mexico

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Ariadna Flores Ortega

Full Text Available ABSTRACT This is the first report on circulating canine rotavirus in Mexico. Fifty samples from dogs with gastroenteritis were analyzed used polymerase chain reaction and reverse transcription polymerase chain reaction in order to identify parvovirus and rotavirus, respectively; 7% of dogs were infected with rotavirus exclusively, while 14% were co-infected with both rotavirus and parvovirus; clinical signs in co-infected dogs were more severe.

Rotavirus vaccine effectiveness in preventing hospitalizations due to gastroenteritis: a descriptive epidemiological study from Germany.

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Pietsch, C; Liebert, U G

2018-04-10

Rotavirus infections are common causes of infant hospitalization. The present study examined the effectiveness of anti-rotavirus vaccination in preventing rotavirus-related hospitalizations in Germany, following its state and nationwide introductions in 2008 and 2013, respectively. During 15 consecutive seasons 9557 stool samples of hospitalized children of 5 years and younger with acute gastroenteritis were screened for rotavirus A. Rotavirus G and P genotypes were assessed after vaccine introduction. Vaccine effectiveness was determined by comparison of rotavirus incidence in pre-vaccine and post-vaccine cohorts. The herd effect was calculated as the difference between the observed reduction of rotavirus-related hospitalizations and the expected direct vaccine effect. The number of rotavirus-related hospitalizations declined after vaccine introduction. Approximately 26% (503/1955) of prevented cases could be attributed to the herd effect. Human rotaviruses of genotypes G3P[8], G1P[8], G9P[8], G4P[8], G2P[4] and G12P[8] were most frequent. Uncommon genotypes remained rare. The direct, indirect, total and overall vaccine effectiveness was 86% (95% confidence interval (CI) 83.2-89.1%), 48% (95% CI 42.8-52.6%), 93% (95% CI 91.3-94.3%) and 69% (95% CI 66.5-72.0%), respectively. There was no significant difference in vaccine-type or in genotype-specific vaccine effectiveness. Anti-rotavirus vaccination efficiently reduced rotavirus-related hospitalizations in Germany in the past decade. The vaccines analysed in this article provide a broadly heterologous and long-lasting protection. The herd effect substantially contributed to the observed drop in the number of incidences of severe rotavirus infections. Presumably, constant high vaccine coverage will lead to a continued upward trend in the overall vaccine efficiency. Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Effect of human rotavirus vaccine on severe diarrhea in African infants.

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Madhi, Shabir A; Cunliffe, Nigel A; Steele, Duncan; Witte, Desirée; Kirsten, Mari; Louw, Cheryl; Ngwira, Bagrey; Victor, John C; Gillard, Paul H; Cheuvart, Brigitte B; Han, Htay H; Neuzil, Kathleen M

2010-01-28

Rotavirus is the most common cause of severe gastroenteritis among young children worldwide. Data are needed to assess the efficacy of the rotavirus vaccine in African children. We conducted a randomized, placebo-controlled, multicenter trial in South Africa (3166 infants; 64.1% of the total) and Malawi (1773 infants; 35.9% of the total) to evaluate the efficacy of a live, oral rotavirus vaccine in preventing severe rotavirus gastroenteritis. Healthy infants were randomly assigned in a 1:1:1 ratio to receive two doses of vaccine (in addition to one dose of placebo) or three doses of vaccine--the pooled vaccine group--or three doses of placebo at 6, 10, and 14 weeks of age. Episodes of gastroenteritis caused by wild-type rotavirus during the first year of life were assessed through active follow-up surveillance and were graded with the use of the Vesikari scale. A total of 4939 infants were enrolled and randomly assigned to one of the three groups; 1647 infants received two doses of the vaccine, 1651 infants received three doses of the vaccine, and 1641 received placebo. Of the 4417 infants included in the per-protocol efficacy analysis, severe rotavirus gastroenteritis occurred in 4.9% of the infants in the placebo group and in 1.9% of those in the pooled vaccine group (vaccine efficacy, 61.2%; 95% confidence interval, 44.0 to 73.2). Vaccine efficacy was lower in Malawi than in South Africa (49.4% vs. 76.9%); however, the number of episodes of severe rotavirus gastroenteritis that were prevented was greater in Malawi than in South Africa (6.7 vs. 4.2 cases prevented per 100 infants vaccinated per year). Efficacy against all-cause severe gastroenteritis was 30.2%. At least one serious adverse event was reported in 9.7% of the infants in the pooled vaccine group and in 11.5% of the infants in the placebo group. Human rotavirus vaccine significantly reduced the incidence of severe rotavirus gastroenteritis among African infants during the first year of life. (Clinical

Group A rotavirus gastroenteritis: post-vaccine era, genotypes and zoonotic transmission

Science.gov (United States)

Luchs, Adriana; Timenetsky, Maria do Carmo Sampaio Tavares

2016-01-01

ABSTRACT This article provides a review of immunity, diagnosis, and clinical aspects of rotavirus disease. It also informs about the changes in epidemiology of diarrheal disease and genetic diversity of circulating group A rotavirus strains following the introduction of vaccines. Group A rotavirus is the major pathogen causing gastroenteritis in animals. Its segmented RNA genome can lead to the emergence of new or unusual strains in human populations via interspecies transmission and/or reassortment events. PMID:27462899

Rotavirus Virus-Like Particles as Surrogates in Environmental Persistence and Inactivation Studies

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Caballero, Santiago; Abad, F. Xavier; Loisy, Fabienne; Le Guyader, Françoise S.; Cohen, Jean; Pintó, Rosa M.; Bosch, Albert

2004-01-01

Virus-like particles (VLPs) with the full-length VP2 and VP6 rotavirus capsid proteins, produced in the baculovirus expression system, have been evaluated as surrogates of human rotavirus in different environmental scenarios. Green fluorescent protein-labeled VLPs (GFP-VLPs) and particles enclosing a heterologous RNA (pseudoviruses), whose stability may be monitored by flow cytometry and antigen capture reverse transcription-PCR, respectively, were used. After 1 month in seawater at 20°C, no significant differences were observed between the behaviors of GFP-VLPs and of infectious rotavirus, whereas pseudovirus particles showed a higher decay rate. In the presence of 1 mg of free chlorine (FC)/liter both tracers persisted longer in freshwater at 20°C than infectious viruses, whereas in the presence of 0.2 mg of FC/liter no differences were observed between tracers and infectious rotavirus at short contact times. However, from 30 min of contact with FC onward, the decay of infectious rotavirus was higher than that of recombinant particles. The predicted Ct value for a 90% reduction of GFP-VLPs or pseudoviruses induces a 99.99% inactivation of infectious rotavirus. Both tracers were more resistant to UV light irradiation than infectious rotavirus in fresh and marine water. The effect of UV exposure was more pronounced on pseudovirus than in GFP-VLPs. In all types of water, the UV dose to induce a 90% reduction of pseudovirus ensures a 99.99% inactivation of infectious rotavirus. Recombinant virus surrogates open new possibilities for the systematic validation of virus removal practices in actual field situations where pathogenic agents cannot be introduced. PMID:15240262

Rotavirus gastroenteritis in children in 4 regions in Brazil: a hospital-based surveillance study.

Science.gov (United States)

Munford, Veridiana; Gilio, Alfredo Elias; de Souza, Eloisa Correa; Cardoso, Debora Morais; Cardoso, Divina das Dores de Paula; Borges, Ana Maria Tavares; Costa, Paulo Sergio Sucasas da; Melgaço, Irene Angela Melo; Rosa, Humberto; Carvalho, Paulo Roberto Antonacci; Goldani, Marcelo Zubaran; Moreira, Edson Duarte; Santana, Ciria; El Khoury, Antoine; Ikedo, Fabio; Rácz, Maria Lucia

2009-11-01

Rotavirus is a major cause of gastroenteritis in children. Knowledge of rotavirus genotypes is important for vaccination strategies. During 2005-2006, rotavirus surveillance studies were conducted in São Paulo, Salvador, Goiânia, and Porto Alegre, Brazil. Stool samples were collected from children <5 years of age who had diarrhea and were screened by the Rotaclone Enzyme Immunoassay for the presence of rotavirus. Confirmed rotavirus-positive samples were characterized for P and G genotypes by reverse-transcriptase polymerase chain reaction. A total of 510 stool samples were collected. Of these, 221 (43.3%) were positive for rotavirus. Overall, G9 was the predominant G type, followed by G2, and G1; P[4] and P[8] were the predominant P types. The most frequent G/P genotype combination detected was G2P[4], followed by G9P[8], G9P[4], and G1P[8]. G2P[4] was the predominant type in Goiânia and Salvador; G9P[8] and G1P[8] were predominant in São Paulo and Porto Alegre, respectively. The prevalence, seasonality, and genotype distribution of rotavirus infection varied in different regions in Brazil. With immunization programs, continuous monitoring of rotavirus types is important to detect novel and emerging strains.

Evidence for presumable feline origin of sporadic G6P[9] rotaviruses in humans.

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Pietsch, Corinna; Liebert, Uwe G

2018-05-31

Species A rotaviruses are highly diverse and impose a substantial burden to human and animal health. Interspecies transmission between livestock, domestic animals and humans is commonly observed, but spread of animal-like rotaviruses within the human population is limited. During the continued monitoring of rotavirus strains in Germany, an unusual G6P[9] rotavirus strain was detected in feces of a child. The complete rotavirus coding sequences revealed a unique G6-P[9]-I2-R2-C2-M2-A3-N2-T3-E2-H3 genotype constellation. The virus was phylogenetically related to feline G3P[9] strains and other human G6P[9] rotaviruses of presumable zoonotic origin. Analysis of primer binding sites of G6 specific genotyping revealed further evidence of a G6P[9] feline reservoir. Moreover, substantial deficits of conventional semi-nested PCR genotyping approaches in detecting contemporary G6P[9] were revealed. Rotavirus strain GER29-14 most likely resulted from a direct or recent interspecies transmission from a cat to human. Further studies could assess nucleic acid sequences and genotype constellations of feline rotavirus to confirm the likely feline origin of sporadic human G6P[9] strains. Copyright © 2018 Elsevier B.V. All rights reserved.

Emergence of Double- and Triple-Gene Reassortant G1P[8] Rotaviruses Possessing a DS-1-Like Backbone after Rotavirus Vaccine Introduction in Malawi.

Science.gov (United States)

Jere, Khuzwayo C; Chaguza, Chrispin; Bar-Zeev, Naor; Lowe, Jenna; Peno, Chikondi; Kumwenda, Benjamin; Nakagomi, Osamu; Tate, Jacqueline E; Parashar, Umesh D; Heyderman, Robert S; French, Neil; Cunliffe, Nigel A; Iturriza-Gomara, Miren

2018-02-01

To combat the high burden of rotavirus gastroenteritis, multiple African countries have introduced rotavirus vaccines into their childhood immunization programs. Malawi incorporated a G1P[8] rotavirus vaccine (Rotarix) into its immunization schedule in 2012. Utilizing a surveillance platform of hospitalized rotavirus gastroenteritis cases, we examined the phylodynamics of G1P[8] rotavirus strains that circulated in Malawi before (1998 to 2012) and after (2013 to 2014) vaccine introduction. Analysis of whole genomes obtained through next-generation sequencing revealed that all randomly selected prevaccine G1P[8] strains sequenced ( n = 32) possessed a Wa-like genetic constellation, whereas postvaccine G1P[8] strains ( n = 18) had a DS-1-like constellation. Phylodynamic analyses indicated that postvaccine G1P[8] strains emerged through reassortment events between human Wa- and DS-1-like rotaviruses that circulated in Malawi from the 1990s and hence were classified as atypical DS-1-like reassortants. The time to the most recent common ancestor for G1P[8] strains was from 1981 to 1994; their evolutionary rates ranged from 9.7 × 10 -4 to 4.1 × 10 -3 nucleotide substitutions/site/year. Three distinct G1P[8] lineages chronologically replaced each other between 1998 and 2014. Genetic drift was the likely driver for lineage turnover in 2005, whereas replacement in 2013 was due to reassortment. Amino acid substitution within the outer glycoprotein VP7 of G1P[8] strains had no impact on the structural conformation of the antigenic regions, suggesting that it is unlikely that they would affect recognition by vaccine-induced neutralizing antibodies. While the emergence of DS-1-like G1P[8] rotavirus reassortants in Malawi was therefore likely due to natural genotype variation, vaccine effectiveness against such strains needs careful evaluation. IMPORTANCE The error-prone RNA-dependent RNA polymerase and the segmented RNA genome predispose rotaviruses to genetic mutation and

Geo(spatial) Health Investigation of Rotavirus in an Endemic Region: Hydroclimatic Influences and Epidemiology of Rotavirus in Bangladesh

Science.gov (United States)

Hasan, M. A.; Akanda, A. S.; Jutla, A.; Colwell, R. R.

2016-12-01

Rotavirus is the leading cause of severe dehydrating diarrhea among children under 5. Over 80% of the approximate half a million child deaths every year occur in South Asia and sub-Saharan Africa alone. Although less explored than cholera as a climate driven and influenced global health problem, recent studies have showed that the disease shown strong seasonality and spatio-temporal variability depending on regional hydroclimatic and local environmental conditions. Understanding the epidemiology of this disease, especially the spatio-temporal incidence patterns with respect to environmental factors is vitally important to allow for identification of "hotspots", preventative preparations, and vaccination strategies to improve wellbeing of the vulnerable populations. With climate change, spatio-temporal signatures and footprints of the disease are changing along with increasing burden. However, a robust understanding of the relationships between rotavirus epidemiology and hydroclimatic drivers is yet to be developed. In this study, we evaluate the seasonality and epidemiologic characteristics of rotavirous infection and its spatio-temporal incidence patterns with respect to regional hydroclimatic variables and their extremes in an endemic region in South Asia. Hospital-based surveillance data from different geographic locations allowed us to explore the detailed spatial and temporal characteristics of rotavirus propagation under the influence of climate variables in both coastal and inland areas. The rotavirus transmission patterns show two peaks in a year in the capital city of Dhaka, where winter season (highest in January) shows a high peak and the July-August monsoon season shows a smaller peak. Correlation with climate variables revealed that minimum temperature has strong influence on the winter season outbreak, while rainfall extremes show a strong positive association with the secondary monsoon peak. Spatial analysis also revealed that humidity and soil

Prevalence and factors associated with rotavirus infection among children admitted with acute diarrhea in Uganda

Directory of Open Access Journals (Sweden)

Mworozi Edison A

2010-09-01

Full Text Available Abstract Background Rotavirus remains the commonest cause of severe dehydrating diarrhea among children worldwide. Children in developing countries die more because of several factors including poorer access to hydration therapy and greater prevalence of malnutrition. Hitherto, the magnitude of rotavirus disease in Uganda has remained unknown. This study was therefore done to determine the prevalence and factors associated with rotavirus infection among children aged 3-59 months admitted with acute diarrhea to paediatric emergency ward of Mulago Hospital, Uganda Methods Three hundred and ninety children, aged between 3-59 months with acute diarrhoea were recruited. The clinical history, socio-demographic characteristics, physical examination findings and laboratory investigations were recorded. Stool samples were tested for rotavirus antigens using the DAKO IDEIA rotavirus EIA detection kit. Results The prevalence of rotavirus infection was 45.4%. On multivariate analysis rotavirus was significantly associated with a higher education (above secondary level of the mother [OR 1.8; 95% CI 1.1-2.7]; dehydration [OR 1.8; 95% CI 1.1-3.0] and breastfeeding [OR 2.6; 95% CI 1.4-4.0]. Although age was significantly associated with rotavirus on bivariate analysis; this association disappeared on multivariate analysis. No significant association was found between rotavirus infection and nutritional status, HIV status and attendance of day care or school. Conclusions Rotavirus infection is highly prevalent among children with acute diarrhoea admitted to Mulago Hospital in Uganda.

Rotavirus vaccine effectiveness in low-income settings: An evaluation of the test-negative design

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Schwartz, Lauren M.; Halloran, M. Elizabeth; Rowhani-Rahbar, Ali; Neuzil, Kathleen M.; Victor, John C.

2017-01-01

Background The test-negative design (TND), an epidemiologic method currently used to measure rotavirus vaccine (RV) effectiveness, compares the vaccination status of rotavirus-positive cases and rotavirus-negative controls meeting a pre-defined case definition for acute gastroenteritis. Despite the use of this study design in low-income settings, the TND has not been evaluated to measure rotavirus vaccine effectiveness. Methods This study builds upon prior methods to evaluate the use of the T...

Estimated reductions in hospitalizations and deaths from childhood diarrhea following implementation of rotavirus vaccination in Africa.

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Shah, Minesh P; Tate, Jacqueline E; Mwenda, Jason M; Steele, A Duncan; Parashar, Umesh D

2017-10-01

Rotavirus is the leading cause of hospitalizations and deaths from diarrhea. 33 African countries had introduced rotavirus vaccines by 2016. We estimate reductions in rotavirus hospitalizations and deaths for countries using rotavirus vaccination in national immunization programs and the potential of vaccine introduction across the continent. Areas covered: Regional rotavirus burden data were reviewed to calculate hospitalization rates, and applied to under-5 population to estimate baseline hospitalizations. Rotavirus mortality was based on 2013 WHO estimates. Regional pre-licensure vaccine efficacy and post-introduction vaccine effectiveness studies were used to estimate summary effectiveness, and vaccine coverage was applied to calculate prevented hospitalizations and deaths. Uncertainties around input parameters were propagated using boot-strapping simulations. In 29 African countries that introduced rotavirus vaccination prior to end 2014, 134,714 (IQR 112,321-154,654) hospitalizations and 20,986 (IQR 18,924-22,822) deaths were prevented in 2016. If all African countries had introduced rotavirus vaccines at benchmark immunization coverage, 273,619 (47%) (IQR 227,260-318,102) hospitalizations and 47,741 (39%) (IQR 42,822-52,462) deaths would have been prevented. Expert commentary: Rotavirus vaccination has substantially reduced hospitalizations and deaths in Africa; further reductions are anticipated as additional countries implement vaccination. These estimates bolster wider introduction and continued support of rotavirus vaccination programs.

Epidemiology of rotavirus infection among young children with acute diarrhoea in Burkina Faso

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Haukka Kaisa

2010-12-01

Full Text Available Abstract Background In anticipation of vaccine introduction, we assessed epidemiology of rotavirus disease among children visiting medical centre due to acute diarrhoea in Ouagadougou, Burkina Faso. Methods Between November 2008 and February 2010, stool specimens from 447 children less than 5 years of age suffering from diarrhoea were tested for the presence of rotavirus by antigen detection using an immunochromatographic test. Sociodemographic, environmental and clinical factors were assessed during the study. Results Rotavirus antigen was detected in 151 (33.8% of the patients. Most of the cases (94.2% were in children Conclusions The results of this study underscore the need to control rotavirus infections among young children in Burkina Faso and may argue a decision on the introduction of rotavirus vaccine in Burkina Faso.

Identification of co-infection by rotavirus and parvovirus in dogs with gastroenteritis in Mexico.

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Ortega, Ariadna Flores; Martínez-Castañeda, José Simón; Bautista-Gómez, Linda G; Muñoz, Raúl Fajardo; Hernández, Israel Quijano

This is the first report on circulating canine rotavirus in Mexico. Fifty samples from dogs with gastroenteritis were analyzed used polymerase chain reaction and reverse transcription polymerase chain reaction in order to identify parvovirus and rotavirus, respectively; 7% of dogs were infected with rotavirus exclusively, while 14% were co-infected with both rotavirus and parvovirus; clinical signs in co-infected dogs were more severe. Copyright © 2017 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda. All rights reserved.

Efficacy and immunogenicity of two or three dose rotavirus-vaccine regimen in South African children over two consecutive rotavirus-seasons: a randomized, double-blind, placebo-controlled trial.

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Madhi, S A; Kirsten, M; Louw, C; Bos, P; Aspinall, S; Bouckenooghe, A; Neuzil, K M; Steele, A D

2012-04-27

Human rotavirus vaccine (HRV; i.e., Rotarix) reduced the incidence of severe rotavirus gastroenteritis (RVGE) by 77% (95% Confidence interval: 56-88%) during the first year of life in South Africa. Persistence of HRV-derived protection against RVGE during subsequent rotavirus seasons, although evident in industrialized settings, remains to be established in African settings. This study reports on the efficacy of HRV against severe RVGE over two consecutive rotavirus seasons in South African children. A prospective, double-blind, placebo controlled multi-centered trial in South Africa and Malawi randomly assigned infants in a 1:1:1 ratio to receive either two (10 and 14 weeks; HRV_2D) or three (6, 10 and 14 weeks; HRV_3D) doses of HRV or placebo. The primary analysis involved pooling of HRV_2D and HRV_3D arms. Episodes of gastroenteritis caused by wild-type rotavirus were identified through active follow-up surveillance and graded by the Vesikari scale. 1339 infants (447 in the HRV_2D group, 447 in the HRV_3D group and 445 in the placebo group) were enrolled in Year 2 of the study, including 1035 (77.3%) who were followed up over two consecutive rotavirus seasons (i.e., Cohort 2 subjects). Rotarix was associated with ongoing protection against severe RVGE, preventing 2.5 episodes per 100 vaccinated children over two consecutive rotavirus seasons; vaccine efficacy: 59% (95% Confidence interval: 1-83%). An exploratory analysis indicated better immunogenicity (among Cohort 1 subjects) and a higher point-efficacy estimate over two seasons in the HRV_3D compared to HRV_2D arms of the study in Cohort 2 subjects. Rotarix is associated with significant reductions in severe gastroenteritis episodes through 2 years of life among South African children. Further research is needed to determine the optimal dosing schedule of Rotarix in providing long-term protection against rotavirus illness in African children. Copyright © 2011 Elsevier Ltd. All rights reserved.

Differences of Rotavirus Vaccine Effectiveness by Country: Likely Causes and Contributing Factors

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Ulrich Desselberger

2017-12-01

Full Text Available Rotaviruses are a major cause of acute gastroenteritis in infants and young children worldwide and in many other mammalian and avian host species. Since 2006, two live-attenuated rotavirus vaccines, Rotarix® and RotaTeq®, have been licensed in >100 countries and are applied as part of extended program of vaccination (EPI schemes of childhood vaccinations. Whereas the vaccines have been highly effective in high-income countries, they were shown to be considerably less potent in low- and middle-income countries. Rotavirus-associated disease was still the cause of death in >200,000 children of <5 years of age worldwide in 2013, and the mortality is concentrated in countries of sub-Saharan Africa and S.E. Asia. Various factors that have been identified or suggested as being involved in the differences of rotavirus vaccine effectiveness are reviewed here. Recognition of these factors will help to achieve gradual worldwide improvement of rotavirus vaccine effectiveness.

Decreased performance of live attenuated, oral rotavirus vaccines in low-income settings: causes and contributing factors.

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Velasquez, Daniel E; Parashar, Umesh; Jiang, Baoming

2018-02-01

Numerous studies have shown that the oral rotavirus vaccines are less effective in infants born in low income countries compared to those born in developed countries. Identifying the specific factors in developing countries that decrease and/or compromise the protection that rotavirus vaccines offer, could lead to a path for designing new strategies for the vaccines' improvement. Areas covered: We accessed PubMed to identify rotavirus vaccine performance studies (i.e., efficacy, effectiveness and immunogenicity) and correlated performance with several risk factors. Here, we review the factors that might contribute to the low vaccine efficacy, including passive transfer of maternal rotavirus antibodies, rotavirus seasonality, oral polio vaccine (OPV) administered concurrently, microbiome composition and concomitant enteric pathogens, malnutrition, environmental enteropathy, HIV, and histo blood group antigens. Expert commentary: We highlight two major factors that compromise rotavirus vaccines' efficacy: the passive transfer of rotavirus IgG antibodies to infants and the  co-administration of rotavirus vaccines with OPV. We also identify other potential risk factors that require further research because the data about their interference with the efficacy of rotavirus vaccines are inconclusive and at times conflicting.

Rotavirus in the Netherlands : Background information for the Health Council

NARCIS (Netherlands)

Verberk, J D M; Bruijning, P.C.; de Melker, Hester

2017-01-01

Rotavirus can cause a gastrointestinal infection and is common in young children. There are two vaccines available; both have to be administered via the mouth. The Dutch Health Council will advise the Ministry of Health, Welfare and Sport on how childhood vaccination against rotavirus will be made

Distribution of rotavirus genotypes associated with acute diarrhoea in Zimbabwean children less than five years old before and after rotavirus vaccine introduction.

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Mukaratirwa, Arnold; Berejena, Chipo; Nziramasanga, Pasipanodya; Ticklay, Ismail; Gonah, Archebald; Nathoo, Kusum; Manangazira, Portia; Mangwanya, Douglas; Marembo, Joan; Mwenda, Jason M; Weldegebriel, Goitom; Seheri, Mapaseka; Tate, Jacqueline E; Yen, Catherine; Parashar, Umesh; Mujuru, Hilda

2018-04-05

Sentinel surveillance for diarrhoea is important to monitor changes in rotavirus epidemiological trends and circulating genotypes among children under 5 years before and after vaccine introduction. The Zimbabwe Ministry of Health and Child Care introduced rotavirus vaccine in national immunization program in May 2014. Active hospital-based surveillance for diarrhoea was conducted at 3 sentinel sites from 2008 to 2016. Children aged less than 5 years, who presented with acute gastroenteritis as a primary illness and who were admitted to a hospital ward or treated at the emergency unit, were enrolled and had a stool specimen collected and tested for rotavirus by enzyme immunoassay (EIA). Genotyping of positive stools was performed using reverse-transcription polymerase chain reaction and genotyping assays. Pre-vaccine introduction, 10% of all positive stool specimens were genotyped and all adequate positive stools were genotyped post-vaccine introduction. During the pre-vaccine period, a total of 6491 acute gastroenteritis stools were collected, of which 3016 (46%) tested positive for rotavirus and 312 (10%) of the rotavirus positive stools were genotyped. During the post-vaccine period, a total of 3750 acute gastroenteritis stools were collected, of which 937 (25%) tested positive for rotavirus and 784 (84%) were genotyped. During the pre-vaccine introduction the most frequent genotype was G9P[8] (21%) followed by G2P[4] (12%), G1P[8] (6%), G2P[6] (5%), G12P[6] (4%), G9P[6] (3%) and G8P[4] (3%). G1P[8] (30%) was most dominant two years after vaccine introduction followed by G9P[6] (20%), G2P[4] (15%), G9P[8] (11%) and G1P[6] (4%). The decline in positivity rate is an indication of early vaccine impact. Diversity of circulating strains underscores the importance of continued monitoring and strain surveillance after vaccine introduction. Copyright © 2018. Published by Elsevier Ltd.

Influence of birth rates and transmission rates on the global seasonality of rotavirus incidence.

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Pitzer, Virginia E; Viboud, Cécile; Lopman, Ben A; Patel, Manish M; Parashar, Umesh D; Grenfell, Bryan T

2011-11-07

Rotavirus is a major cause of mortality in developing countries, and yet the dynamics of rotavirus in such settings are poorly understood. Rotavirus is typically less seasonal in the tropics, although recent observational studies have challenged the universality of this pattern. While numerous studies have examined the association between environmental factors and rotavirus incidence, here we explore the role of intrinsic factors. By fitting a mathematical model of rotavirus transmission dynamics to published age distributions of cases from 15 countries, we obtain estimates of local transmission rates. Model-predicted patterns of seasonal incidence based solely on differences in birth rates and transmission rates are significantly correlated with those observed (Spearman's ρ = 0.65, p birth rates and transmission rates and explore how vaccination may impact these patterns. Our results suggest that the relative lack of rotavirus seasonality observed in many tropical countries may be due to the high birth rates and transmission rates typical of developing countries rather than being driven primarily by environmental conditions. While vaccination is expected to decrease the overall burden of disease, it may increase the degree of seasonal variation in the incidence of rotavirus in some settings.

Short term clinical outcome of children with rotavirus infection at ...

African Journals Online (AJOL)

Background: Rotavirus infection is the single most common cause of acute gastroenteritis in children under five years of age. Rotavirus gastroenteritis has a high morbidity and mortality in children in Kenya. Objectives: To determine the short term clinical outcome for children admitted to Kenyatta National Hospital with ...

The incidence of infants with rotavirus enteritis combined with lactose intolerance.

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Hu, Yulian; Gui, Linyan; Chang, Jing; Liu, Jingyan; Xu, Shuling; Deng, Caiyan; Yu, Fengqin; Ma, Zhanmin; Wang, Guangzhou; Zhang, Changjun

2016-01-01

This study was to research the incidence of infants with rotavirus enteritis combined with lactose intolerance and the clinical effect of low lactose milk powder for infantile rotavirus enteritis with lactose intolerance. The control groups were 126 cases of infants with diarrhea randomly collected from our hospital at the same period, which their rotavirus detection was negative. The observation group was 185 cases of infants with rotavirus, which was tested to be positive. Through the urine galactose determination, 62 cases of the control group were positive and 124 cases of the observation group were positive. Then 124 cases of infants with rotavirus combined with lactose intolerance were randomly divided into two groups. 60 cases in the control group were given rehydration, correction of acidosis, oral smecta, Intestinal probiotics and other conventional treatment, then continued to the original feeding method. While, 64 cases in the treatment group, on the basis of routine treatment, applied the low lactose milk feeding. To observe the total effective rate for the two groups. The incidence of lactose intolerance in children with rotavirus enteritis (67.03%) was significantly higher than that of children with diarrhea (49.2%), which was tested to be negative. And the difference was statistically significant (plactose intolerance. The low lactose milk powder could improve the therapeutic effectively and could reduce the duration of disease, and restored to normal diet for 2 weeks feeding time.

The VP7 Outer Capsid Protein of Rotavirus Induces Polyclonal B-Cell Activation

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Blutt, Sarah E.; Crawford, Sue E.; Warfield, Kelly L.; Lewis, Dorothy E.; Estes, Mary K.; Conner, Margaret E.

2004-01-01

The early response to a homologous rotavirus infection in mice includes a T-cell-independent increase in the number of activated B lymphocytes in the Peyer's patches. The mechanism of this activation has not been previously determined. Since rotavirus has a repetitively arranged triple-layered capsid and repetitively arranged antigens can induce activation of B cells, one or more of the capsid proteins could be responsible for the initial activation of B cells during infection. To address this question, we assessed the ability of rotavirus and virus-like particles to induce B-cell activation in vivo and in vitro. Using infectious rotavirus, inactivated rotavirus, noninfectious but replication-competent virus, and virus-like particles, we determined that neither infectivity nor RNA was necessary for B-cell activation but the presence of the rotavirus outer capsid protein, VP7, was sufficient for murine B-cell activation. Preincubation of the virus with neutralizing VP7 antibodies inhibited B-cell activation. Polymyxin B treatment and boiling of the virus preparation were performed, which ruled out possible lipopolysaccharide contamination as the source of activation and confirmed that the structural conformation of VP7 is important for B-cell activation. These findings indicate that the structure and conformation of the outer capsid protein, VP7, initiate intestinal B-cell activation during rotavirus infection. PMID:15194774

Overland Transport of Rotavirus and the Effect of Soil Type and Vegetation

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Paul C. Davidson

2016-03-01

Full Text Available Soil and vegetation are two critical factors for controlling the overland transport kinetics of pathogens in a natural environment. With livestock operations moving more towards concentrated animal operations, the need to dispose of a very large amount of manure in a localized area is becoming increasingly important. Animal manure contains a substantial amount of microbial pathogens, including rotavirus, which may pose a threat of contamination of water resources. This study examined the kinetics of rotavirus in overland transport, with an overall objective of optimizing the design of best management practices, especially vegetative filter strips. The overland transport of rotavirus was studied using three soil types (Catlin silt-loam, Darwin silty-clay, Alvin fine sandy-loam, spanning the entire spectrum of typical Illinois soil textures. A 20-min rainfall event was produced using a small-scale (1.07 m × 0.66 m laboratory rainfall simulator over a soil box measuring 0.610 m × 0.305 m. Each soil type was tested for rotavirus transport kinetics with bare surface conditions, as well as with Smooth Brome and Fescue vegetative covers. Surface runoff, near-surface runoff, soil cores, and vegetation were each analyzed for infective rotavirus particles using cell-culture infectivity assays. Results show that vegetation reduces the recovery of infective rotavirus particles in surface runoff by an average of 73%, in addition to delaying the time to peak recovery. The vegetation, in general, appeared to decrease the recovery of infective rotavirus particles in surface runoff by impeding surface flow and increasing the potential for infiltration into the soil profile.

Cost-effectiveness analysis of rotavirus vaccination in Argentina.

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Urueña, Analía; Pippo, Tomás; Betelu, María Sol; Virgilio, Federico; Hernández, Laura; Giglio, Norberto; Gentile, Ángela; Diosque, Máximo; Vizzotti, Carla

2015-05-07

Rotavirus is a leading cause of severe diarrhea in children under 5. In Argentina, the most affected regions are the Northeast and Northwest, where hospitalizations and deaths are more frequent. This study estimated the cost-effectiveness of adding either of the two licensed rotavirus vaccines to the routine immunization schedule. The integrated TRIVAC vaccine cost-effectiveness model from the Pan American Health Organization's ProVac Initiative (Version 2.0) was used to assess health benefits, costs savings, life-years gained (LYGs), DALYs averted, and cost/DALY averted of vaccinating 10 successive cohorts, from the health care system and societal perspectives. Two doses of monovalent (RV1) rotavirus vaccine and three doses of pentavalent (RV5) rotavirus vaccine were each compared to a scenario assuming no vaccination. The price/dose was US$ 7.50 and US$ 5.15 for RV1 and RV5, respectively. We ran both a national and sub-national analysis, discounting all costs and benefits 3% annually. Our base case results were compared to a range of alternative univariate and multivariate scenarios. The number of LYGs was 5962 and 6440 for RV1 and RV5, respectively. The cost/DALY averted when compared to no vaccination from the health care system and societal perspective was: US$ 3870 and US$ 1802 for RV1, and US$ 2414 and US$ 358 for RV5, respectively. Equivalent figures for the Northeast were US$ 1470 and US$ 636 for RV1, and US$ 913 and US$ 80 for RV5. Therefore, rotavirus vaccination was more cost-effective in the Northeast compared to the whole country; and, in the Northwest, health service's costs saved outweighed the cost of introducing the vaccine. Vaccination with either vaccine compared to no vaccination was highly cost-effective based on WHO guidelines and Argentina's 2011 per capita GDP of US$ 9090. Key variables influencing results were vaccine efficacy, annual loss of efficacy, relative coverage of deaths, vaccine price, and discount rate. Compared to no

Frequently Asked Questions about Rotavirus

Science.gov (United States)

... Scientific Achievement John P. Utz Leadership Award Dr. Charles Mérieux Award for Achievement in Vaccinology and Immunology ... There's no reliable way to predict how rotavirus will affect your child. New and expecting parents should ...

Rotavirus Infection in Four States in North-western Nigeria | Aminu ...

African Journals Online (AJOL)

Background: Rotaviruses are associated with ~ 611,000 deaths worldwide and with 33,000 deaths in Nigeria in children < 5 years of age annually. However, limited data exit on rotavirus (RV) infection in North-western Nigeria. This study surveyed RV infection in four states in Northwestern Nigeria. Methods: During July ...

Rotavirus-Like Particles: A Novel Nanocarrier for the Gut

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Naima G. Cortes-Perez

2010-01-01

Full Text Available The delivery of bioactive molecules directly to damaged tissues represents a technological challenge. We propose here a new system based on virus-like particles (VLP from rotavirus, with a marked tropism for the gut to deliver bio-active molecules to intestinal cells. For this, nonreplicative VLP nanoparticles were constructed using a baculovirus expression system and used to deliver an exogenous biomolecule, the green fluorescent protein (GFP, into either MA104 cells or intestinal cells from healthy and 2,4,6-trinitrobenzene sulfonic acid (TNBS-treated mice. Our results show that expression of rotavirus capsid proteins in baculovirus led to the auto assembly of VLP that display similar properties to rotavirus. In vitro experiments showed that VLP were able to enter into MA104 cells and deliver the reporter protein. Intragastric administration of fluorescent VLP in healthy and TNBS-treated mice resulted in the detection of GFP and viral proteins in intestinal samples. Our results demonstrate an efficient entry of non-replicative rotavirus VLP into the epithelial cell line MA104 and provide the first in vivo evidence of the potential of these nanoparticles as a promising safe candidate for drug delivery to intestinal cells.

Prospective study of the burden of rotavirus gastroenteritis in Danish children and their families

DEFF Research Database (Denmark)

Hoffmann, Thomas; Iturriza, Miren; Faaborg-Andersen, Jens

2011-01-01

This was the first study to characterize the total burden of rotavirus gastroenteritis (RVGE) at both hospital and general physician (GP) clinics in Denmark, and also the first to confirm rotavirus (RV) as the leading cause of acute gastroenteritis (GE) among children......This was the first study to characterize the total burden of rotavirus gastroenteritis (RVGE) at both hospital and general physician (GP) clinics in Denmark, and also the first to confirm rotavirus (RV) as the leading cause of acute gastroenteritis (GE) among children...

Rotavirus Vaccines: a story of success with challenges ahead [version 1; referees: 3 approved

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Miguel O’Ryan

2017-08-01

Full Text Available Approximately 40 years have passed since the discovery of the rotavirus and 10 years since the introduction and progressive dissemination of rotavirus vaccines worldwide. Currently, 92 countries have introduced rotavirus vaccines into national or subnational programs with evident impact in disease reduction. Two vaccines have been widely used, and four additional vaccines have been licensed and are being used in defined regions. In this context, one main issue that remains unsolved is the lower vaccine efficacy/effectiveness in low-income countries. An additional partially answered issue relates to rotavirus strain circulation in vaccinated populations. These issues are discussed in this review. The most imperative challenge ahead is to fulfill the WHO’s recommendation to introduce rotavirus vaccines in all countries.

Rotavirus and other enteropathogens in childhood acute diarrhoea: a study of two centres in Malaysia.

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Lee, Way S; Rajasekaran, Ganeswrie; Pee, Susan; Karunakaran, Rina; Hassan, Hamimah H; Puthucheary, Savithri D

2006-09-01

To study the role of rotavirus in children hospitalised for acute gastroenteritis (AGE) in two urban hospitals in Malaysia. A 12-month prospective study (January to December 2002), in children younger than 14 years with AGE hospitalised to the paediatric units of University of Malaya Medical Centre (UMMC), Kuala Lumpur; and Hospital Sultanah Aminah (HSA), Johor Bahru, Malaysia was conducted. In 2002, 399 and 1307 children with AGE were admitted to UMMC and HSA, respectively. Two hundred and eighty-eight (72%) stool samples from UMMC and 901 (69%) samples from HSA were analysed. Rotavirus was the most common aetiological agent identified in both centres (average 32%; UMMC 35%, HSA 30%, P = 0.94). The peak age group for rotavirus-related hospitalisation was 24-35 months for UMMC and 12-23 months for HSA. Nine percent of patients hospitalised for rotavirus infection in UMMC and 22% of patients in HSA were older than 5 years of age. An outbreak of rotavirus infection within the communities served by both centres resulting in an increase in hospital admissions of rotavirus gastroenteritis was observed in both units from January to March 2002. The peak age group for rotavirus-related hospital admission in this study was much older, between 12 to 35 months. It is uncertain whether this was related to the outbreak of rotavirus gastroenteritis observed within two urban areas from January to March 2002 causing re-infection with rotavirus in older children.

Understanding reduced rotavirus vaccine efficacy in low socio-economic settings.

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Benjamin A Lopman

Full Text Available Rotavirus vaccine efficacy ranges from >90% in high socio-economic settings (SES to 50% in low SES. With the imminent introduction of rotavirus vaccine in low SES countries, understanding reasons for reduced efficacy in these settings could identify strategies to improve vaccine performance.We developed a mathematical model to predict rotavirus vaccine efficacy in high, middle and low SES based on data specific for each setting on incidence, protection conferred by natural infection and immune response to vaccination. We then examined factors affecting efficacy.Vaccination was predicted to prevent 93%, 86% and 51% of severe rotavirus gastroenteritis in high, middle and low SES, respectively. Also predicted was that vaccines are most effective against severe disease and efficacy declines with age in low but not high SES. Reduced immunogenicity of vaccination and reduced protection conferred by natural infection are the main factors that compromise efficacy in low SES.The continued risk of severe disease in non-primary natural infections in low SES is a key factor underpinning reduced efficacy of rotavirus vaccines. Predicted efficacy was remarkably consistent with observed clinical trial results from different SES, validating the model. The phenomenon of reduced vaccine efficacy can be predicted by intrinsic immunological and epidemiological factors of low SES populations. Modifying aspects of the vaccine (e.g. improving immunogenicity in low SES and vaccination program (e.g. additional doses may bring improvements.

Understanding reduced rotavirus vaccine efficacy in low socio-economic settings.

Science.gov (United States)

Lopman, Benjamin A; Pitzer, Virginia E; Sarkar, Rajiv; Gladstone, Beryl; Patel, Manish; Glasser, John; Gambhir, Manoj; Atchison, Christina; Grenfell, Bryan T; Edmunds, W John; Kang, Gagandeep; Parashar, Umesh D

2012-01-01

Rotavirus vaccine efficacy ranges from >90% in high socio-economic settings (SES) to 50% in low SES. With the imminent introduction of rotavirus vaccine in low SES countries, understanding reasons for reduced efficacy in these settings could identify strategies to improve vaccine performance. We developed a mathematical model to predict rotavirus vaccine efficacy in high, middle and low SES based on data specific for each setting on incidence, protection conferred by natural infection and immune response to vaccination. We then examined factors affecting efficacy. Vaccination was predicted to prevent 93%, 86% and 51% of severe rotavirus gastroenteritis in high, middle and low SES, respectively. Also predicted was that vaccines are most effective against severe disease and efficacy declines with age in low but not high SES. Reduced immunogenicity of vaccination and reduced protection conferred by natural infection are the main factors that compromise efficacy in low SES. The continued risk of severe disease in non-primary natural infections in low SES is a key factor underpinning reduced efficacy of rotavirus vaccines. Predicted efficacy was remarkably consistent with observed clinical trial results from different SES, validating the model. The phenomenon of reduced vaccine efficacy can be predicted by intrinsic immunological and epidemiological factors of low SES populations. Modifying aspects of the vaccine (e.g. improving immunogenicity in low SES) and vaccination program (e.g. additional doses) may bring improvements.

Inhibition of cyclooxygenase activity reduces rotavirus infection at a postbinding step.

NARCIS (Netherlands)

J.W. Rossen (John); J. Bouma (Janneke); R.H. Raatgeep (Rolien); H.A. Büller (Hans); A.W.C. Einerhand (Sandra)

2004-01-01

textabstractElevated levels of prostaglandins (PGs), products of cyclooxygenases (COXs), are found in the plasma and stool of rotavirus-infected children. We sought to determine the role of COXs, PGs, and the signal transduction pathways involved in rotavirus infection to elucidate

ABO blood grouping in Egyptian children with rotavirus gastroenteritis

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Hala Gouda Elnady

2017-09-01

Full Text Available Introduction : Rotavirus gastroenteritis is an important public health problem all over the world, causing a notable economic burden in both developing and developed countries. Aim: To explore the relationship between blood group typing, rotavirus gastroenteritis, and its severity in Egyptian children. Material and methods: A cross sectional case control study was conducted on 231 cases of acute gastroenteritis attending the outpatient clinic of Al-Zahraa University Hospital. Full history taking, clinical examination, and clinical data collection were done. Blood samples were collected for an ABO grouping. Stool samples were tested for viral gastroenteritis agents. Results : Rota positive cases of GE were significantly more prevalent among cases with blood group A (p < 0.05 and significantly less among cases with blood group B (p < 0.05. The rate of hospitalisation was highly significantly greater among cases with group A (p < 0.005, and significantly lower among cases with group AB and O (p < 0.05. As regards the degree of dehydration, moderate and severe cases were highly significant in groups A and O (p < 0.005. Rota-positive gastroenteritis showed significant positive correlations with indicators of severity such as hospitalisation, degree of dehydration, and duration of fever (p < 0.005. Conclusions : Blood group A is highly associated with paediatric rotavirus gastroenteritis. This could highlight an important risk factor, which could play a significant role for the pathogenesis of rotavirus gastroenteritis and severity as well. Furthermore, more intervention care could be needed for blood group A paediatric patients, if gastroenteritis especially rotavirus affect this group to avoid comorbidities.

Genetic Diversity of Circulating Rotavirus Strains in Tanzania Prior to the Introduction of Vaccination

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Moyo, Sabrina J.; Blomberg, Bjørn; Hanevik, Kurt; Kommedal, Oyvind; Vainio, Kirsti; Maselle, Samuel Y.; Langeland, Nina

2014-01-01

Background Tanzania currently rolls out vaccination against rotavirus-diarrhea, a major cause of child illness and death. As the vaccine covers a limited number of rotavirus variants, this study describes the molecular epidemiology of rotavirus among children under two years in Dar es Salaam, Tanzania, prior to implementation of vaccination. Methods Stool specimens, demographic and clinical information, were collected from 690 children admitted to hospital due to diarrhea (cases) and 545 children without diarrhea (controls) during one year. Controls were inpatient or children attending child health clinics. Rotavirus antigen was detected using ELISA and positive samples were typed by multiplex semi-nested PCR and sequencing. Results The prevalence of rotavirus was higher in cases (32.5%) than in controls (7.7%, Protavirus prevalence was higher in cool (23.9%) than hot months (17.1%) of the year (P = 0.012). We also observed significant seasonal variation of G genotypes. Rotavirus was most frequently found in the age group of four to six months. The prevalence of rotavirus in cases was lower in stunted children (28.9%) than in non-stunted children (40.1%, P = 0.003) and lower in HIV-infected (15.4%, 4/26) than in HIV-uninfected children (55.3%, 42/76, PRotavirus infection and circulating genotypes showed seasonal variation. This study also suggests that rotavirus may not be an opportunistic pathogen in children infected with HIV. PMID:24844631

Efectos en ratas de los alcoholes de cera de abejas (D-002 sobre la colitis ulcerativa inducida por sulfato de dextrano y etanol

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Vivian Molina-Cuevas

Full Text Available Objetivos. Investigar los efectos del D-002, mezcla de seis alcoholes alifáticos primarios de alto peso molecular, obtenida de la cera de abejas (Apis mellifera, sobre la colitis ulcerativa (CU inflamatoria severa inducida por sulfato de dextrano (DSS y etanol en ratas (Ratus ratus. Materiales y métodos. Las ratas se distribuyeron aleatoriamente en seis grupos: un control cero al que no se provocó daño, y cinco a los que se les indujo la CU: un control negativo (vehículo, tres tratados con D-002 (25, 100 y 400 mg/kg y un control positivo con sulfazalacina (200 mg/kg (sustancia de referencia. Se cuantificaron las manifestaciones clínicas (variación del peso corporal, presencia de diarrea y de sangrado rectal, el puntaje de daño macroscópico e histológico, y la actividad de mieoloperoxidasa (MPO. Resultados. El tratamiento oral con D-002 (25, 100 y 400 mg/kg previno significativamente la disminución del peso corporal. La dosis de 400 mg/kg redujo la presencia de diarreas y sangrado rectal, aunque su comparación con el control negativo solo alcanzó significación estadística sobre las diarreas. El D-002 (25, 100 y 400 mg/kg redujo significativamente el puntaje de las lesiones macroscópicas (40,0; 43,3 y 47,2% de inhibición, respectivamente, el puntaje de daño histológico (31,5; 53,7 y 67,1% de inhibición, respectivamente y la actividad de MPO (73,2; 83,6 y 85,0% de inhibición, respectivamente, comparado con el grupo control negativo. La sulfazalacina redujo significativamente todas las variables estudiadas. Conclusiones. El D-002 (25, 100 y 400 mg/kg protegió significativamente la mucosa colónica en ratas con CU inflamatoria severa inducida por DSS y etanol.

Efectos en ratas de los alcoholes de cera de abejas (D-002 sobre la colitis ulcerativa inducida por sulfato de dextrano y etanol

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Vivian Molina-Cuevas

Full Text Available RESUMEN Objetivos. Investigar los efectos del D-002, mezcla de seis alcoholes alifáticos primarios de alto peso molecular, obtenida de la cera de abejas (Apis mellifera, sobre la colitis ulcerativa (CU inflamatoria severa inducida por sulfato de dextrano (DSS y etanol en ratas (Ratus ratus. Materiales y métodos. Las ratas se distribuyeron aleatoriamente en seis grupos: un control cero al que no se provocó daño, y cinco a los que se les indujo la CU: un control negativo (vehículo, tres tratados con D-002 (25, 100 y 400 mg/kg y un control positivo con sulfazalacina (200 mg/kg (sustancia de referencia. Se cuantificaron las manifestaciones clínicas (variación del peso corporal, presencia de diarrea y de sangrado rectal, el puntaje de daño macroscópico e histológico, y la actividad de mieoloperoxidasa (MPO. Resultados. El tratamiento oral con D-002 (25, 100 y 400 mg/kg previno significativamente la disminución del peso corporal. La dosis de 400 mg/kg redujo la presencia de diarreas y sangrado rectal, aunque su comparación con el control negativo solo alcanzó significación estadística sobre las diarreas. El D-002 (25, 100 y 400 mg/kg redujo significativamente el puntaje de las lesiones macroscópicas (40,0; 43,3 y 47,2% de inhibición, respectivamente, el puntaje de daño histológico (31,5; 53,7 y 67,1% de inhibición, respectivamente y la actividad de MPO (73,2; 83,6 y 85,0% de inhibición, respectivamente, comparado con el grupo control negativo. La sulfazalacina redujo significativamente todas las variables estudiadas. Conclusiones. El D-002 (25, 100 y 400 mg/kg protegió significativamente la mucosa colónica en ratas con CU inflamatoria severa inducida por DSS y etanol.

Cost effectiveness of a pentavalent rotavirus vaccine in Oman.

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Al Awaidy, Salah Thabit; Gebremeskel, Berhanu G; Al Obeidani, Idris; Al Baqlani, Said; Haddadin, Wisam; O'Brien, Megan A

2014-06-17

Rotavirus gastroenteritis (RGE) is the leading cause of diarrhea in young children in Oman, incurring substantial healthcare and economic burden. We propose to formally assess the potential cost effectiveness of implementing universal vaccination with a pentavalent rotavirus vaccine (RV5) on reducing the health care burden and costs associated with rotavirus gastroenteritis (RGE) in Oman A Markov model was used to compare two birth cohorts, including children who were administered the RV5 vaccination versus those who were not, in a hypothetical group of 65,500 children followed for their first 5 years of life in Oman. The efficacy of the vaccine in reducing RGE-related hospitalizations, emergency department (ED) and office visits, and days of parental work loss for children receiving the vaccine was based on the results of the Rotavirus Efficacy and Safety Trial (REST). The outcome of interest was cost per quality-adjusted life year (QALY) gained from health care system and societal perspectives. A universal RV5 vaccination program is projected to reduce, hospitalizations, ED visits, outpatient visits and parental work days lost due to rotavirus infections by 89%, 80%, 67% and 74%, respectively. In the absence of RV5 vaccination, RGE-related societal costs are projected to be 2,023,038 Omani Rial (OMR) (5,259,899 United States dollars [USD]), including 1,338,977 OMR (3,481,340 USD) in direct medical costs. However, with the introduction of RV5, direct medical costs are projected to be 216,646 OMR (563,280 USD). Costs per QALY saved would be 1,140 OMR (2,964 USD) from the health care payer perspective. An RV5 vaccination program would be considered cost saving, from the societal perspective. Universal RV5 vaccination in Oman is likely to significantly reduce the health care burden and costs associated with rotavirus gastroenteritis and may be cost-effective from the payer perspective and cost saving from the societal perspective.

One Family's Struggles with Rotavirus

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One Family's Struggles with Rotavirus

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One Family's Struggles with Rotavirus

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One Family's Struggles with Rotavirus

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SHIFT IN HUMAN ROTAVIRUS DISTRIBUTION IN BELO HORIZONTE, BRAZIL DETECTED BY RIBONUCLEIC ACID ELECTROPHORESIS

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Millan Scarabeli Alves Coelho da Silva

2013-04-01

Full Text Available Rotavirus has been considered the main agent of infectious diarrhea especially among younger children. We addressed the prevalence of rotavirus-associated diarrhea and the diversity of circulating electropherotypes by immunochromatography and RNA electrophoresis. Stool samples were taken from 391 children (267 with diarrhea from the lower socioeconomic stratum who sought treatment in the Hospital Infantil João Paulo II/Belo Horizonte, during 2005 and 2006. Rotavirus was detected in 79/20.2% of subjects, 64/24.0% with diarrhea and 15/12.1% with no diarrhea. The virus was strongly associated with diarrhea (p = 0.003. A total of 76/19.4% and 69/17.6% rotavirus-positive children were identified by immunochromatography and electrophoresis, respectively. Rotavirus-associated diarrhea was more frequently detected in dry months (p < 0.001 and almost exclusively in children aged up to three years. Long profile strains prevailed (54/78.3% but a shift toward short electropherotype was identified. Despite the decrease seen in 2006, rotavirus infection is still very common in our area. Although viral RNA electrophoresis is useful as a typing method, it should not be used exclusively in the diagnosis of rotavirus infection. We confirmed a shift from long to short profile strains, as already described for other South American countries.

Importance of rotavirus as a cause of gastroenteritis in Jordan: a hospital based study.

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Khuri-Bulos, Najwa; Al Khatib, Mohammad

2006-01-01

Rotavirus is recognized to be a very important cause of GE in younger children in both developed as well as developing countries, but causes most of the mortality and morbidity in the latter. The recent introduction of a rotavirus vaccine in some parts of the world makes it necessary for us to determine the impact of this organism in our population with the aim of determining the need for the vaccine. In order to determine this, a study was conducted at the JUH and 3 other private hospitals. At the JUH, 64/256 (25%) of children with GE had rotavirus in 1995. The proportions of cases attributed to rotavirus in the other 3 y were 70/199 (35.2%), 69/279 (24.7%) and 76/294 (25.8%) for 2002, 2003 and 2004, respectively. The cumulative proportion of cases attributable to rotavirus gastroenteritis in all the y was 27.14%. With regard to the 3 private hospitals, rotavirus accounted for 38/225 (16.9%), 140/664 (21%) and 668/1496 (44.6%) at the Khalidy, Jordan and Islamic hospitals, respectively. It is concluded that rotavirus is a significant cause of GE in Jordanian children regardless of their social background, and attempt at controlling this infection may be warranted.

Nationwide survey of rotavirus-associated encephalopathy and sudden unexpected death in Japan.

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Kawamura, Yoshiki; Ohashi, Masahiro; Ihira, Masaru; Hashimoto, Shuji; Taniguchi, Koki; Yoshikawa, Tetsushi

2014-08-01

Rotavirus can cause severe complications such as encephalopathy/encephalitis and sudden unexpected death. The incidence of rotavirus-associated encephalopathy/encephalitis or sudden unexpected death remains unknown. To clarify the clinical features of rotavirus-associated encephalitis/encephalopathy and sudden unexpected death, we conducted a nationwide survey in Japan. A two-part questionnaire was designed to determine the number of the cases and the clinical features of severe cases of rotavirus infection, including encephalitis/encephalopathy and sudden unexpected death, between 2009 and 2011. Of the 1365 questionnaires sent to hospitals, 963 (70.5%) were returned and eligible for analysis. We determined 58 cases of rotavirus-associated encephalitis/encephalopathy and 7 cases of sudden unexpected death. These patients were diagnosed with rotavirus infection by immunochromatography. Although 36/58 (62.1%) encephalitis/encephalopathy patients had no sequelae, 15/58 (25.9%) patients had neurological sequelae, and 7/58 (12.1%) patients had fatal outcomes. Pleocytosis was observed in 9/40 (22.5%) patients and cerebrospinal fluid protein levels were elevated in only 4/40 (10%) patients. Elevated lactate dehydrogenase (LDH) (>500 IU/L) or acidemia (pHdeath were 44.0 and 4.9 cases in Japan, respectively. Elevated LDH (>500 IU/L) or acidemia (pH<7.15) were related to a poor prognosis of the encephalitis/encephalopathy. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Dose response and efficacy of a live, attenuated human rotavirus vaccine in Mexican infants.

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Ruiz-Palacios, Guillermo M; Guerrero, M Lourdes; Bautista-Márquez, Aurora; Ortega-Gallegos, Hilda; Tuz-Dzib, Fernando; Reyes-González, Leticia; Rosales-Pedraza, Gustavo; Martínez-López, Julia; Castañón-Acosta, Erika; Cervantes, Yolanda; Costa-Clemens, SueAnn; DeVos, Beatrice

2007-08-01

Immunization against rotavirus has been proposed as the most cost-effective intervention to reduce the disease burden associated with this infection worldwide. The objective of this study was to determine the dose response, immunogenicity, and efficacy of 2 doses of an oral, attenuated monovalent G1[P8] human rotavirus vaccine in children from the same setting in Mexico, where the natural protection against rotavirus infection was studied. From June 2001 through May 2003, 405 healthy infants were randomly assigned to 1 of 3 vaccine groups (virus concentrations 10(4.7), 10(5.2), and 10(5.8) infectious units) and to a placebo group and were monitored to the age of 2 years. The vaccine/placebo was administered concurrently with diphtheria-tetanus toxoid-pertussis/hepatitis B/Haemophilus influenzae type b vaccine at 2 and 4 months of age. After the administration of the first vaccine/placebo dose, weekly home visits to collect information regarding infant health were conducted. Stool samples were collected during each gastroenteritis episode and tested for rotavirus antigen and serotype. The vaccine was well tolerated and induced a greater rate of seroconversion than observed in infants who received placebo. For the pooled vaccine groups, efficacy after 2 oral doses was 80% and 95% against any and severe rotavirus gastroenteritis, respectively. Efficacy was 100% against severe rotavirus gastroenteritis and 70% against severe gastroenteritis of any cause with the vaccine at the highest virus concentration (10(5.8) infectious units). The predominant infecting rotavirus serotype in this cohort was wild-type G1 (85%). Adverse events, including fever, irritability, loss of appetite, cough, diarrhea, and vomiting, were similar among vaccinees and placebo recipients. This new oral, live, attenuated human rotavirus vaccine was safe, immunogenic, and highly efficacious in preventing any and, more importantly, severe rotavirus gastroenteritis in healthy infants. This vaccine

Inhibition of cyclooxygenase activity reduces rotavirus infection at a postbinding step

NARCIS (Netherlands)

Rossen, John W A; Bouma, Janneke; Raatgeep, Rolien H C; Büller, Hans A; Einerhand, Alexandra W C

Elevated levels of prostaglandins (PGs), products of cyclooxygenases (COXs), are found in the plasma and stool of rotavirus-infected children. We sought to determine the role of COXs, PGs, and the signal transduction pathways involved in rotavirus infection to elucidate possible new targets for

Health economics of rotavirus immunization in Vietnam : Potentials for favorable cost-effectiveness in developing countries

NARCIS (Netherlands)

Tu, Hong-Anh T.; Rozenbaum, Mark H.; Coyte, Peter C.; Li, Shu Chuen; Woerdenbag, Herman J.; Postma, Maarten J.

2012-01-01

Introduction: Rotavirus is the most common cause of severe diarrhoea worldwide. Vietnam is situated in the region of high rotavirus infection incidence and eligible for financial support to introduce rotavirus vaccines into the Expanded Program of Immunization (EPI) from the GAVI. This study was

Consenso chileno de prevención, diagnóstico y tratamiento de la diarrea asociada a Clostridium difficile

OpenAIRE

Hernández-Rocha, Cristian; Pidal, Paola; Ajenjo, M. Cristina; Quera, Rodrigo; Quintanilla, Marcela; Lubascher, Jaime; Jemenao, M. Irene; Ibáñez, Patricio; Álvarez-Lobos, Manuel; Diomedi, Alexis; Marcotti, Alejandra; Acuña, Mirta; Arab, Juan P; Riquelme, Arnoldo; Candía, Roberto

2016-01-01

Introducción: La diarrea asociada a Clostridium difficile (DACD) ha adquirido gran relevancia debido al aumento en su incidencia, gravedad, capacidad de recurrencia y carga económica asociada. Contar con una guía de consenso local es fundamental para mejorar su manejo. Objetivo: Elaborar un consenso multidisciplinara y basado en la evidencia en la prevención, diagnóstico y tratamiento de la DACD. Métodos: Se convocó a un panel de expertos en el área de enfermedades infecciosas, gastroenterolo...

La prevenzione dell'influenza, della malattia da meningococco C e della diarrea da colera

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R. Trivello

2003-05-01

Full Text Available Influenza, meningococco C e colera: tre differenti agenti infettivi che causano malattie molto diverse tra loro, tutte però con un denominatore comune: sono prevenibili con la vaccinazione. La vaccinazione influenzale nei bambini è un argomento di grande attualità e dibattito: i vari aspetti verranno messi a confronto sulla base delle esperienze internazionali e nazionali. La vaccinazione contro il meningococco C: saranno riportati i risultati di una esperienza di collaborazione tra Pediatria di Famiglia e Sanità Pubblica. La diarrea da colera e la sua prevenzione: molti Paesi considerati ad alto rischio per il colera stanno trasformandosi in destinazioni turistiche popolari e la possibilità di contrarne le forme più lievi è molto elevata; la vaccinazione consente efficacemente di eliminare questo rischio.

[Prospective study of rotavirus infection in a maternity unit. Demonstration of a nosocomial infection].

Science.gov (United States)

Brussieux, J; Boisivon, A; Michelon, B

1985-10-01

Eighty-eight children born at the maternity hospital in Saint-Germain-en-Laye between May 24 and June 7, 1983 were followed clinically, with a special supervision concerning stools, weight curves and the way of feeding. Stool samplings looking for Rotavirus were performed in all the children and their mothers, at the 3rd and 6th days of life. No mother was found with Rotavirus infection. In neonates, Rotavirus excretion was significantly related to a slow down in weight curves and the occurrence of diarrhea. All rotaviruses had the same electrophoretype. Breast-feeding had an undeniable protective effect.

Rotavirus RRV associates with lipid membrane microdomains during cell entry

International Nuclear Information System (INIS)

Isa, Pavel; Realpe, Mauricio; Romero, Pedro; Lopez, Susana; Arias, Carlos F.

2004-01-01

Rotavirus cell entry is a multistep process, not completely understood, which requires at least four interactions between the virus and cell surface molecules. In this work, we investigated the role of the sphingolipid- and cholesterol-enriched lipid microdomains (rafts) in the entry of rotavirus strain RRV to MA104 cells. We found that ganglioside GM1, integrin subunits α2 and β3, and the heat shock cognate protein 70 (hsc70), all of which have been implicated as rotavirus receptors, are associated with TX-100 and Lubrol WX detergent-resistant membranes (DRMs). Integrin subunits α2 and β3 were found to be particularly enriched in DRMs resistant to lysis by Lubrol WX. When purified RRV particles were incubated with cells at 4 deg. C, about 10% of the total infectious virus was found associated with DRMs, and the DRM-associated virus increased to 37% in Lubrol-resistant membrane domains after 60-min incubation at 37 deg. C. The virus was excluded from DRMs if the cells were treated with methyl-β-cyclodextrin (MβCD). Immunoblot analysis of the viral proteins showed that the virus surface proteins became enriched in DRMs upon incubation at 37 deg. C, being almost exclusively localized in Lubrol-resistant DRMs after 60 min. These data suggest that detergent-resistant membrane domains play an important role in the cell entry of rotaviruses, which could provide a platform to facilitate the efficient interaction of the rotavirus receptors with the virus particle

Rotavirus genotypes associated with acute diarrhea in Egyptian infants.

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Ahmed, Salwa F; Mansour, Adel M; Klena, John D; Husain, Tupur S; Hassan, Khaled A; Mohamed, Farag; Steele, Duncan

2014-01-01

Before the introduction of rotavirus vaccine in Egypt, information on the burden of disease and the circulating rotavirus genotypes is critical to monitor vaccine effectiveness. A cohort of 348 Egyptian children was followed from birth to 2 years of age with twice-weekly home visits to detect diarrheal illness. VP7 and VP4 genes were genotyped by reverse-transcription polymerase chain reaction and DNA sequencing. Forty percentage of children had rotavirus-associated diarrhea at least once by their second birthday. One hundred and twelve children experienced a single rotavirus diarrheal episodes (RDE) at a median age of 9 months; while 27 infants had their second RDE at a median age of 15 months and 1 infant had 3 RDE at the age of 2, 16 and 22 months. Of the 169 RDE, 82% could be assigned a G-type, while 58% had been identified a P-type. The most prevalent genotype was G2 (32%), followed by G1 (24%) and G9 (19%). G2P[4] rotavirus episodes were significantly associated with fever (P = 0.03) and vomiting (P = 0.06) when compared with other genotypes. G2 strains were the predominant genotype causing 50% of the second RDE while G9 represented 25% of the second RDE. Genotypes identified are similar to those detected globally except for absence of G4. Our finding that 75% of the second RDE were due to G2 and G9 indicates a possible reduction in natural protection afforded by these types compared with G1, where 90% of G1 cases did not experience a second xposure, indicating greater protection against recurrent symptomatic infection.

New tetrameric forms of the rotavirus NSP4 with antiparallel helices.

Science.gov (United States)

Kumar, Sushant; Ramappa, Raghavendra; Pamidimukkala, Kiranmayee; Rao, C D; Suguna, K

2018-06-01

Rotavirus nonstructural protein 4, the first viral enterotoxin to be identified, is a multidomain, multifunctional glycoprotein. Earlier, we reported a Ca 2+ -bound coiled-coil tetrameric structure of the diarrhea-inducing region of NSP4 from the rotavirus strains SA11 and I321 and a Ca 2+ -free pentameric structure from the rotavirus strain ST3, all with a parallel arrangement of α-helices. pH was found to determine the oligomeric state: a basic pH favoured a tetramer, whereas an acidic pH favoured a pentamer. Here, we report two novel forms of the coiled-coil region of NSP4 from the bovine rotavirus strains MF66 and NCDV. These crystallized at acidic pH, forming antiparallel coiled-coil tetrameric structures without any bound Ca 2+ ion. Structural and mutational studies of the coiled-coil regions of NSP4 revealed that the nature of the residue at position 131 (Tyr/His) plays an important role in the observed structural diversity.

Projecting the effectiveness of RotaTeq® against rotavirus-related hospitalisations in Brazil

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Antoine Chaouki El Khoury

2011-08-01

Full Text Available RotaTeq® (Merck & Company, Inc, Whitehouse Station, NJ, USA is an oral pentavalent rotavirus vaccine (RV5 that has shown high and consistent efficacy in preventing rotavirus gastroenteritis (RGE in randomised clinical trials previously conducted in industrialised countries with high medical care resources. To date, the efficacy and effectiveness data for RV5 are available in some Latin American countries, but not Brazil. In this analysis, we projected the effectiveness of RV5 in terms of the percentage reduction in RGE-related hospitalisations among children less than five years of age in four regions of Brazil, using a previously validated mathematical model. The model inputs included hospital-based rotavirus surveillance data from Goiânia, Porto Alegre, Salvador and São Paulo from 2005-2006, which provided the proportions of rotavirus attributable to serotypes G1, G2, G3, G4 and G9, and published rotavirus serotype-specific efficacy from the Rotavirus Efficacy and Safety Trial. The model projected an overall percentage reduction of 93% in RGE-related hospitalisations, with an estimated annual reduction in RGE-related hospitalisations between 42,991-77,383 in the four combined regions of Brazil. These results suggest that RV5 could substantially prevent RGE-related hospitalisations in Brazil.

Sunlight-induced inactivation of human Wa and porcine OSU rotaviruses in the presence of exogenous photosensitizers

KAUST Repository

Romero-Maraccini, Ofelia C.; Sadik, Nora J.; Rosado-Lausell, Sahid L.; Pugh, Charles R.; Niu, Xi-Zhi; Croue, Jean-Philippe; Nguyen, Thanh Ha

2013-01-01

dark experiments conducted at different temperatures suggest that porcine rotavirus has higher thermostability than human rotavirus. Concentrations of 3′-MAP excited triplet states of 1.8 fM and above resulted in significant human rotavirus inactivation

One Family's Struggles with Rotavirus

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One Family's Struggles with Rotavirus

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Whole genome detection of rotavirus mixed infections in human, porcine and bovine samples co-infected with various rotavirus strains collected from sub-Saharan Africa.

Science.gov (United States)

Nyaga, Martin M; Jere, Khuzwayo C; Esona, Mathew D; Seheri, Mapaseka L; Stucker, Karla M; Halpin, Rebecca A; Akopov, Asmik; Stockwell, Timothy B; Peenze, Ina; Diop, Amadou; Ndiaye, Kader; Boula, Angeline; Maphalala, Gugu; Berejena, Chipo; Mwenda, Jason M; Steele, A Duncan; Wentworth, David E; Mphahlele, M Jeffrey

2015-04-01

Group A rotaviruses (RVA) are among the main global causes of severe diarrhea in children under the age of 5years. Strain diversity, mixed infections and untypeable RVA strains are frequently reported in Africa. We analysed rotavirus-positive human stool samples (n=13) obtained from hospitalised children under the age of 5years who presented with acute gastroenteritis at sentinel hospital sites in six African countries, as well as bovine and porcine stool samples (n=1 each), to gain insights into rotavirus diversity and evolution. Polyacrylamide gel electrophoresis (PAGE) analysis and genotyping with G-(VP7) and P-specific (VP4) typing primers suggested that 13 of the 15 samples contained more than 11 segments and/or mixed G/P genotypes. Full-length amplicons for each segment were generated using RVA-specific primers and sequenced using the Ion Torrent and/or Illumina MiSeq next-generation sequencing platforms. Sequencing detected at least one segment in each sample for which duplicate sequences, often having distinct genotypes, existed. This supported and extended the PAGE and RT-PCR genotyping findings that suggested these samples were collected from individuals that had mixed rotavirus infections. The study reports the first porcine (MRC-DPRU1567) and bovine (MRC-DPRU3010) mixed infections. We also report a unique genome segment 9 (VP7), whose G9 genotype belongs to lineage VI and clusters with porcine reference strains. Previously, African G9 strains have all been in lineage III. Furthermore, additional RVA segments isolated from humans have a clear evolutionary relationship with porcine, bovine and ovine rotavirus sequences, indicating relatively recent interspecies transmission and reassortment. Thus, multiple RVA strains from sub-Saharan Africa are infecting mammalian hosts with unpredictable variations in their gene segment combinations. Whole-genome sequence analyses of mixed RVA strains underscore the considerable diversity of rotavirus sequences and

Analysis of complete genome sequences of G9P[19] rotavirus strains from human and piglet with diarrhea provides evidence for whole-genome interspecies transmission of nonreassorted porcine rotavirus.

Science.gov (United States)

Yodmeeklin, Arpaporn; Khamrin, Pattara; Chuchaona, Watchaporn; Kumthip, Kattareeya; Kongkaew, Aphisek; Vachirachewin, Ratchaya; Okitsu, Shoko; Ushijima, Hiroshi; Maneekarn, Niwat

2017-01-01

Whole genomes of G9P[19] human (RVA/Human-wt/THA/CMH-S070-13/2013/G9P[19]) and porcine (RVA/Pig-wt/THA/CMP-015-12/2012/G9P[19]) rotaviruses concurrently detected in the same geographical area in northern Thailand were sequenced and analyzed for their genetic relationships using bioinformatic tools. The complete genome sequence of human rotavirus RVA/Human-wt/THA/CMH-S070-13/2013/G9P[19] was most closely related to those of porcine rotavirus RVA/Pig-wt/THA/CMP-015-12/2012/G9P[19] and to those of porcine-like human and porcine rotaviruses reference strains than to those of human rotavirus reference strains. The genotype constellation of G9P[19] detected in human and piglet were identical and displayed as the G9-P[19]-I5-R1-C1-M1-A8-N1-T1-E1-H1 genotypes with the nucleotide sequence identities of VP7, VP4, VP6, VP1, VP2, VP3, NSP1, NSP2, NSP3, NSP4, and NSP5 at 99.0%, 99.5%, 93.2%, 97.7%, 97.7%, 85.6%, 89.5%, 93.2%, 92.9%, 94.0%, and 98.1%, respectively. The findings indicate that human rotavirus strain RVA/Human-wt/THA/CMH-S070-13/2013/G9P[19] containing the genome segments of porcine genetic backbone is most likely a human rotavirus of porcine origin. Our data provide an evidence of interspecies transmission and whole-genome transmission of nonreassorted G9P[19] porcine RVA to human occurring in nature in northern Thailand. Copyright © 2016. Published by Elsevier B.V.

Prospective study of enteropathogens in two communities of Misiones, Argentina Estudio prospectivo de enteropatógenos en dos comunidades de Misiones, Argentina

Directory of Open Access Journals (Sweden)

Marta Vergara

1996-10-01

Full Text Available Children under five years of age, from two communities of different socio-economic strata (97 from Zaiman and 55 from Las Dolores were examined epidemiologically during 2 years, by means of quarterly visits of the working team, who carried out the collection of faecal samples. During the study, one or more enteropathogens were identified in 73.9% of samples in children from Zaiman and in 58.3% of the samples from Las Dolores, being associated to diarrhoea in 70.5% and to asymptomatic infections in 65.7%. The number of diarrheic episodes was higher in Zaiman (15.45% than in Las Dolores (12.35%, being more frequent in the spring-summer seasons. In Zaiman, the bacterial enteropathogen proportion was relevantly higher (pNiños menores de cinco años de edad de dos comunidades de diferente condición socio-económica (97 del Barrio Zaimán y 55 del Barrio Las Dolores, fueron vigilados epidemiologicamente durante 2 años, mediante visitas trimestrales del equipo de trabajo, el que realizó la toma de muestras fecales. Durante el estudio, se identificaron uno o más enteropatógenos en el 73,9% de las muestras de niños del Barrio Zaimán y en el 58,3% de Las Dolores, estando asociados a diarrea en un 70,5% y en infecciones asintomáticas en un 65,7%. El número de episodios de diarrea fue superior en Zaimán (15,5% que en Las Dolores (12,4%, presentándose con mayor frecuencia en los meses de primavera-verano. En el Barrio Zaimán la proporción de enteropatógenos bacterianos fue significativamente mayor (p < 0.005 en los niños con diarrea, mientras que los parásitos se presentaron con mayor frecuencia en niños asintomáticos (p < 0.01. Rotavirus tuvo una distribución comparable en niños con diarrea y asintomáticos. En el Barrio Las Dolores, no se encontraron diferencias significativas en la deteccion de enteroparásitos entre asintomáticos y niños con diarrea. Se detectaron infecciones mixtas, siendo ECET-rotavirus y ECET-parásitos, las mas

THE PREVENTION OF ROTAVIRUS INFECTION: THE MODERN VIEW OF THE POSSIBILITY

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T. A. Grechukha

2014-01-01

Full Text Available Rotavirus is a major public health problem in all countries. The incidence of rotavirus infection is growing steadily in the Russian Federation and over the past 10 years increased by 7 times, amounting to 72 cases per 100,000 in 2010. The rotavirus vaccine was registered in the Russian Federation in 2012 and successfully applied from 2013. The vaccine used for more than 8 years and have enough experience on the efficacy and safety. Different foreign investigations have shown the herd immunity of the vaccine. The authors present data about the effectiveness and safety of vaccines, established during clinical studies of the foreign scientists.

Cost-effectiveness of rotavirus immunization in vietnam: Exploring impacts of herd immunity and patterns of breastfeedingof

NARCIS (Netherlands)

Tu, H.A.T.; Coyte, P.; Li, S.C.; Postma, M.J.

2012-01-01

OBJECTIVES: : Rotavirus is the most common cause of severe diarrhoea worldwide. This study was designed to evaluate the cost-effectiveness of rotavirus immunization in Vietnam taking into account herd immunity and patterns of breastfeeding. The affordability of implementing universal rotavirus

The role of the intestinal microbiome in rotavirus vaccine immunogenicity : An exploration from correlation to causation

NARCIS (Netherlands)

Harris, V.C.

2018-01-01

Rotavirus (RV) is one of the leading causes of serious gastroenteritis and diarrheal deaths in children under the age of five across the globe. Rotavirus vaccines (RVV) protect infants, reducing rotavirus disease, diarrheal outpatient visits, hospitalizations, and deaths following introduction into

Detection of rotavirus VP7 gene in helmeted guinea fowls and ...

African Journals Online (AJOL)

Rotaviruses classified into groups A through H are important etiological agents of gastroenteritis in man and animal. In Nigeria vaccination of infants has continuously been carried out, however the disease is still a burden to the nation which remains one of the countries with the highest cases of rotavirus gastroenteritis.

Reporte de insuficiencia renal producida por Leptospira Interrogans Serovar Pomona en Colombia

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Fortunato Ospino

1988-06-01

Full Text Available Se describe la presentación de un caso de leptospirosis producida por L. pomona en un paciente de 20 años de edad, trabajadora habitual en un molino de arroz y caracterizado por un síndrome de insuficiencia renal y hepática. El cuadro clínico consistió principalmente en malestar general, anorexia, vómito, fiebre, diarrea, ictericia y hemorragias subconjuntivales. Los exámenes de laboratorio mostraron alteraciones, en los niveles de nitrógeno ureico, creatinina, depuración de creatinina, concentración de cloro, fosfatasa alcalina y bilirrubina directa lo cual podría indicar un daño en el funcionamiento hepático y renal. Las alteraciones en la velocidad de sedimentación, hemoglobina, hematocrito y leucocitos (Tabla 1 explican la anemia e infección ocasionada por la L. pomona en la paciente. El diagnóstico de leptospirosis fue confirmado por el aislamiento del microorganismo de la orina a pesar de no haber detectado anticuerpos en el suero de la paciente. Se pone en evidencia la necesidad de realizar siempre el diagnóstico diferencial con leptospirosis en todo síndrome hepatorrenal, especialmente en los casos con antecedentes epidemiológicos o que por la sintomatología clínica se sospeche la infección.

Determinación de la carga parasitaria gastrointestinal en Bovinos de la zona rural de Rio de Oro y el Municipio de Aguachica, Cesar por la técnica de McMaster

OpenAIRE

Sierra, Marly; Flórez, Paola; Morales Ramírez, Elsa; Vásquez, María Cristina; Calle, Manuel; Sierra Barcarcel, Raúl Fernando

2016-01-01

Introducción: Los parásitos gastrointestinales afectan principalmente a animales jóvenes entre 3 semanas y 1 año de vida aunque también a mayores de 1 año, sus manifestaciones clínicas son diarrea, anorexia, deshidratación cuando se encuentran parasitados por coccidias y en caso severo puede llevar a la muerte, los nemátodos presentan similitud en los síntomas y la mayor morbilidad está dada por Haemonchus spp (larva), la muerte puede ser repentina en casos de hiperinfestación y los bovinos p...

Rotavirus disease in Guinea-Bissau, West Africa: a review of longitudinal community and hospital studies

DEFF Research Database (Denmark)

Fischer, Thea Kølsen; Aaby, Peter; Mølbak, Kåre

2010-01-01

Rotavirus is one of the most common causes of childhood diarrheal disease and deaths in sub-Saharan Africa. This article reviews community- and hospital-based surveillance of rotavirus disease in Bissau, Guinea-Bissau, West Africa. Here, rotavirus infections exhibit a seasonal pattern, with annual...... epidemics occurring during the relatively dry and cooler months, from January to April, and few cases registered from May to December. Most children (74%) experience their first infection before the age of 2 years, and rotavirus has been identified as the most pathogenic of all diarrheal agents during 2...

Prospective evaluation of indirect costs due to acute rotavirus gastroenteritis in Spain: the ROTACOST study

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Sánchez-Lastres Juan

2011-09-01

Full Text Available Abstract Background The effect of rotavirus in developed countries is mainly economic. This study aimed to assess the indirect costs induced by rotavirus acute gastroenteritis (RVAGE in Spain. Methods A prospective observational study was conducted from October 2008 to June 2009. It included 682 children up to 5 years of age with acute gastroenteritis (AGE who attended primary care (n = 18 and emergency room/hospital settings (n = 10, covering the regions of Galicia and Asturias (North-west Spain. All non-medical expenses incurred throughout the episode were recorded in detail using personal interviews and telephone contact. Results Among the 682 enrolled children, 207 (30.4% were rotavirus positive and 170 (25% had received at least one dose of rotavirus vaccine. The mean (standard deviation indirect cost caused by an episode of AGE was estimated at 135.17 (182.70 Euros. Costs were 1.74-fold higher when AGE was caused by rotavirus compared with other etiologies: 192.7 (219.8 Euros vs. 111.6 (163.5 Euros (p Conclusions Rotavirus generates a significant indirect economic burden. Our data should be considered in the decision-making process of the eventual inclusion of rotavirus vaccine in the national immunization schedule of well developed countries.

Uptake of yeast (Saccharomyces boulardii) in normal and rotavirus treated intestine.

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Cartwright-Shamoon, J; Dickson, G R; Dodge, J; Carr, K E

1996-01-01

BACKGROUND: There has recently been a growing interest in the use of the non-pathogenic yeast Saccharomyces boulardii, in the treatment of gastrointestinal disorders, including diarrhoea. The full effects of administration of the yeast are not fully understood. AIMS: To investigate the morphological effects of inoculated S boulardii on mouse intestinal villi, both in control animals and those treated with rotavirus. METHODS: Seven day old BALB/c seronegative mice were intubated with either rotavirus (30 microliters orally) or S boulardii (1.5 g/kg) or both rotavirus and S boulardii administered together. Control animals were given saline only. Animals were killed by decapitation 48 hours post-treatment. The middle region of the small intestine was studied using light microscopy and transmission and scanning electron microscopy, including backscattered electron imaging. RESULTS: Animals treated with rotavirus with or without S boulardii developed severe diarrhoea and showed morphological villous changes such as stromal separation and increased epithelial vacuolation. Specimens treated with S boulardii contained yeast particles within the mucosal tissues. CONCLUSION: The administration of S boulardii did not influence the changes produced by rotavirus, but yeast particles appeared to be taken up by the villous mucosa, with the predominant route apparently being uptake between adjacent epithelial cells. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 PMID:8991857

Effectiveness of pentavalent rotavirus vaccine in a large urban population in the United States.

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Boom, Julie A; Tate, Jacqueline E; Sahni, Leila C; Rench, Marcia A; Hull, Jennifer J; Gentsch, Jon R; Patel, Manish M; Baker, Carol J; Parashar, Umesh D

2010-02-01

The goal was to assess the effectiveness of complete (3-dose) or partial (1- or 2-dose) immunization with pentavalent rotavirus vaccine (RV5) against rotavirus acute gastroenteritis (AGE) in US clinical practice. A case-control evaluation was conducted in February through June 2008 at an emergency department in Houston, Texas. Case patients with rotavirus AGE (N = 90) were identified through testing for rotavirus in fecal specimens obtained from 205 children 15 days through 23 months of age presenting with AGE. Control groups included rotavirus-negative AGE patients (N = 115), concurrently enrolled patients with acute respiratory infection (ARI) (N = 228), and up to 10 age- and zip code-matched children sampled from the Houston-Harris County Immunization Registry (HHCIR) for each case patient >8 months of age. Immunization data were obtained from parent records, health care providers, and/or the HHCIR. Vaccine effectiveness was calculated as 1 minus odds of RV5 vaccination for case patients versus control patients, after adjustment for age at presentation and birth date. The vaccine effectiveness of a complete RV5 series was 89% (95% confidence interval [CI]: 70%-96%) and 85% (95% CI: 55%-95%) with rotavirus-negative AGE and ARI control patients, respectively. Immunization data were available for 44% of case patients (n = 40) from the HHCIR; the estimated 3-dose vaccine effectiveness with these HHCIR control patients was 82% (95% CI: 19%-96%). A complete RV5 series conferred 100% protection (95% CI: 71%-100%) against severe rotavirus disease requiring hospitalization and 96% protection (95% CI: 72%-99%) against disease requiring intravenous hydration. Vaccine effectiveness of 1 and 2 doses against hospitalization and emergency department visits was 69% (95% CI: 13%-89%) and 81% (95% CI: 13%-96%), respectively, using rotavirus-negative AGE and ARI control groups combined. In this setting, a complete series of RV5 was highly effective against severe rotavirus AGE

Acute Rotavirus-Induced Diarrhea in Children: Clinical Picture, Diagnosis, Treatment

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S.L. Niankovskyi

2015-09-01

Full Text Available The paper considers the current aspects of epidemiology, diagnosis, clinical picture and treatment of acute rotavirus-induced diarrhea in children. There are presented the basic thesis of ESPGHAN consensus (2014 about acute diarrheas. There was analyzed the effectiveness of probiotic Subalin producing interferon for the treatment of acute rotavirus-induced diarrhea. It was demonstrated its effectiveness according to the literature review and own data.

[Reverse genetics system of rotaviruses: development and application for analysis of VP4 spike protein].

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Komoto, Satoshi

2013-01-01

The rotavirus genome is composed of 11 gene segments of double-stranded (ds)RNA. Reverse genetics is the powerful and ideal methodology for the molecular analysis of virus biology, which enables the virus genome to be artificially manipulated. Although reverse genetics systems exist for nearly all major groups of RNA viruses, development of such a system for rotaviruses is more challenging owing in part to the technical complexity of manipulation of their multi-segmented genome. A breakthrough in the field of rotavirus reverse genetics came in 2006, when we established the first reverse genetics system for rotaviruses, which is a partially plasmid-based system that permits replacement of a viral gene segment with the aid of a helper virus. Although this helper virus-driven system is technically limited and gives low levels of recombinant viruses, it allows alteration of the rotavirus genome, thus contributing to our understanding of these medically important viruses. In this review, I describe the development and application of our rotavirus reverse genetics system, and its future perspectives.

Analysis of Host Range Restriction Determinants in the Rabbit Model: Comparison of Homologous and Heterologous Rotavirus Infections

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Ciarlet, Max; Estes, Mary K.; Barone, Christopher; Ramig, Robert F.; Conner, Margaret E.

1998-01-01

The main limitation of both the rabbit and mouse models of rotavirus infection is that human rotavirus (HRV) strains do not replicate efficiently in either animal. The identification of individual genes necessary for conferring replication competence in a heterologous host is important to an understanding of the host range restriction of rotavirus infections. We recently reported the identification of the P type of the spike protein VP4 of four lapine rotavirus strains as being P[14]. To determine whether VP4 is involved in host range restriction in rabbits, we evaluated infection in rotavirus antibody-free rabbits inoculated orally with two P[14] HRVs, PA169 (G6) and HAL1166 (G8), and with several other HRV strains and animal rotavirus strains of different P and G types. We also evaluated whether the parental rhesus rotavirus (RRV) (P5B[3], G3) and the derived RRV-HRV reassortant candidate vaccine strains RRV × D (G1), RRV × DS-1 (G2), and RRV × ST3 (G4) would productively infect rabbits. Based on virus shedding, limited replication was observed with the P[14] HRV strains and with the SA11 Cl3 (P[2], G3) and SA11 4F (P6[1], G3) animal rotavirus strains, compared to the homologous ALA strain (P[14], G3). However, even limited infection provided complete protection from rotavirus infection when rabbits were challenged orally 28 days postinoculation (DPI) with 103 50% infective doses of ALA rabbit rotavirus. Other HRVs did not productively infect rabbits and provided no significant protection from challenge, in spite of occasional seroconversion. Simian RRV replicated as efficiently as lapine ALA rotavirus in rabbits and provided complete protection from ALA challenge. Live attenuated RRV reassortant vaccine strains resulted in no, limited, or productive infection of rabbits, but all rabbits were completely protected from heterotypic ALA challenge. The altered replication efficiency of the reassortants in rabbits suggests a role for VP7 in host range restriction

Caracterización de aislamientos de Vibrio cholerae no-O1, no-O139 asociados a cuadros de diarrea Characterization of Vibrio cholerae non-O1 and non-O139 isolates associated with diarrhea

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S. González Fraga

2009-03-01

Full Text Available La infección por Vibrio cholerae, el agente causal del cólera, se trasmite al hombre por ingestión de agua y alimentos contaminados. Aunque son los serogrupos O1 y O139 los que habitualmente se asocian al cólera epidémico, los aislamientos de otros serogrupos también son causales de gastroenteritis e infecciones extra-intestinales. Durante el período 2003-2005, se investigó la presencia de V. cholerae en la materia fecal de niños con diarrea atendidos en el Hospital del Niño Jesús, Tucumán. Se recuperaron 34 aislamientos de V. cholerae no-O1, no-O139. Se determinaron sus perfiles de virulencia por PCR, la sensibilidad a los antimicrobianos y la diversidad genética por electroforesis en campo pulsado. Se obtuvieron ocho perfiles de virulencia, aunque ningún aislamiento fue positivo para la toxina colérica ni para la toxina termoestable. Cuatro aislamientos fueron positivos para el sistema de secreción de tipo tres. El 17,6% de los aislamientos fueron resistentes o de sensibilidad intermedia a ampicilina y el 5,9% fueron resistentes a trimetoprima-sulfametoxazol. Los aislamientos resultaron muy diversos: se hallaron 27 patrones distintos en 29 aislamientos tipificables por electroforesis en campo pulsado. A pesar de su baja incidencia, V. cholerae continúa siendo un agente causal de diarrea en niños, los que se ven afectados por una amplia variedad de cepas circulantes.Vibrio cholerae, etiologic agent of cholera, is transmitted to humans by ingestion of contaminated food or water. Even though serogroups O1 and O139 are the ones usually associated to epidemic cholera, isolates from other serogroups also cause gastroenteritis and extraintestinal infections. During the period 2003-2005, presence of V. cholerae in stools was investigated in children with diarrhea that seaked assistance at the Niño Jesús Hospital in Tucumán. Thirty four isolates of V. cholerae non-O1, non-O139 were recovered. We characterized the isolates studying

Molecular characterization of different equine-like G3 rotavirus strains from Germany.

Science.gov (United States)

Pietsch, Corinna; Liebert, Uwe G

2018-01-01

The genetic heterogeneity of rotaviruses constitutes a substantial burden to human and animal health. Occasional interspecies transmissions can generate novel virus strains in the human population. We detected equine-like G3P[8] strains in feces sampled from three children in Germany in 2015 and 2016, respectively. Thereof two showed a DS-1-like backbone. In one strain the NSP2 gene segment was of distinct genotype (G3-P[8]-I2-R2-C2-M2-A2-N1-T2-E2-H2). Phylogenetic analyses of the German strains showed a relation to other equine-like G3 rotaviruses circulating in different countries. The reconstruction of reassortment events in the evolution of novel equine-like G3 rotaviruses suggests an independent introduction of the three strains into the local human rotavirus population. Copyright © 2017 Elsevier B.V. All rights reserved.

Determinants of Parents' Decision to Vaccinate Their Children against Rotavirus: Results of a Longitudinal Study

Science.gov (United States)

Dube, E.; Bettinger, J. A.; Halperin, B.; Bradet, R.; Lavoie, F.; Sauvageau, C.; Gilca, V.; Boulianne, N.

2012-01-01

Rotavirus disease is a common cause of health care utilization and almost all children are affected by the age of 5 years. In Canada, at the time of this survey (2008-09), immunization rates for rotavirus were less than 20%. We assessed the determinants of a parent's acceptance to have their child immunized against rotavirus. The survey…

Subunit Rotavirus Vaccine Administered Parenterally to Rabbits Induces Active Protective Immunity

Science.gov (United States)

Ciarlet, Max; Crawford, Sue E.; Barone, Christopher; Bertolotti-Ciarlet, Andrea; Ramig, Robert F.; Estes, Mary K.; Conner, Margaret E.

1998-01-01

Virus-like particles (VLPs) are being evaluated as a candidate rotavirus vaccine. The immunogenicity and protective efficacy of different formulations of VLPs administered parenterally to rabbits were tested. Two doses of VLPs (2/6-, G3 2/6/7-, or P[2], G3 2/4/6/7-VLPs) or SA11 simian rotavirus in Freund’s adjuvants, QS-21 (saponin adjuvant), or aluminum phosphate (AlP) were administered. Serological and mucosal immune responses were evaluated in all vaccinated and control rabbits before and after oral challenge with 103 50% infective doses of live P[14], G3 ALA lapine rotavirus. All VLP- and SA11-vaccinated rabbits developed high levels of rotavirus-specific serum and intestinal immunoglobulin G (IgG) antibodies but not intestinal IgA antibodies. SA11 and 2/4/6/7-VLPs afforded similar but much higher mean levels of protection than 2/6/7- or 2/6-VLPs in QS-21. The presence of neutralizing antibodies to VP4 correlated (P < 0.001, r = 0.55; Pearson’s correlation coefficient) with enhanced protection rates, suggesting that these antibodies are important for protection. Although the inclusion of VP4 resulted in higher mean protection levels, high levels of protection (87 to 100%) from infection were observed in individual rabbits immunized with 2/6/7- or 2/6-VLPs in Freund’s adjuvants. Therefore, neither VP7 nor VP4 was absolutely required to achieve protection from infection in the rabbit model when Freund’s adjuvant was used. Our results show that VLPs are immunogenic when administered parenterally to rabbits and that Freund’s adjuvant is a better adjuvant than QS-21. The use of the rabbit model may help further our understanding of the critical rotavirus proteins needed to induce active protection. VLPs are a promising candidate for a parenterally administered subunit rotavirus vaccine. PMID:9765471

One Family's Struggles with Rotavirus

Medline Plus

Full Text Available ... thimerosal vaccine safety q & a videos chickenpox (varicella) hepatitis b hib hpv pertussis (whooping cough) pneumococcal rotavirus shingles media room Flu's Gonna Lose M.O.V.E. newsfeeds PSAs publications infectious disease workshop pediatric hepatitis report someone you know has hbv/hcv standard ...

Presence of rotavirus and free-living amoebae in the water supplies of Karachi, Pakistan

Science.gov (United States)

Yousuf, Farzana Abubakar; Siddiqui, Ruqaiyyah; Khan, Naveed Ahmed

2017-01-01

ABSTRACT Rotavirus and pathogenic free-living amoebae are causative agents of important health problems, especially for developing countries like Pakistan where the population has limited access to clean water supplies. Here, we evaluated the prevalence of rotavirus and free-living amoebae (Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri) in drinking water supplies of Karachi, Pakistan. Six water filtration plants that supply drinking water to the population of Karachi were investigated. Additionally, drinking water samples from households were analyzed for the presence of rotavirus and free-living amoebae. Rotavirus was present in 35% of the water samples collected from water filtration plants; however, domestic tap water samples had a prevalence of only 5%. Out of 20 water samples from filtration plants, 13 (65%) were positive for Acanthamoeba spp., and one (5%) was positive for B. mandrillaris. Out of 20 drinking water samples collected from different areas of Karachi, 35% were positive for Acanthamoeba spp. Rotavirus was detected in 5% of the drinking water samples tested. Overall, these findings showed for the first time the presence of rotavirus, in addition to pathogenic free-living amoebae in drinking water supplies of Karachi that could be an important public health risk for the affected population. PMID:28591260

Presence of rotavirus and free-living amoebae in the water supplies of Karachi, Pakistan

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Farzana Abubakar Yousuf

Full Text Available ABSTRACT Rotavirus and pathogenic free-living amoebae are causative agents of important health problems, especially for developing countries like Pakistan where the population has limited access to clean water supplies. Here, we evaluated the prevalence of rotavirus and free-living amoebae (Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri in drinking water supplies of Karachi, Pakistan. Six water filtration plants that supply drinking water to the population of Karachi were investigated. Additionally, drinking water samples from households were analyzed for the presence of rotavirus and free-living amoebae. Rotavirus was present in 35% of the water samples collected from water filtration plants; however, domestic tap water samples had a prevalence of only 5%. Out of 20 water samples from filtration plants, 13 (65% were positive for Acanthamoeba spp., and one (5% was positive for B. mandrillaris. Out of 20 drinking water samples collected from different areas of Karachi, 35% were positive for Acanthamoeba spp. Rotavirus was detected in 5% of the drinking water samples tested. Overall, these findings showed for the first time the presence of rotavirus, in addition to pathogenic free-living amoebae in drinking water supplies of Karachi that could be an important public health risk for the affected population.

Rotavirus Infection and Disease in a Multisite Birth Cohort: Results From the MAL-ED Study.

Science.gov (United States)

Mohan, Venkata Raghava; Karthikeyan, Ramanujam; Babji, Sudhir; McGrath, Monica; Shrestha, Sanjaya; Shrestha, Jasmin; Mdumah, Estomih; Amour, Caroline; Samie, Amidou; Nyathi, Emanuel; Haque, Rashidul; Qureshi, Shahida; Yori, Pablo Peñataro; Lima, Aldo A M; Bodhidatta, Ladaporn; Svensen, Erling; Bessong, Pascal; Ahmed, Tahmeed; Seidman, Jessica C; Zaidi, Anita K M; Kosek, Margaret N; Guerrant, Richard L; Gratz, Jean; Platts-Mills, James A; Lang, Dennis R; Gottlieb, Michael; Houpt, Eric R; Kang, Gagandeep

2017-08-01

In a multicountry birth cohort study, we describe rotavirus infection in the first 2 years of life in sites with and without rotavirus vaccination programs. Children were recruited by 17 days of age and followed to 24 months with collection of monthly surveillance and diarrheal stools. Data on sociodemographics, feeding, and illness were collected at defined intervals. Stools were tested for rotavirus and sera for antirotavirus immunoglobulins by enzyme immunoassays. A total of 1737 children contributed 22646 surveillance and 7440 diarrheal specimens. Overall, rotavirus was detected in 5.5% (408/7440) of diarrheal stools, and 344 (19.8%) children ever had rotavirus gastroenteritis. Household overcrowding and a high pathogen load were consistent risk factors for infection and disease. Three prior infections conferred 74% (P < .001) protection against subsequent infection in sites not using vaccine. In Peru, incidence of rotavirus disease was relatively higher during the second year of life despite high vaccination coverage. Rotavirus infection and disease were common, but with significant heterogeneity by site. Protection by vaccination may not be sustained in the second year of life in settings with high burdens of transmission and poor response to oral vaccines. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Rotavirus epidemiology and surveillance before vaccine introduction in Argentina, 2012-2014.

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Degiuseppe, Juan Ignacio; Reale, Ezequiel Agustín; Stupka, Juan Andrés

2017-03-01

Group A Rotavirus has been widely described as one of the most important infantile diarrheal pathogens worldwide. In Argentina, it is responsible for over 200,000 acute diarrhea cases and from 30 to 50 deaths annually in children under 5 years. The aim of this study is to analyze frequency, seasonality, age group distribution, and circulating genotypes based on data notified in the 2012-2014 period and in turn to assess the pre-vaccine scenario, considering that rotavirus vaccine was introduced in 2015. Data were taken from the Viral Diarrhea Notification module of the Argentine SNVS-SIVILA surveillance tool. Analyses of circulating genotypes were performed on rotavirus-positive stool specimens by conventional binary characterization of the outermost capsid genes. Overall data showed rotavirus detection in about 25% of samples tested, and higher rates in children under 2 years old were observed. Rotavirus positive cases were distributed according to a typical winter seasonal pattern. A heterogeneous regional pattern of prevalence was also observed, with higher rates detected in the North region. Genotype co-circulation and annual fluctuation were observed. In general, G1P[8], G2P[4], G3P[8], and G12P[8] were the most frequently detected genotypes. This study represents the last survey taken of a population considered to be naïve. J. Med. Virol. 89:423-428, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Public finance of rotavirus vaccination in India and Ethiopia: an extended cost-effectiveness analysis.

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Verguet, Stéphane; Murphy, Shane; Anderson, Benjamin; Johansson, Kjell Arne; Glass, Roger; Rheingans, Richard

2013-10-01

An estimated 4% of global child deaths (approximately 300,000 deaths) were attributed to rotavirus in 2010. About a third of these deaths occurred in India and Ethiopia. Public finance of rotavirus vaccination in these two countries could substantially decrease child mortality and also reduce rotavirus-related hospitalizations, prevent health-related impoverishment and bring significant cost savings to households. We use a methodology of 'extended cost-effectiveness analysis' (ECEA) to evaluate a hypothetical publicly financed program for rotavirus vaccination in India and Ethiopia. We measure program impact along four dimensions: 1) rotavirus deaths averted; 2) household expenditures averted; 3) financial risk protection afforded; 4) distributional consequences across the wealth strata of the country populations. In India and Ethiopia, the program would lead to a substantial decrease in rotavirus deaths, mainly among the poorer; it would reduce household expenditures across all income groups and it would effectively provide financial risk protection, mostly concentrated among the poorest. Potential indirect benefits of vaccination (herd immunity) would increase program benefits among all income groups, whereas potentially decreased vaccine efficacy among poorer households would reduce the equity benefits of the program. Our approach incorporates financial risk protection and distributional consequences into the systematic economic evaluation of vaccine policy, illustrated here with the case study of public finance for rotavirus vaccination. This enables selection of vaccine packages based on the quantitative inclusion of information on equity and on how much financial risk protection is being bought per dollar expenditure on vaccine policy, in addition to how much health is being bought. Copyright © 2013 Elsevier Ltd. All rights reserved.

Rotavirus 2/6 Viruslike Particles Administered Intranasally with Cholera Toxin, Escherichia coli Heat-Labile Toxin (LT), and LT-R192G Induce Protection from Rotavirus Challenge

Science.gov (United States)

O’Neal, Christine M.; Clements, John D.; Estes, Mary K.; Conner, Margaret E.

1998-01-01

We have shown that rotavirus 2/6 viruslike particles composed of proteins VP2 and VP6 (2/6-VLPs) administered to mice intranasally with cholera toxin (CT) induced protection from rotavirus challenge, as measured by virus shedding. Since it is unclear if CT will be approved for human use, we evaluated the adjuvanticity of Escherichia coli heat-labile toxin (LT) and LT-R192G. Mice were inoculated intranasally with 10 μg of 2/6-VLPs combined with CT, LT, or LT-R192G. All three adjuvants induced equivalent geometric mean titers of rotavirus-specific serum antibody and intestinal immunoglobulin G (IgG). Mice inoculated with 2/6-VLPs with LT produced significantly higher titers of intestinal IgA than mice given CT as the adjuvant. All mice inoculated with 2/6-VLPs mixed with LT and LT-R192G were totally protected (100%) from rotavirus challenge, while mice inoculated with 2/6-VLPs mixed with CT showed a mean 91% protection from challenge. The availability of a safe, effective mucosal adjuvant such as LT-R192G will increase the practicality of administering recombinant vaccines mucosally. PMID:9525668

Economic evaluation of routine infant rotavirus immunisation program in Japan.

Science.gov (United States)

Hoshi, Shu-Ling; Kondo, Masahide; Okubo, Ichiro

2017-05-04

Two rotavirus vaccines are currently available in Japan. We estimated the incremental cost-effectiveness ratio (ICER) of routine infant rotavirus immunisation program without defining which vaccine to be evaluated, which reflects the current deliberation at the Health Science Council in charge of Immunisation and Vaccine established by the Ministry of Health, Labor and Welfare of Japan. Three ICERs were estimated, one from payers' perspective and 2 from societal perspective depending on the scenarios to uptake vaccines. The health statuses following the birth cohort were as follows: not infected by rotavirus, asymptomatic infection, outpatients after infection, hospitalised after infection, developing encephalitis/encephalopathy followed by recovery, sequelae, and death. Costs of per course of vaccination was ¥30,000 (US$283; US$1 = ¥106). The model runs for 60 months with one month cycle. From payers' perspective, estimated ICERs were ¥6,877,000 (US$64,877) per QALY. From societal perspective, immunisation program turns out to be cost-saving for 75% simultaneous vaccination scenario, while it is at ¥337,000 (US$3,179) per QALY gained with vaccine alone scenario. The probability of rotavirus immunisation program to be under ¥5,000,000 (US$47,170) per QALY was at 19.8%, 40.7%, and 75.6% when costs per course of vaccination were set at ¥30,000 (US$283), ¥25,000 (US$236), and ¥20,000 (US$189), respectively. Rotavirus immunisation program has a potential to be cost-effective from payers' perspective and even cost-saving from societal perspective in Japan, however, caution should be taken with regard to the interpretation of the results as cost-effectiveness is critically dependent on vaccination costs.

Acute myositis associated with concurrent infection of rotavirus and norovirus in a 2-year-old girl

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Kei Yamamoto

2015-09-01

Full Text Available Rotavirus and norovirus are common pathogens associated with gastroenteritis in children. Although rotavirus occasionally induces central nervous system disease, only 3 cases with rotavirus-induced acute myositis have been reported in the English literature. We recently treated a female patient with acute myositis associated with gastroenteritis induced by concurrent infection with rotavirus and norovirus. Having suffered from gastroenteritis for 3 days, she suddenly developed myositis affecting her lower extremities with concomitant creatine kinase elevation. Herein, we present our patient and review the previous cases including those reported in the Japanese literature.

The Role of Rotavirus Infection Requiring Treatment in a Hospital in Children with Diarrheal Syndrome

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Yu.Yu. Stepanova

2013-11-01

Full Text Available The aim of this research was to investigate the prognostic and diagnostic value of some clinical and biological factors in the development of acute intestinal rotavirus infection in children. We observed 161 children aged 1 month to 6 years. 81 children were diagnosed with rotavirus infection, and 80 — with secretory diarrhea of unknown origin. Treatment of children was carried out in a hospital. Analysis of clinical and anamnestic data enabled to choose the most prognostically and diagnostically important predictors out of 117 studied risk factors. The authors investigated the association of clinical and biological factors with the severity of rotavirus infection, which would highlight the groups of children with high risk of rotavirus infection, which requires treatment in a hospital. The practical application of the results of this work should be the optimization of early diagnostics of rotavirus infections and timeliness of preventive measures.

Genetic Factors in the Pathogenesis of Rotavirus Infection in Children

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I.I. Nezgoda

2013-08-01

Full Text Available The paper presents the results of examination of 40 children with a diagnosis of rotavirus infection. We examined and analyzed the clinical course of rotavirus infection depending on the genotype in polymorphism C > T at position 13910 of lactase gene (LCT. It is found that the most severe course of infection is associated with genotypes that are responsible for lactose intolerance — C/C-13910 and C/T-13910.

Prevalence and characterization of rotaviruses in children hospitalized for diarrheal disease in a tertiary care hospital, Pune

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Sae Satish Pol

2017-01-01

Full Text Available Background: Diarrhoea remains the second most common cause of death among children below 5 years globally. Among various enteric pathogens, rotavirus appears to be the most important aetiological agent of acute gastroenteritis in infants and young children. Increased understanding of epidemiology of rotavirus infections is needed to improve the vaccine efficacy. Aim: This study aims to determine prevalence rotavirus infection and prevalent circulating strains of rotavirus in and around Pune. Setting and Design: Prospective hospital-based study. The study was approved by Institutional Ethical Committee. Materials and Methods: Stool samples (n = 100 were collected from children aged <5 years, hospitalised for acute diarrhoea in paediatric ward at a tertiary care hospital. Samples were subjected for rotavirus antigen capture ELISA. The viral RNA was subjected to multiplex reverse transcription polymerase chain reaction to amplify VP7 genotypes G1–G4, G8–G10 and G12 and VP4 genotypes P[4], P[6], P[8], P[9], P[10] and P[11]. Nontypable rotavirus strains were sequenced. Results: About 35% stool samples were positive for rotavirus antigen by ELISA. G9P[4] (28.6% was found to be the most prevalent rotavirus strain. The detection of emerging strain G12P[6] (14.3% and rare reassortant strain G9P[4] was the significant finding. Conclusion: Genotypes found in circulation are not present in the currently used vaccine. Thus, an emergence of newer genotypes over a period calls for the continued surveillance and genomic characterisation of rotaviruses to improve the vaccine efficacy.

Estimating global, regional and national rotavirus deaths in children aged <5 years: Current approaches, new analyses and proposed improvements.

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Andrew Clark

Full Text Available Rotavirus is a leading cause of diarrhoeal mortality in children but there is considerable disagreement about how many deaths occur each year.We compared CHERG, GBD and WHO/CDC estimates of age under 5 years (U5 rotavirus deaths at the global, regional and national level using a standard year (2013 and standard list of 186 countries. The global estimates were 157,398 (CHERG, 122,322 (GBD and 215,757 (WHO/CDC. The three groups used different methods: (i to select data points for rotavirus-positive proportions; (ii to extrapolate data points to individual countries; (iii to account for rotavirus vaccine coverage; (iv to convert rotavirus-positive proportions to rotavirus attributable fractions; and (v to calculate uncertainty ranges. We conducted new analyses to inform future estimates. We found that acute watery diarrhoea was associated with 87% (95% CI 83-90% of U5 diarrhoea hospitalisations based on data from 84 hospital sites in 9 countries, and 65% (95% CI 57-74% of U5 diarrhoea deaths based on verbal autopsy reports from 9 country sites. We reanalysed data from the Global Enteric Multicenter Study (GEMS and found 44% (55% in Asia, and 32% in Africa rotavirus-positivity among U5 acute watery diarrhoea hospitalisations, and 28% rotavirus-positivity among U5 acute watery diarrhoea deaths. 97% (95% CI 95-98% of the U5 diarrhoea hospitalisations that tested positive for rotavirus were entirely attributable to rotavirus. For all clinical syndromes combined the rotavirus attributable fraction was 34% (95% CI 31-36%. This increased by a factor of 1.08 (95% CI 1.02-1.14 when the GEMS results were reanalysed using a more sensitive molecular test.We developed consensus on seven proposals for improving the quality and transparency of future rotavirus mortality estimates.

Postdiarrheal Shiga Toxin-Mediated Hemolytic Uremic Syndrome Similar to Septic Shock Síndrome urémico hemolítico símil shock séptico, posterior a diarrea mediada por toxina shiga

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Patricia G. Valles

2005-10-01

enterohemorrágica que deviene en Síndrome Urémico Hemolítico (SUH. Se evaluó en forma prospectiva, entre 1999 y 2003, la respuesta a un tratamiento no convencional, en doce pacientes, edad 2.8 ± 0.6 años, que desarrollaron SUH con presencia de diarrea sanguinolenta (SUH D+ y evidencia serológica de toxina Shiga, los cuales en fase inicial presentaron parámetros hemodinámicos compatibles con shock séptico y compromiso neurológico grave. El protocolo incluyó transfusión de plasma fresco, pulsos de metilprednisolona (10mg/k/día por tres días consecutivos y plasmaféresis por cinco días, iniciados en las primeras 48 horas. Los doce pacientes ingresaron en terapia intensiva, presentando una puntuación de riesgo de mortalidad pediátrica (PRISM: 18 ± 2, con requerimiento de diálisis por 17.4 ± 4 días, asistencia ventilatoria mecánica por 10 ± 1días y soporte temprano con drogas inotrópicas por un período de 10.5 ± 1 días. La disfunción neurológica se presentó con convulsiones tónico-clónicas generalizadas por 5.4 ± 1 días en 8 pacientes y con convulsiones focalizadas en los restantes. Seis pacientes desarrollaron miocardiopatía dilatada y 8 presentaron colitis hemorrágica. Sobrevivieron a la etapa aguda de la enfermedad 9 pacientes. Al finalizar el primer año de seguimiento, dos de ellos presentaban secuelas neurológicas (escala de seguimiento de Glasgow; GOS 3 y 4 respectivamente y uno, fallo renal crónico. La introducción temprana de este protocolo podría beneficiar a pacientes con SUH D+ con inestabilidad hemodinámica grave y disfunción neurológica al inicio. Los mecanismos involucrados en esta temprana presentación clínica adversa de SUH D+ permanecen aún sin dilucidar.

Interactions between Rotavirus and Suwannee River Organic Matter: Aggregation, Deposition, and Adhesion Force Measurement

KAUST Repository

Gutierrez, Leonardo

2012-08-21

Interactions between rotavirus and Suwannee River natural organic matter (NOM) were studied by time-resolved dynamic light scattering, quartz crystal microbalance, and atomic force microscopy. In NOM-containing NaCl solutions of up to 600 mM, rotavirus suspension remained stable for over 4 h. Atomic force microscopy (AFM) measurement for interaction force decay length at different ionic strengths showed that nonelectrostatic repulsive forces were mainly responsible for eliminating aggregation in NaCl solutions. Aggregation rates of rotavirus in solutions containing 20 mg C/L increased with divalent cation concentration until reaching a critical coagulation concentration of 30 mM CaCl2 or 70 mM MgCl2. Deposition kinetics of rotavirus on NOM-coated silica surface was studied using quartz crystal microbalance. Experimental attachment efficiencies for rotavirus adsorption to NOM-coated surface in MgCl2 solution were lower than in CaCl2 solution at a given divalent cation concentration. Stronger adhesion force was measured for virus-virus and virus-NOM interactions in CaCl2 solution compared to those in MgCl2 or NaCl solutions at the same ionic strength. This study suggested that divalent cation complexation with carboxylate groups in NOM and on virus surface was an important mechanism in the deposition and aggregation kinetics of rotavirus. © 2012 American Chemical Society.

Effect of breastfeeding promotion interventions on cost-effectiveness of rotavirus immunization in Indonesia

NARCIS (Netherlands)

Suwantika, Auliya A.; Postma, Maarten J.

2013-01-01

BACKGROUND: Rotavirus infection has been reported to be responsible for the majority of severe diarrhea in children under-5-years-old in Indonesia. Breast milk is considered to give protection against rotavirus infection. Increasing breastfeeding promotion programs could be an alternative target to

Progress in the introduction of the rotavirus vaccine in Latin America and the Caribbean: four years of accumulated experience.

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de Oliveira, Lucia Helena; Danovaro-Holliday, M Carolina; Sanwogou, N Jennifer; Ruiz-Matus, Cuauhtemoc; Tambini, Gina; Andrus, Jon Kim

2011-01-01

Two effective and safe rotavirus vaccines became available in 2006 and have been recommended for use in all countries by the World Health Organization. This article provides an update on the use of rotavirus vaccine in Latin American and Caribbean (LAC) countries. Data reported by LAC countries to the Pan American Health Organization (PAHO) were reviewed. As of May 2010, 14 LAC countries and 1 territory have introduced the rotavirus vaccine into their national expanded program on immunization (EPI). Reported coverage levels for rotavirus vaccine are lower than those for other EPI vaccines recommended at the same age. A total of 15 LAC countries are part of the PAHO's LAC rotavirus surveillance network; 12 of them are using the vaccine. LAC countries are conducting several studies on rotavirus vaccine effectiveness, cost-effectiveness, and monitoring safety. Also, LAC countries are generating lessons learned on the public health implications of introducing a new vaccine into the EPI. Nine countries and the Cayman Islands pay for the entire cost of the vaccine using government funds. All but 2 countries purchase their rotavirus vaccine through PAHO's Revolving Fund. Rotavirus vaccine introduction in LAC has been faster than for other new vaccines, but coverage levels need to increase to maximize the effect of the intervention. Rotavirus surveillance needs to expand and be strengthened to better assess the effect of vaccine use. LAC countries will continue to provide useful data to monitor rotavirus trends and vaccine effect.

Strain diversity plays no major role in the varying efficacy of rotavirus vaccines: an overview.

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Velasquez, Daniel E; Parashar, Umesh D; Jiang, Baoming

2014-12-01

While a monovalent Rotarix® [RV1] and a pentavalent RotaTeq® [RV5] have been extensively tested and found generally safe and equally efficacious in clinical trials, the question still lingers about the evolving diversity of circulating rotavirus strains over time and their relationship with protective immunity induced by rotavirus vaccines. We reviewed data from clinical trials and observational studies that assessed the efficacy or field effectiveness of rotavirus vaccines against different rotavirus strains worldwide. RV1 provided broad clinical efficacy and field effectiveness against severe diarrhea due to all major circulating strains, including the homotypic G1P[8] and the fully heterotypic G2P[4] strains. Similarly, RV5 provided broad efficacy and effectiveness against RV5 and non-RV5 strains throughout different locations. Rotavirus vaccination provides broad heterotypic protection; however continuing surveillance is needed to track the change of circulating strains and monitor the effectiveness and safety of vaccines. Published by Elsevier B.V.

Rotavirus VP7, and VP4 Types circulating in Plateau State Nigeria ...

African Journals Online (AJOL)

Objective: To determine the rotavirus genotypes circulating in Plateau State using RT – PCR. Materials and Methods: Thirty one rotavirus isolates recovered from diarrhoeic stools in 1998 and 1999 were analyzed using nested multiplex RT – PCR technique for the determination of VP7 and VP4 genotypes. Results: VP7 ...

Real-time RT-PCR, a necessary tool to support the diagnosis and surveillance of rotavirus in Mexico.

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De La Cruz Hernández, Sergio Isaac; Anaya Molina, Yazmin; Gómez Santiago, Fabián; Terán Vega, Heidi Lizbeth; Monroy Leyva, Elda; Méndez Pérez, Héctor; García Lozano, Herlinda

2018-04-01

Rotavirus produces diarrhea in children under 5 years old. Most of those conventional methods such as polyacrylamide gel electrophoresis (PAGE) and reverse transcription-polymerase chain reaction (RT-PCR) have been used for rotavirus detection. However, these techniques need a multi-step process to get the results. In comparison with conventional methods, the real-time RT-PCR is a highly sensitive method, which allows getting the results in only one day. In this study a real-time RT-PCR assay was tested using a panel of 440 samples from patients with acute gastroenteritis, and characterized by PAGE and RT-PCR. The results show that the real-time RT-PCR detected rotavirus from 73% of rotavirus-negative samples analyzed by PAGE and RT-PCR; thus, the percentage of rotavirus-positive samples increased to 81%. The results indicate that this real-time RT-PCR should be part of a routine analysis, and as a support of the diagnosis of rotavirus in Mexico. Copyright © 2017 Elsevier Inc. All rights reserved.

Epidemiological features of rotavirus infection in Goiânia, Goiás, Brazil, from 1986 to 2000

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Divina das Dôres de Paula Cardoso

2003-01-01

Full Text Available A total of 2,605 faecal specimens from children up to 10 years old with or without diarrhoea were collected. Samples were obtained from 1986 to 2000 in hospitals, outpatient clinics and day-care centers in Goiânia, Goiás. Two methodologies for viral detection were utilized: a combined enzyme immunoassay for rotavirus and adenovirus and polyacrylamide gel electrophoresis. Results showed 374 (14.4% faecal specimens positive for Rotavirus A, most of them collected from hospitalized children. A significant detection rate of rotavirus during the period from April to August, dry season in Goiânia, and different frequencies of viral detection throughout the years of study were also observed. Rotavirus was significantly related to hospitalization and to diarrhoeal illness in children up to 24 months old. This study reinforces the importance of rotavirus as a cause of diarrhoea in children and may be important in regards to the implementation of rotavirus vaccination strategies in our country.

Cost-effectiveness of rotavirus vaccination in Kenya and Uganda.

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Sigei, Charles; Odaga, John; Mvundura, Mercy; Madrid, Yvette; Clark, Andrew David

2015-05-07

Rotavirus vaccines have the potential to prevent a substantial amount of life-threatening gastroenteritis in young African children. This paper presents the results of prospective cost-effectiveness analyses for rotavirus vaccine introduction for Kenya and Uganda. In each country, a national consultant worked with a national technical working group to identify appropriate data and validate study results. Secondary data on demographics, disease burden, health utilization, and costs were used to populate the TRIVAC cost-effectiveness model. The baseline analysis assumed an initial vaccine price of $0.20 per dose, corresponding to Gavi, the Vaccine Alliance stipulated copay for low-income countries. The incremental cost-effectiveness of a 2-dose rotavirus vaccination schedule was evaluated for 20 successive birth cohorts from the government perspective in both countries, and from the societal perspective in Uganda. Between 2014 and 2033, rotavirus vaccination can avert approximately 60,935 and 216,454 undiscounted deaths and hospital admissions respectively in children under 5 years in Kenya. In Uganda, the respective number of undiscounted deaths and hospital admission averted is 70,236 and 329,779 between 2016 and 2035. Over the 20-year period, the discounted vaccine program costs are around US$ 80 million in Kenya and US$ 60 million in Uganda. Discounted government health service costs avoided are US$ 30 million in Kenya and US$ 10 million in Uganda (or US$ 18 million including household costs). The cost per disability-adjusted life-year (DALY) averted from a government perspective is US$ 38 in Kenya and US$ 34 in Uganda (US$ 29 from a societal perspective). Rotavirus vaccine introduction is highly cost-effective in both countries in a range of plausible 'what-if' scenarios. The involvement of national experts improves the quality of data used, is likely to increase acceptability of the results in decision-making, and can contribute to strengthened national

Prospective evaluation of indirect costs due to acute rotavirus gastroenteritis in Spain: the ROTACOST study.

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Bouzón-Alejandro, Marta; Redondo-Collazo, Lorenzo; Sánchez-Lastres, Juan Manuel; Martinón-Torres, Nazareth; Martinón-Sánchez, José María; Martinón-Torres, Federico

2011-09-14

The effect of rotavirus in developed countries is mainly economic. This study aimed to assess the indirect costs induced by rotavirus acute gastroenteritis (RVAGE) in Spain. A prospective observational study was conducted from October 2008 to June 2009. It included 682 children up to 5 years of age with acute gastroenteritis (AGE) who attended primary care (n = 18) and emergency room/hospital settings (n = 10), covering the regions of Galicia and Asturias (North-west Spain). All non-medical expenses incurred throughout the episode were recorded in detail using personal interviews and telephone contact. Among the 682 enrolled children, 207 (30.4%) were rotavirus positive and 170 (25%) had received at least one dose of rotavirus vaccine. The mean (standard deviation) indirect cost caused by an episode of AGE was estimated at 135.17 (182.70) Euros. Costs were 1.74-fold higher when AGE was caused by rotavirus compared with other etiologies: 192.7 (219.8) Euros vs. 111.6 (163.5) Euros (p purchase of material. Patients with RVAGE were admitted to hospital more frequently than those with other etiologies (47.8% vs 14%, p decision-making process of the eventual inclusion of rotavirus vaccine in the national immunization schedule of well developed countries.

Pediatric Rotavirus Gastroenteritis: A 2 year Analysis to Understand Current Prevalence in Mumbai

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Vidya Nerurkar

2011-04-01

Full Text Available Many studies have established the high prevalence of paediatric Rotavirus gastroenteritis in India. The importance of rapid diagnosis of rotavirus infection has also been stressed upon, to initiate prompt rehydration therapy and prevent unnecessary use of antibiotics .We undertook a retrospective analysis of 327 paediatric stool specimens to understand the current prevalence and seasonal distribution of cases in Mumbai and its surrounding areas. Overall Rotavirus positivity rate was 37.9 %, with peak positivity in winter seasons. Infections were more common upto 2 years of age. Incidence of bacterial and parasitic coinfections was low.

Construction and characterization of human rotavirus recombinant VP8* subunit parenteral vaccine candidates.

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Wen, Xiaobo; Cao, Dianjun; Jones, Ronald W; Li, Jianping; Szu, Shousun; Hoshino, Yasutaka

2012-09-21

Two currently licensed live oral rotavirus vaccines (Rotarix® and RotaTeq®) are highly efficacious against severe rotavirus diarrhea. However, the efficacy of such vaccines in selected low-income African and Asian countries is much lower than that in middle or high-income countries. Additionally, these two vaccines have recently been associated with rare case of intussusception in vaccinated infants. We developed a novel recombinant subunit parenteral rotavirus vaccine which may be more effective in low-income countries and also avert the potential problem of intussusception. Truncated recombinant VP8* (ΔVP8*) protein of human rotavirus strain Wa P[8], DS-1 P[4] or 1076 P[6] expressed in Escherichia coli was highly soluble and was generated in high yield. Guinea pigs hyperimmunized intramuscularly with each of the ΔVP8* proteins (i.e., P[8], P[4] or P[6]) developed high levels of homotypic as well as variable levels of heterotypic neutralizing antibodies. Moreover, the selected ΔVP8* proteins when administered to mice at a clinically relevant dosage, route and schedule, elicited high levels of serum anti-VP8* IgG and/or neutralizing antibodies. Our data indicated that the ΔVP8* proteins may be a plausible additional candidate as new parenteral rotavirus vaccines. Published by Elsevier Ltd.

New approaches in oral rotavirus vaccines.

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Kuate Defo, Zenas; Lee, Byong

2016-05-01

Rotavirus is the leading cause of severe dehydrating diarrhea worldwide, and affects primarily developing nations, in large part because of the inaccessibility of vaccines and high rates of mortality present therein. At present, there exist two oral rotaviral vaccines, Rotarix™ and RotaTeq™. These vaccines are generally effective in their actions: however, associated costs often stymie their effectiveness, and they continue to be associated with a slight risk of intussusception. While different programs are being implemented worldwide to enhance vaccine distribution and monitor vaccine administration for possible intussusception in light of recent WHO recommendation, another major problem persists: that of the reduced efficacy of the existing rotaviral vaccines in developing countries over time. The development of new oral rotavirus vaccine classes - live-attenuated vaccines, virus-like particles, lactic acid bacteria-containing vaccines, combination therapy with immunoglobulins, and biodegradable polymer-encapsulated vaccines - could potentially circumvent these problems.

SPREAD AND PRIMARY MANIFESTATIONS OF ROTAVIRUS INFECTION MORBIDITY IN DIFFERENT PARTS OF THE WORLD

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V. V. Kudryavtsev

2013-01-01

Full Text Available The article presents data on the peculiarities of the rotavirus infection spreading in the Russian Federation and other certain countries. It is shown that morbidity levels depend on both objective (population size and territory density, transmission paths activity and subjective (detectability levels factors. It has been established that children 0-3 years of age are the most susceptible to rotavirus infection. The epidemic process development intensity is higher in bigger cities. Considerable regional and seasonal changeability of circulating rotavirus strains is noted.

Socio-demographic, Clinical and Laboratory Features of Rotavirus Gastroenteritis in Children Treated in Pediatric Clinic

OpenAIRE

Azemi, Mehmedali; Berisha, Majlinda; Ismaili-Jaha, Vlora; Kolgeci, Selim; Avdiu, Muharrem; Jakupi, Xhevat; Hoxha, Rina; Hoxha-Kamberi, Teuta

2013-01-01

Aim: The aim of work was presentation of several socio-demographic, clinical and laboratory characteristics of gastroenteritis caused by rotavirus. The examinees and methods: The examinees were children under the age of five years treated at the Pediatric Clinic due to acute gastroenteritis caused by rotavirus. Rotavirus is isolated by method chromatographic immunoassay by Cer Test Biotec. Results: From the total number of patients (850) suffering from acute gastroenteritis, feces test on bac...

Epidemiologic Association Between FUT2 Secretor Status and Severe Rotavirus Gastroenteritis in Children in the United States

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Payne, Daniel C.; Currier, Rebecca L.; Staat, Mary A.; Sahni, Leila C.; Selvarangan, Rangaraj; Halasa, Natasha B.; Englund, Janet A.; Weinberg, Geoffrey A.; Boom, Julie A.; Szilagyi, Peter G.; Klein, Eileen J.; Chappell, James; Harrison, Christopher J.; Davidson, Barbara S.; Mijatovic-Rustempasic, Slavica; Moffatt, Mary D.; McNeal, Monica; Wikswo, Mary; Bowen, Michael D.; Morrow, Ardythe L.; Parashar, Umesh D.

2016-01-01

IMPORTANCE A genetic polymorphism affecting FUT2 secretor status in approximately one-quarter of humans of European descent affects the expression of histo-blood group antigens on the mucosal epithelia of human respiratory, genitourinary, and digestive tracts. These histo-blood group antigens serve as host receptor sites necessary for attachment and infection of some pathogens, including norovirus. OBJECTIVE We investigated whether an association exists between FUT2 secretor status and laboratory-confirmed rotavirus infections in US children. DESIGN, SETTING, AND PARTICIPANTS Multicenter case-control observational study involving active surveillance at 6 US pediatric medical institutions in the inpatient and emergency department clinical settings. We enrolled 1564 children younger than 5 years with acute gastroenteritis (diarrhea and/or vomiting) and 818 healthy controls frequency matched by age and month, from December 1, 2011, through March 31, 2013. MAIN OUTCOMES AND MEASURES Paired fecal-saliva specimens were tested for rotavirus and for secretor status. Comparisons were made between rotavirus test–positive cases and healthy controls stratified by ethnicity and vaccination status. Adjusted multivariable analyses assessed the preventive association of secretor status against severe rotavirus gastroenteritis. RESULTS One (0.5%) of 189 rotavirus test–positive cases was a nonsecretor, compared with 188 (23%) of 818 healthy control participants (P < .001). Healthy control participants of Hispanic ethnicity were significantly less likely to be nonsecretors (13%) compared with healthy children who were not of Hispanic ethnicity (25%) (P < .001). After controlling for vaccination and other factors, children with the nonsecretor FUT2 polymorphism appeared statistically protected (98% [95% CI, 84%–100%]) against severe rotavirus gastroenteritis. CONCLUSIONS AND RELEVANCE Severe rotavirus gastroenteritis was virtually absent among US children who had a genetic

Diversity in Rotavirus–Host Glycan Interactions: A “Sweet” SpectrumSummary

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Sasirekha Ramani

2016-05-01

Full Text Available Interaction with cellular glycans is a critical initial step in the pathogenesis of many infectious agents. Technological advances in glycobiology have expanded the repertoire of studies delineating host glycan–pathogen interactions. For rotavirus, the VP8* domain of the outer capsid spike protein VP4 is known to interact with cellular glycans. Sialic acid was considered the key cellular attachment factor for rotaviruses for decades. Although this is true for many rotavirus strains causing infections in animals, glycan array screens show that many human rotavirus strains bind nonsialylated glycoconjugates, called histo-blood group antigens, in a strain-specific manner. The expression of histo-blood group antigens is determined genetically and is regulated developmentally. Variations in glycan binding between different rotavirus strains are biologically relevant and provide new insights into multiple aspects of virus pathogenesis such as interspecies transmission, host range restriction, and tissue tropism. The genetics of glycan expression may affect susceptibility to different rotavirus strains and vaccine viruses, and impact the efficacy of rotavirus vaccination in different populations. A multidisciplinary approach to understanding rotavirus–host glycan interactions provides molecular insights into the interaction between microbial pathogens and glycans, and opens up new avenues to translate findings from the bench to the human population. Keywords: Rotavirus, VP8*, Glycans, Sia, Histo-Blood Group Antigens

Stability of live attenuated rotavirus vaccine with selected preservatives and primary containers.

Science.gov (United States)

Lal, Manjari; Jarrahian, Courtney; Zhu, Changcheng; Hosken, Nancy A; McClurkan, Chris L; Koelle, David M; Saxon, Eugene; Roehrig, Andrew; Zehrung, Darin; Chen, Dexiang

2016-05-11

Rotavirus infection, which can be prevented by vaccination, is responsible for a high burden of acute gastroenteritis disease in children, especially in low-income countries. An appropriate formulation, packaging, and delivery device for oral rotavirus vaccine has the potential to reduce the manufacturing cost of the vaccine and the logistical impact associated with introduction of a new vaccine, simplify the vaccination procedure, and ensure that the vaccine is safely and accurately delivered to children. Single-dose prefilled presentations can be easy to use; however, they are typically more expensive, can be a bottleneck during production, and occupy a greater volume per dose vis-à-vis supply chain storage and medical waste disposal, which is a challenge in low-resource settings. Multi-dose presentations used thus far have other issues, including increased wastage of vaccine and the need for separate delivery devices. In this study, the goals were to evaluate both the technical feasibility of using preservatives to develop a liquid multi-dose formulation and the primary packaging alternatives for orally delivered, liquid rotavirus vaccines. The feasibility evaluation included evaluation of commonly used preservatives for compatibility with rotavirus vaccines and stability testing of rotavirus vaccine in various primary containers, including Lameplast's plastic tubes, BD's oral dispenser version of Uniject™ (Uniject DP), rommelag's blow-fill-seal containers, and MEDInstill's multi-dose vial and pouch. These presentations were compared to a standard glass vial. The results showed that none of the preservatives tested were compatible with a live attenuated rotavirus vaccine because they had a detrimental effect on the viability of the virus. In the presence of preservatives, vaccine virus titers declined to undetectable levels within 1 month. The vaccine formulation without preservatives maintained a stability profile over 12 months in all primary containers

Efficacy of a Low-Cost, Heat-Stable Oral Rotavirus Vaccine in Niger.

Science.gov (United States)

Isanaka, Sheila; Guindo, Ousmane; Langendorf, Celine; Matar Seck, Amadou; Plikaytis, Brian D; Sayinzoga-Makombe, Nathan; McNeal, Monica M; Meyer, Nicole; Adehossi, Eric; Djibo, Ali; Jochum, Bruno; Grais, Rebecca F

2017-03-23

Each year, rotavirus gastroenteritis is responsible for about 37% of deaths from diarrhea among children younger than 5 years of age worldwide, with a disproportionate effect in sub-Saharan Africa. We conducted a randomized, placebo-controlled trial in Niger to evaluate the efficacy of a live, oral bovine rotavirus pentavalent vaccine (BRV-PV, Serum Institute of India) to prevent severe rotavirus gastroenteritis. Healthy infants received three doses of the vaccine or placebo at 6, 10, and 14 weeks of age. Episodes of gastroenteritis were assessed through active and passive surveillance and were graded on the basis of the score on the Vesikari scale (which ranges from 0 to 20, with higher scores indicating more severe disease). The primary end point was the efficacy of three doses of vaccine as compared with placebo against a first episode of laboratory-confirmed severe rotavirus gastroenteritis (Vesikari score, ≥11) beginning 28 days after dose 3. Among the 3508 infants who were included in the per-protocol efficacy analysis, there were 31 cases of severe rotavirus gastroenteritis in the vaccine group and 87 cases in the placebo group (2.14 and 6.44 cases per 100 person-years, respectively), for a vaccine efficacy of 66.7% (95% confidence interval [CI], 49.9 to 77.9). Similar efficacy was seen in the intention-to-treat analyses, which showed a vaccine efficacy of 69.1% (95% CI, 55.0 to 78.7). There was no significant between-group difference in the risk of adverse events, which were reported in 68.7% of the infants in the vaccine group and in 67.2% of those in the placebo group, or in the risk of serious adverse events (in 8.3% in the vaccine group and in 9.1% in the placebo group); there were 27 deaths in the vaccine group and 22 in the placebo group. None of the infants had confirmed intussusception. Three doses of BRV-PV, an oral rotavirus vaccine, had an efficacy of 66.7% against severe rotavirus gastroenteritis among infants in Niger. (Funded by M�

Higiene alimentaria para la prevención de trastornos digestivos infecciosos y por toxinas

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G. Manuel Moreno, Dr.

2010-09-01

Full Text Available El principal factor que interviene en el origen y prevención de las enfermedades trasmitidas por los alimentos es la higiene alimentaria. Dichas enfermedades son causadas por la ingestión de alimentos o agua contaminados con microorganismos patógenos ocasionando una infección o por la ingestión de alimentos contaminados con toxinas. Los principales agentes involucrados son Escherichia Coli, Campylobacter, Salmonella, Shigella, Listeria Monocytogenes, Norovirus, virus Hepatitis A, Astrovirus, Rotavirus, y Virus Coxsackie. Toxinas producidas por hongos o por microflora marina y los contaminantes orgánicos persistentes pueden también causar serios problemas de salud. La inocuidad alimentaría ha tomado relevancia debido a una mayor exigencia por consumidores cada día más informados y por las demandas del comercio exterior. Medidas que aseguren una adecuada higiene alimentaría nos permitirá prevenir enfermedades, principalmente digestivas, causadas por variados agentes en los alimentos. Esto se logra por la implementación de las medidas propuestas por la Comisión Internacional conocida como Codex Alimentarius.

Prevalence of rotavirus in children hospitalized with acute gastroenteritis in Imam Sajjad Hospital of Yasuj, 2011

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P Khodadadi

2013-04-01

Full Text Available Abstract Background & Aim: Rotavirus infection is the most common cause of dehydrating and gastroenteritis among children worldwide. . The aim of this study was to determine the prevalence of rotavirus in children hospitalized with acute gastroenteritis in Imam Sajjad Hospital of Yasuj. Methods: This cross sectional – descriptive study was done on 184 stool samples of children younger than 7 years of age hospitalized at Imam Sajjad hospital of Yasuj in 2011 due to acute gastroenteritis. All samples were routinely analyzed for detection of rotavirus by Enzyme Immunoassay (EIA test. Data was analyzed by SPSS version 16, Chi-square test and Fisher's exact test. Results: Of the 184 samples analyzed, 52(28.26% were positive.The Results showed significant relationship between the seasonal distribution and virus detection (p=0/001. The highest incidence of rotavirus was seen in autumn with frequency of (48.08% and the lowest in spring (5.77%. Conclusions: According to high prevalence of rotavirus infection, continual surveillance is necessary to provide useful data for formulating effective vaccines and perform diarrhea prevention programs. Key words: Rotavirus, Gastroenteritis, Prevalence, Elisa

Use of Internet Search Data to Monitor Rotavirus Vaccine Impact in the United States, United Kingdom, and Mexico.

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Shah, Minesh P; Lopman, Benjamin A; Tate, Jacqueline E; Harris, John; Esparza-Aguilar, Marcelino; Sanchez-Uribe, Edgar; Richardson, Vesta; Steiner, Claudia A; Parashar, Umesh D

2018-02-19

Previous studies have found a strong correlation between internet search and public health surveillance data. Less is known about how search data respond to public health interventions, such as vaccination, and the consistency of responses in different countries. In this study, we aimed to study the correlation between internet searches for "rotavirus" and rotavirus disease activity in the United States, United Kingdom, and Mexico before and after introduction of rotavirus vaccine. We compared time series of internet searches for "rotavirus" from Google Trends with rotavirus laboratory reports from the United States and United Kingdom and with hospitalizations for acute gastroenteritis in the United States and Mexico. Using time and location parameters, Google quantifies an internet query share (IQS) to measure the relative search volume for specific terms. We analyzed the correlation between IQS and laboratory and hospitalization data before and after national vaccine introductions. There was a strong positive correlation between the rotavirus IQS and laboratory reports in the United States (R2 = 0.79) and United Kingdom (R2 = 0.60) and between the rotavirus IQS and acute gastroenteritis hospitalizations in the United States (R2 = 0.87) and Mexico (R2 = 0.69) (P United States and by 70% (95% CI, 55%-86%) in Mexico. In the United Kingdom, there was a loss of seasonal variation after vaccine introduction. Rotavirus internet search data trends mirrored national rotavirus laboratory trends in the United States and United Kingdom and gastroenteritis-hospitalization data in the United States and Mexico; lower correlations were found after rotavirus vaccine introduction. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Efficacy and immunogenicity of live-attenuated human rotavirus vaccine in breast-fed and formula-fed European infants.

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Vesikari, Timo; Prymula, Roman; Schuster, Volker; Tejedor, Juan-C; Cohen, Robert; Bouckenooghe, Alain; Damaso, Silvia; Han, Htay Htay

2012-05-01

Rotavirus is the main cause of severe gastroenteritis and diarrhea in infants and young children less than 5 years of age. Potential impact of breast-feeding on the efficacy and immunogenicity of human rotavirus G1P[8] vaccine was examined in this exploratory analysis. Healthy infants (N = 3994) aged 6-14 weeks who received 2 doses of human rotavirus vaccine/placebo according to a 0-1 or 0-2 month schedule were followed for rotavirus gastroenteritis during 2 epidemic seasons. Rotavirus IgA seroconversion rate (anti-IgA antibody concentration ≥ 20 mIU/mL) and geometric mean concentrations were measured prevaccination and 1-2 months post-dose 2. Vaccine efficacy against any and severe rotavirus gastroenteritis was analyzed according to the infants being breast-fed or exclusively formula-fed at the time of vaccination. Antirotavirus IgA seroconversion rate was 85.5% (95% confidence interval [CI]: 82.4-88.3) in breast-fed and 89.2% (95% CI: 84.2-93) in exclusively formula-fed infants; geometric mean concentrations in the respective groups were 185.8 U/mL (95% CI: 161.4-213.9) and 231.5 U/mL (95% CI: 185.9-288.2). Vaccine efficacy was equally high in breast-fed and exclusively formula-fed children in the first season but fell in breast-fed infants in the second rotavirus season. During the combined 2-year efficacy follow-up period, vaccine efficacy against any rotavirus gastroenteritis was 76.2% (95% CI: 68.7-82.1) and 89.8% (95% CI: 77.6-95.9) and against severe rotavirus gastroenteritis 88.4% (95% CI: 81.6-93) and 98.1% (95% CI: 88.2-100) in the breast-fed and exclusively formula-fed infants, respectively. The difference in immunogenicity of human rotavirus vaccine in breast-fed and exclusively formula-fed infants was small. Vaccine efficacy was equally high in breast-fed and exclusively formula-fed children in the first season. Breast-feeding seemed to reduce slightly the efficacy in the second season.

Impact of rotavirus vaccination on hospitalisations in Belgium: comparing model predictions with observed data.

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Baudouin Standaert

Full Text Available BACKGROUND: Published economic assessments of rotavirus vaccination typically use modelling, mainly static Markov cohort models with birth cohorts followed up to the age of 5 years. Rotavirus vaccination has now been available for several years in some countries, and data have been collected to evaluate the real-world impact of vaccination on rotavirus hospitalisations. This study compared the economic impact of vaccination between model estimates and observed data on disease-specific hospitalisation reductions in a country for which both modelled and observed datasets exist (Belgium. METHODS: A previously published Markov cohort model estimated the impact of rotavirus vaccination on the number of rotavirus hospitalisations in children aged <5 years in Belgium using vaccine efficacy data from clinical development trials. Data on the number of rotavirus-positive gastroenteritis hospitalisations in children aged <5 years between 1 June 2004 and 31 May 2006 (pre-vaccination study period or 1 June 2007 to 31 May 2010 (post-vaccination study period were analysed from nine hospitals in Belgium and compared with the modelled estimates. RESULTS: The model predicted a smaller decrease in hospitalisations over time, mainly explained by two factors. First, the observed data indicated indirect vaccine protection in children too old or too young for vaccination. This herd effect is difficult to capture in static Markov cohort models and therefore was not included in the model. Second, the model included a 'waning' effect, i.e. reduced vaccine effectiveness over time. The observed data suggested this waning effect did not occur during that period, and so the model systematically underestimated vaccine effectiveness during the first 4 years after vaccine implementation. CONCLUSIONS: Model predictions underestimated the direct medical economic value of rotavirus vaccination during the first 4 years of vaccination by approximately 10% when assessing

Cost-effectiveness of rotavirus vaccination in the Netherlands; the results of a consensus model

NARCIS (Netherlands)

Rozenbaum, M.H.; Mangen, M.J.J.; Giaquinto, C.; Wilschut, J.C.; Hak, E.; Postma, M.J.

2011-01-01

Background: Each year rotavirus gastroenteritis results in thousands of paediatric hospitalisations and primary care visits in the Netherlands. While two vaccines against rotavirus are registered, routine immunisation of infants has not yet been implemented. Existing cost-effectiveness studies

Effective prophylaxis against rotavirus diarrhea using a combination of Lactobacillus rhamnosus GG and antibodies

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Hammarström Lennart

2007-09-01

Full Text Available Abstract Background Rotavirus is a worldwide cause of infectious infantile diarrhea that claims over 600,000 lives annually. Recently, two new vaccine candidates have been developed but their efficacy in developing countries, still remains to be proven. Oral delivery of specific immunoglobulins provides passive immunity and is a fast acting treatment for rotavirus diarrhea. Probiotic bacteria have also gained considerable attention lately as treatment for rotavirus diarrhea. Here we report an evaluation of the therapeutic potential of different probiotics and their combination with anti – rotavirus antibodies in a mouse model of rotavirus diarrhea. Results Of the six probiotic bacteria tested, Lactobacillus rhamnosus strain GG had the strongest influence in reducing prevalence, duration and severity of diarrhea and was therefore chosen for combination treatment with immunoglobulins. The combination treatment reduced the diarrhea outcome measures significantly, prevented histopathological changes and reduced the virus load in the intestines. Conclusion The advantages associated with immunoglobulins and probiotics based therapy is that the treatment provides a rapid therapeutic effect and is cost efficient. These components do not require special storage conditions and could potentially complement the rehydration therapy that is currently used.

A PREVALÊNCIA DE DIARRÉIA EM CRIANÇAS COM UMA AMAMENTAÇÃO AUSENTE OU INFERIOR A SEIS MESES

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MÁRCIO FLÁVIO MOURA DE ARAÚJO

2007-01-01

Full Text Available La lactancia materna es un acto que repercute de forma biológica, psicológica y social en el desarrollo del niño, interfiriendo, especialmente, en la prevención de enfermedades infecciosas como la diarrea. Por consiguiente, se planteó la necesidad de verificar el predominio del diagnóstico de diarrea en niños que nunca mamaron o cuya lactancia fue inferior a seis meses, atendidos en un servicio de atención básica de Fortaleza. Durante los meses de junio y julio de 2005 fueron observados 121 niños, las informaciones se recogieron con las madres por medio de un formulario. Los resultados mostraron que 39,6% de los bebes mamaron por menos de seis meses y que 5,7% de ellos no mamaron. En el contexto de los niños con ausencia de lactancia materna o ineficaz, el diagnóstico de diarrea fue identificado en el 23.6% de ellos. Es consenso de varios estudios que la leche materna tiene características inmunológicas que previenen un brote de diarreas. Así, se concluye que la lactancia materna hasta los seis meses de vida es una acción importante en la promoción de la salud del niño.

Oral live attenuated human rotavirus vaccine (RotarixTM offers sustained high protection against severe G9P[8] rotavirus gastroenteritis during the first two years of life in Brazilian children

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Maria Cleonice A Justino

2012-11-01

Full Text Available In a large Phase III trial conducted in 10 Latin American countries, the safety and efficacy of the live attenuated monovalent rotavirus vaccine RIX4414 was evaluated in 15,183 healthy infants followed up during the first two years of life. Belém was the only site in Brazil included in this multicentre trial. The study in Belém included a subset of 653 infants who were followed up until 24 months of age for protection against severe rotavirus gastroenteritis. These subjects were randomly assigned in a 1:1 ratio to receive two doses of vaccine (n = 328 or two doses of placebo (n = 325 at approximately two and four months of age. Of the 653 enrolled infants, 23 dropped out during the study period. For the combined two-year period, the efficacy of RIX4414 was 72.3% [95% confidence interval (CI 37.5-89.1%] against severe rotavirus-related gastroenteritis, reaching a protection rate of 81.8% (95% CI 36.4-96.6% against circulating wild-type G9 rotavirus strains. It is concluded that two doses of RIX4414 are highly efficacious against severe rotavirus gastroenteritis in Belém during the first two years of life and provide high protection against the worldwide emergence and spread of G9P[8] strains.

Removing the age restrictions for rotavirus vaccination: a benefit-risk modeling analysis.

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Manish M Patel

Full Text Available BACKGROUND: To minimize potential risk of intussusception, the World Health Organization (WHO recommended in 2009 that rotavirus immunization should be initiated by age 15 weeks and completed before 32 weeks. These restrictions could adversely impact vaccination coverage and thereby its health impact, particularly in developing countries where delays in vaccination often occur. METHODS AND FINDINGS: We conducted a modeling study to estimate the number of rotavirus deaths prevented and the number of intussusception deaths caused by vaccination when administered on the restricted schedule versus an unrestricted schedule whereby rotavirus vaccine would be administered with DTP vaccine up to age 3 years. Countries were grouped on the basis of child mortality rates, using WHO data. Inputs were estimates of WHO rotavirus mortality by week of age from a recent study, intussusception mortality based on a literature review, predicted vaccination rates by week of age from USAID Demographic and Health Surveys, the United Nations Children's Fund (UNICEF Multiple Indicator Cluster Surveys (MICS, and WHO-UNICEF 2010 country-specific coverage estimates, and published estimates of vaccine efficacy and vaccine-associated intussusception risk. On the basis of the error estimates and distributions for model inputs, we conducted 2,000 simulations to obtain median estimates of deaths averted and caused as well as the uncertainty ranges, defined as the 5th-95th percentile, to provide an indication of the uncertainty in the estimates. We estimated that in low and low-middle income countries a restricted schedule would prevent 155,800 rotavirus deaths (5th-95th centiles, 83,300-217,700 while causing potentially 253 intussusception deaths (76-689. In contrast, vaccination without age restrictions would prevent 203,000 rotavirus deaths (102,000-281,500 while potentially causing 547 intussusception deaths (237-1,160. Thus, removing the age restrictions would avert an

Epidemiology and genetic diversity of rotavirus strains in children with acute gastroenteritis in Lahore, Pakistan.

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Muhammad Masroor Alam

Full Text Available Pakistan harbors high disease burden of gastro-enteric infections with majority of these caused by rotavirus. Unfortunately, lack of proper surveillance programs and laboratory facilities have resulted in scarcity of available data on rotavirus associated disease burden and epidemiological information in the country. We investigated 1306 stool samples collected over two years (2008-2009 from hospitalized children under 5 years of age for the presence of rotavirus strains and its genotypic diversity in Lahore. The prevalence rate during 2008 and 2009 was found to be 34% (n = 447 out of 1306. No significant difference was found between different age groups positive for rotavirus (p>0.05. A subset of EIA positive samples was further screened for rotavirus RNA through RT-PCR and 44 (49.43% samples, out of total 89 EIA positive samples, were found positive. G and P type prevalence was found as follows: G1P [4] = 3(6.81%; G1P [6] = 9(20.45%; G1P [8] = 1(2.27%; G2P [4] = 21(47.72%; G2P [8] = 1(2.27%; G9P [4] = 1(2.27%; G9P [6] = 1(2.27% and G9P [8] = 7(15.90%. Phylogenetic analysis revealed that the VP7 and VP4 sequences clustered closely with the previously detected strains in the country as well as Belgian rotaviruses. Antigenic characterization was performed by analyzing major epitopes in the immunodominant VP7 and VP4 gene segments. Although the neutralization conferring motifs were found variable between the Pakistani strains and the two recommended vaccines strains (Rotarix™ and RotaTeq™, we validate the use of rotavirus vaccine in Pakistan based on the proven and recognized vaccine efficacy across the globe. Our findings constitute the first report on rotavirus' genotype diversity, their phylogenetic relatedness and epidemiology during the pre-vaccination era in Lahore, Pakistan and support the immediate introduction of rotavirus vaccine in the routine immunization program of the country.

A proposed framework for evaluating and comparing efficacy estimates in clinical trials of new rotavirus vaccines.

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Neuzil, Kathleen M; Zaman, K; Victor, John C

2014-08-11

Oral rotavirus vaccines have yielded different point estimates of efficacy when tested in different populations. While population and environmental factors may account for these differences, study design characteristics should also be considered. We review the study design elements of rotavirus vaccine trials that may affect point estimates of efficacy, and propose a framework for evaluating new rotavirus vaccines. Copyright © 2014. Published by Elsevier Ltd.

Economic evaluations of rotavirus immunization for developing countries : a review of the literature

NARCIS (Netherlands)

Tu, H.A.T.; Woerdenbag, H.J.; Kane, S.; Rozenbaum, M.H.; Li, S.C.; Postma, M.J.

Diarrhea is a leading cause of mortality for children under 5 years of age, and rotavirus is identified as the main cause of severe diarrhea worldwide. Since 2006, two rotavirus vaccines, Rotarix and Rotateq, have been available in the market. These vaccines have proved to have high efficacy in

Zinc supplementation for treating diarrhea in children: a systematic review and meta-analysis Administración de suplementos de zinc para tratar la diarrea infantil: revisión sistemática y metanálisis

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Tais Freire Galvao

2013-05-01

que se les había administrado suplementos de zinc. A los controles se les había administrado un placebo o terapia de rehidratación oral. Después de efectuar búsquedas en las principales bases de datos, sin restricciones en cuanto a idiomas, dos revisores independientes seleccionaron los estudios idóneos, extrajeron los datos y evaluaron el riesgo de sesgo de los estudios incluidos. El metanálisis se efectuó mediante el modelo de efectos aleatorios de Mantel-Haenszel o de la varizanza inversa. RESULTADOS: En la revisión se incluyeron 18 estudios de los 1 041 recuperados (n = 7 314 niños. El zinc tuvo un efecto beneficioso en la reducción de la duración de la diarrea en horas (diferencia media [DM] = -20,12, intervalo de confianza del 95% [IC] de -29,15 a -11,09, I² = 91%. Este efecto fue más intenso en niños malnutridos (DM = -33,17, IC del 95% = de -33,55 a -27,79, I² = 0%. La prevalencia de diarrea en los días 3, 5 y 7 fue inferior en el grupo tratado con zinc. La incidencia de vómitos fue significativamente mayor en el grupo tratado con zinc que en el grupo de referencia. Los ensayos aleatorizados controlados que fueron incluidos mostraron un bajo riesgo de sesgo en la mayoría de los dominios evaluados. CONCLUSIONES: La administración oral de suplementos de zinc reduce significativamente la duración de la diarrea y tiene un efecto aún mayor en niños malnutridos. La administración de suplementos de zinc parece ser una estrategia de salud pública apropiada, principalmente en las zonas afectadas por carencias endémicas.

An evaluation of the inhibitory effects against rotavirus infection of edible plant extracts

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Knipping Karen

2012-07-01

Full Text Available Abstract Background Rotaviruses are the single most important cause of severe diarrhea in young children worldwide. The developments of specific, potent and accessible antiviral treatments that restrain rotavirus infection remain important to control rotavirus disease. Methods 150 plant extracts with nutritional applications were screened in vitro on MA-104 cells for their antiviral activity against rhesus rotavirus (RRV. One extract (Aspalathus linearis (Burm.f. R.Dahlgren was also tested for its effect on the loss of transepithelial resistance (TER of Caco-2 cells caused by simian rotavirus (SA-11 infection. Results Aqueous extracts of Nelumbo nucifera Gaertn. fruit, Urtica dioica L. root, Aspalathus linearis (Burm.f. R.Dahlgren leaves, Glycyrrhiza glabra L. root and Olea europaea L. leaves were found to have strong significant antiviral activity with a 50% inhibitory concentration (IC50 Glycyrrhiza glabra was found to have the strongest antiviral activity (IC50 46 μM, followed by luteolin and vitexin from Aspalathus linearis (IC50 respectively 116 μM and 129 μM and apigenin-7-O-glucoside from Melissa officinalis (IC50 150 μM. A combination of Glycyrrhiza glabra L. + Nelumbo nucifera Gaertn. and Urtica dioica L. + Nelumbo nucifera Gaertn. showed synergy in their anti-viral activities. Aspalathus linearis (Burm.f. R.Dahlgren showed no positive effect on the maintenance of the TER. Conclusions These results indicate that nutritional intervention with extracts of Nelumbo nucifera Gaertn., Aspalathus linearis (Burm.f. R.Dahlgren, Urtica dioica L., Glycyrrhiza glabra L. and Olea europaea L. might be useful in the treatment of diarrhea caused by rotavirus infection.

Reduction in Rotavirus-associated Acute Gastroenteritis Following Introduction of Rotavirus Vaccine Into Australia's National Childhood Vaccine Schedule

NARCIS (Netherlands)

Buttery, Jim P.; Lambert, Stephen B.; Grimwood, Keith; Nissen, Michael D.; Field, Emma J.; Macartney, Kristine K.; Akikusa, Jonathan D.; Kelly, Julian J.; Kirkwood, Carl D.

Introduction: Rotavirus vaccines were introduced into the funded Australian National Immunization Program (NIP) in July 2007. Due to purchasing arrangements, individual states and territories chose either a 2-dose RV1 (Rotarix, GSK) regimen or 3-dose RV5 (Rotateq, Merck/CSL) regimen. This allowed

Molecular characterization of group A rotaviruses detected in children with gastroenteritis in Ireland in 2006-2009.

LENUS (Irish Health Repository)

Cashman, O

2012-02-01

SUMMARYCommunity and hospital-acquired cases of human rotavirus are responsible for millions of gastroenteritis cases in children worldwide, chiefly in developing countries, and vaccines are now available. During surveillance activity for human rotavirus infections in Ireland, between 2006 and 2009, a total of 420 rotavirus strains were collected and analysed. Upon either PCR genotyping and sequence analysis, a variety of VP7 (G1-G4 and G9) and VP4 (P[4], P[6], P[8] and P[9]) genotypes were detected. Strains G1P[8] were found to be predominant throughout the period 2006-2008, with slight fluctuations seen in the very limited samples available in 2008-2009. Upon either PCR genotyping and sequence analysis of selected strains, the G1, G3 and G9 viruses were found to contain E1 (Wa-like) NSP4 and I1 VP6 genotypes, while the analysed G2 strains possessed E2 NSP4 and I2 VP6 genotypes, a genetic make-up which is highly conserved in the major human rotavirus genogroups Wa- and Kun-like, respectively. Upon sequence analysis of the most common VP4 genotype, P[8], at least two distinct lineages were identified, both unrelated to P[8] Irish rotaviruses circulating in previous years, and more closely related to recent European humans rotaviruses. Moreover, sequence analysis of the VP7 of G1 rotaviruses revealed the onset of a G1 variant, previously unseen in the Irish population.

Lack of nonspecific protection against all-cause nonrotavirus gastroenteritis by vaccination with orally administered rotavirus vaccine.

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Grant, Lindsay; Watt, James; Moulton, Lawrence; Weatherholtz, Robert; Reid, Raymond; Santosham, Mathuram; O'Brien, Katherine

2013-06-01

Acute gastroenteritis (AGE) is recognized as a global, common threat to child survival, especially in developing countries. Rotavirus, in particular, has been implicated as a leading cause of severe AGE; however, there are numerous other pathogens that also cause AGE. Several studies have demonstrated that oral vaccination against rotavirus has generated the unanticipated benefit of protecting against AGE caused by nonrotavirus pathogens. Safety and efficacy of the pentavalent bovine-human reassortant rotavirus vaccine were studied in multiple populations, including children of the Navajo and White Mountain Apache tribes in the southwestern United States. Stool specimens were collected from children with AGE and tested for rotavirus using an enzyme immunoassay. Analyses were conducted to detect the presence or absence of a vaccine effect on incidence, severity, and duration of AGE in which rotavirus was not detected. The majority of AGE (N = 558: 472 nonrotavirus vs 86 rotavirus) occurred between August 2002 and March 2004 among children ranging from ages 4 to 23 months. The incidence of nonrotavirus AGE was similar by vaccine groups with an incidence rate ratio of 1.07 (incidence rate ratio = vaccinated/unvaccinated, 95% confidence interval 0.89-1.29). The hazards of first, second, third, or any AGE in which rotavirus was not detected differed little by vaccination status (P > 0.05). Duration of symptoms and severity of nonrotavirus AGE were similar by vaccine group. There was no vaccine effect on frequency or severity of nonrotavirus AGE.

Comparison of 2 Assays for Diagnosing Rotavirus and Evaluating Vaccine Effectiveness in Children with Gastroenteritis

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Mijatovic-Rustempasic, Slavica; Tam, Ka Ian; Lyde, Freda C.; Payne, Daniel C.; Szilagyi, Peter; Edwards, Kathryn; Staat, Mary Allen; Weinberg, Geoffrey A.; Hall, Caroline B.; Chappell, James; McNeal, Monica; Gentsch, Jon R.; Bowen, Michael D.; Parashar, Umesh D.

2013-01-01

We compared rotavirus detection rates in children with acute gastroenteritis (AGE) and in healthy controls using enzyme immunoassays (EIAs) and semiquantitative real-time reverse transcription PCR (qRT-PCR). We calculated rotavirus vaccine effectiveness using different laboratory-based case definitions to determine which best identified the proportion of disease that was vaccine preventable. Of 648 AGE patients, 158 (24%) were EIA positive, and 157 were also qRT-PCR positive. An additional 65 (10%) were qRT-PCR positive but EIA negative. Of 500 healthy controls, 1 was EIA positive and 24 (5%) were qRT-PCR positive. Rotavirus vaccine was highly effective (84% [95% CI 71%–91%]) in EIA-positive children but offered no significant protection (14% [95% CI −105% to 64%]) in EIA-negative children for whom virus was detected by qRT-PCR alone. Children with rotavirus detected by qRT-PCR but not by EIA were not protected by vaccination, suggesting that rotavirus detected by qRT-PCR alone might not be causally associated with AGE in all patients. PMID:23876518

Overcoming perceptions of financial barriers to rotavirus vaccine introduction in Asia.

Science.gov (United States)

Nelson, E Anthony S; de Quadros, Ciro A; Santosham, Mathuram; Parashar, Umesh D; Steele, Duncan

2013-11-01

Despite a WHO recommendation in 2009, reaffirmed in 2013, that all countries should consider introducing rotavirus vaccines into their National Immunization Programs, as of June 2013 only 45 have done so. One major consideration appears to have been the costs of the vaccine to countries. Of concern, is that Asian countries have been slow to introduce rotavirus vaccines despite having robust data that could inform the decision-making process. Although decisions on new vaccine introduction are very complex and vary by country and region, economic evaluations are often pivotal once vaccine efficacy and safety has been established, and disease burden documented and communicated. Unfortunately, with private sector list prices of vaccines often used in economic evaluations, rather than a potential public health sector pricing structure, policy-makers may defer decisions on rotavirus vaccine introduction based on the belief that "the vaccine price is too high," even though this might be based on erroneous data. The Pan American Health Organization's Revolving Fund provides one example of how vaccine price can be made more competitive and transparent through a regional tendering process. Other mechanisms, such as tiered pricing and UNICEF procurement, also exist that could help Asian and other countries move forward more quickly with rotavirus vaccine introduction.

Nlrp9b inflammasome restricts rotavirus infection in intestinal epithelial cells.

Science.gov (United States)

Zhu, Shu; Ding, Siyuan; Wang, Penghua; Wei, Zheng; Pan, Wen; Palm, Noah W; Yang, Yi; Yu, Hua; Li, Hua-Bing; Wang, Geng; Lei, Xuqiu; de Zoete, Marcel R; Zhao, Jun; Zheng, Yunjiang; Chen, Haiwei; Zhao, Yujiao; Jurado, Kellie A; Feng, Ningguo; Shan, Liang; Kluger, Yuval; Lu, Jun; Abraham, Clara; Fikrig, Erol; Greenberg, Harry B; Flavell, Richard A

2017-06-29

Rotavirus, a leading cause of severe gastroenteritis and diarrhoea in young children, accounts for around 215,000 deaths annually worldwide. Rotavirus specifically infects the intestinal epithelial cells in the host small intestine and has evolved strategies to antagonize interferon and NF-κB signalling, raising the question as to whether other host factors participate in antiviral responses in intestinal mucosa. The mechanism by which enteric viruses are sensed and restricted in vivo, especially by NOD-like receptor (NLR) inflammasomes, is largely unknown. Here we uncover and mechanistically characterize the NLR Nlrp9b that is specifically expressed in intestinal epithelial cells and restricts rotavirus infection. Our data show that, via RNA helicase Dhx9, Nlrp9b recognizes short double-stranded RNA stretches and forms inflammasome complexes with the adaptor proteins Asc and caspase-1 to promote the maturation of interleukin (Il)-18 and gasdermin D (Gsdmd)-induced pyroptosis. Conditional depletion of Nlrp9b or other inflammasome components in the intestine in vivo resulted in enhanced susceptibility of mice to rotavirus replication. Our study highlights an important innate immune signalling pathway that functions in intestinal epithelial cells and may present useful targets in the modulation of host defences against viral pathogens.

Nlrp9b inflammasome restricts rotavirus infection in intestinal epithelial cells

Science.gov (United States)

Zhu, Shu; Ding, Siyuan; Wang, Penghua; Wei, Zheng; Pan, Wen; Palm, Noah W; Yang, Yi; Yu, Hua; Li, Hua-Bing; Wang, Geng; Lei, Xuqiu; de Zoete, Marcel R.; Zhao, Jun; Zheng, Yunjiang; Chen, Haiwei; Zhao, Yujiao; Jurado, Kellie A.; Feng, Ningguo; Shan, Liang; Kluger, Yuval; Lu, Jun; Abraham, Clara; Fikrig, Erol; Greenberg, Harry B.; Flavell, Richard A.

2018-01-01

Rotavirus, a leading cause of severe gastroenteritis and diarrhoea in young children, accounts for around 215,000 deaths annually worldwide1. Rotavirus specifically infects the intestinal epithelial cells in the host small intestine and has evolved strategies to antagonize interferon and NF-κB signalling2–5, raising the question as to whether other host factors participate in antiviral responses in intestinal mucosa. The mechanism by which enteric viruses are sensed and restricted in vivo, especially by NOD-like receptor (NLR) inflammasomes, is largely unknown. Here we uncover and mechanistically characterize the NLR Nlrp9b that is specifically expressed in intestinal epithelial cells and restricts rotavirus infection. Our data show that, via RNA helicase Dhx9, Nlrp9b recognizes short double-stranded RNA stretches and forms inflammasome complexes with the adaptor proteins Asc and caspase-1 to promote the maturation of interleukin (Il)-18 and gasdermin D (Gsdmd)-induced pyroptosis. Conditional depletion of Nlrp9b or other inflammasome components in the intestine in vivo resulted in enhanced susceptibility of mice to rotavirus replication. Our study highlights an important innate immune signalling pathway that functions in intestinal epithelial cells and may present useful targets in the modulation of host defences against viral pathogens. PMID:28636595

Overcoming perceptions of financial barriers to rotavirus vaccine introduction in Asia

Science.gov (United States)

Nelson, E Anthony S; de Quadros, Ciro A; Santosham, Mathuram; Parashar, Umesh D; Steele, A Duncan

2013-01-01

Despite a WHO recommendation in 2009, reaffirmed in 2013, that all countries should consider introducing rotavirus vaccines into their National Immunization Programs, as of June 2013 only 45 have done so. One major consideration appears to have been the costs of the vaccine to countries. Of concern, is that Asian countries have been slow to introduce rotavirus vaccines despite having robust data that could inform the decision-making process. Although decisions on new vaccine introduction are very complex and vary by country and region, economic evaluations are often pivotal once vaccine efficacy and safety has been established, and disease burden documented and communicated. Unfortunately, with private sector list prices of vaccines often used in economic evaluations, rather than a potential public health sector pricing structure, policy-makers may defer decisions on rotavirus vaccine introduction based on the belief that “the vaccine price is too high,” even though this might be based on erroneous data. The Pan American Health Organization’s Revolving Fund provides one example of how vaccine price can be made more competitive and transparent through a regional tendering process. Other mechanisms, such as tiered pricing and UNICEF procurement, also exist that could help Asian and other countries move forward more quickly with rotavirus vaccine introduction. PMID:23955246

Oral immunization with rotavirus VP7 expressed in transgenic potatoes induced high titers of mucosal neutralizing IgA

International Nuclear Information System (INIS)

Wu Yuzhang; Li Jintao; Mou Zhirong; Fei Lei; Ni Bing; Geng Miao; Jia Zhengcai; Zhou Wei; Zou Liyun; Tang Yan

2003-01-01

Rotaviruses (RV) are a common cause of severe diarrhea in young children, resulting in nearly one million deaths worldwide annually. Rotavirus VP7 was the rotavirus neutralizing protein. Previous study reported that VP7 DNA vaccine can induce high levels of IgG in mice but cannot protect mice against challenge (Choi, A.H., Basu, M., Rae, M.N., McNeal, M.M., Ward, R.L., 1998. Virology 250, 230-240). We found that rotavirus VP7 could maintain its neutralizing immunity when it was transformed into the potato genome. Mice immunized with the transformed tubers successfully elicited serum IgG and mucosal IgA specific for VP7. The mucosal IgA titer was as high as 1000, while serum IgG titer was only 600. Neutralizing assays indicated that IgA could neutralize rotavirus. These results indicate the potential usefulness of plants for production and delivery of edible rotavirus vaccines

Rotavirus Vaccine will Improve Child Survival by More than Just Preventing Diarrhea: Evidence from Bangladesh.

Science.gov (United States)

Saha, Senjuti; Santosham, Mathuram; Hussain, Manzoor; Black, Robert E; Saha, Samir K

2018-02-01

Despite the high burden of rotavirus diarrhea, uptake of rotavirus vaccines in Asia remains low. This primarily stems from a perception of rotavirus as a non-life-threatening pathogen amidst a background of competing health priorities and limited resources. In the largest pediatric hospital of Bangladesh, where there is a fierce competition for beds, we found that between November 2015 and October 2016, 12% of 23,064 admissions were due to gastrointestinal infections, 54% of which were caused by rotavirus. One in four cases requiring hospitalization, or 5,879 cases, was refused because of unavailability of beds. Most refused cases were of pneumonia (22%), severe perinatal asphyxia (17%), preterm birth complications (7%), and meningitis (2%), all of which bear high risks of death or disability, if not treated timely. When determining vaccine policies and conducting vaccine impact studies, it would be shortsighted to not consider the impact on morbidity and mortality of cases that are refused admission because of the hospitalization of children with a preventable disease as rotavirus diarrhea. In our hospital, routine use of a rotavirus vaccine with 41% efficacy will release 629 beds per year to accommodate previously refused cases. Based on evidence, we make the case that introduction of this vaccine in Bangladesh and the surrounding region will prevent morbidity and mortality, both directly and indirectly, and help us ensure survival and well-being of all children.

Costs of diarrheal disease and the cost-effectiveness of a rotavirus vaccination program in kyrgyzstan.

Science.gov (United States)

Flem, Elmira T; Latipov, Renat; Nurmatov, Zuridin S; Xue, Yiting; Kasymbekova, Kaliya T; Rheingans, Richard D

2009-11-01

We examined the cost-effectiveness of a rotavirus immunization program in Kyrgyzstan, a country eligible for vaccine funding from the GAVI Alliance. We estimated the burden of rotavirus disease and its economic consequences by using national and international data. A cost-effectiveness analysis was conducted from government and societal perspectives, along with a range of 1-way sensitivity analyses. Rotavirus-related hospitalizations and outpatient visits cost US$580,864 annually, of which $421,658 (73%) is direct medical costs and $159,206 (27%) is nonmedical and indirect costs. With 95% coverage, vaccination could prevent 75% of rotavirus-related hospitalizations and deaths and 56% of outpatient visits and could avert $386,193 (66%) in total costs annually. The medical break-even price at which averted direct medical costs equal vaccination costs is $0.65/dose; the societal break-even price is $1.14/dose for a 2-dose regimen. At the current GAVI Alliance-subsidized vaccine price of $0.60/course, rotavirus vaccination is cost-saving for the government. Vaccination is cost-effective at a vaccine price $9.41/dose, according to the cost-effectiveness standard set by the 2002 World Health Report. Addition of rotavirus vaccines to childhood immunization in Kyrgyzstan could substantially reduce disease burden and associated costs. Vaccination would be cost-effective from the national perspective at a vaccine price $9.41 per dose.

Encuesta nacional sobre los conocimientos impartidos en escuelas de medicina de Colombia sobre rehidratación parenteral en niños eutróficos mayores de un año con deshidratación por enfermedad diarreicaIván

OpenAIRE

Iván Darío Flórez; Esteban Ramos; Carlos Bernal; Olga Juliana Cuéllar; José William Cornejo

2011-01-01

Introducción. Ante la deshidratación grave por diarrea y la contraindicación para rehidratación oral, la rehidratación en niños debe realizarse por vía intravenosa. La Organización Mundial de la Salud (OMS) recomienda la rehidratación rápida.Objetivos. Describir los métodos de rehidratación intravenosa enseñados en las escuelas de medicina colombianas y confrontarlos con las recomendaciones de la OMS.Materiales y métodos. Se elaboró una encuesta para docentes de pediatría en escuelas de medic...

Electron microscopic analysis of rotavirus assembly-replication intermediates

International Nuclear Information System (INIS)

Boudreaux, Crystal E.; Kelly, Deborah F.; McDonald, Sarah M.

2015-01-01

Rotaviruses (RVs) replicate their segmented, double-stranded RNA genomes in tandem with early virion assembly. In this study, we sought to gain insight into the ultrastructure of RV assembly-replication intermediates (RIs) using transmission electron microscopy (EM). Specifically, we examined a replicase-competent, subcellular fraction that contains all known RV RIs. Three never-before-seen complexes were visualized in this fraction. Using in vitro reconstitution, we showed that ~15-nm doughnut-shaped proteins in strings were nonstructural protein 2 (NSP2) bound to viral RNA transcripts. Moreover, using immunoaffinity-capture EM, we revealed that ~20-nm pebble-shaped complexes contain the viral RNA polymerase (VP1) and RNA capping enzyme (VP3). Finally, using a gel purification method, we demonstrated that ~30–70-nm electron-dense, particle-shaped complexes represent replicase-competent core RIs, containing VP1, VP3, and NSP2 as well as capsid proteins VP2 and VP6. The results of this study raise new questions about the interactions among viral proteins and RNA during the concerted assembly–replicase process. - Highlights: • Rotaviruses replicate their genomes in tandem with early virion assembly. • Little is known about rotavirus assembly-replication intermediates. • Assembly-replication intermediates were imaged using electron microscopy

Electron microscopic analysis of rotavirus assembly-replication intermediates

Energy Technology Data Exchange (ETDEWEB)

Boudreaux, Crystal E.; Kelly, Deborah F. [Virginia Tech Carilion School of Medicine and Research Institute, Roanoke, VA (United States); McDonald, Sarah M., E-mail: mcdonaldsa@vtc.vt.edu [Virginia Tech Carilion School of Medicine and Research Institute, Roanoke, VA (United States); Department of Biomedical Sciences and Pathobiology, Virginia—Maryland Regional College of Veterinary Medicine, Blacksburg, VA (United States)

2015-03-15

Rotaviruses (RVs) replicate their segmented, double-stranded RNA genomes in tandem with early virion assembly. In this study, we sought to gain insight into the ultrastructure of RV assembly-replication intermediates (RIs) using transmission electron microscopy (EM). Specifically, we examined a replicase-competent, subcellular fraction that contains all known RV RIs. Three never-before-seen complexes were visualized in this fraction. Using in vitro reconstitution, we showed that ~15-nm doughnut-shaped proteins in strings were nonstructural protein 2 (NSP2) bound to viral RNA transcripts. Moreover, using immunoaffinity-capture EM, we revealed that ~20-nm pebble-shaped complexes contain the viral RNA polymerase (VP1) and RNA capping enzyme (VP3). Finally, using a gel purification method, we demonstrated that ~30–70-nm electron-dense, particle-shaped complexes represent replicase-competent core RIs, containing VP1, VP3, and NSP2 as well as capsid proteins VP2 and VP6. The results of this study raise new questions about the interactions among viral proteins and RNA during the concerted assembly–replicase process. - Highlights: • Rotaviruses replicate their genomes in tandem with early virion assembly. • Little is known about rotavirus assembly-replication intermediates. • Assembly-replication intermediates were imaged using electron microscopy.

Concomitant Rotavirus and Salmonella Infections in Children with Acute Diarrhea

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Wen-Tzong Lan

2009-02-01

Conclusion: Concomitant rotavirus and Salmonella infections accounted for 3.7% of cases in this study. Patients in group C (30.0% had a significantly higher incidence of hypokalemia than group R (7.3% or S (8.8%. Group C consisted of 33 cases of the 895 reviewed cases (3.7%. In a child with rotavirus gastroenteritis, concomitant infection with Salmonella should be considered if the child has sustained a high fever (≥ 39°C for over 4 days and a green stool with mucus and blood.

Potential safety issues and other factors that may affect the introduction and uptake of rotavirus vaccines

Science.gov (United States)

Aliabadi, N.; Tate, J.E.; Parashar, U.D.

2018-01-01

Rotavirus vaccines have demonstrated significant impact in reducing the burden of morbidity and mortality from childhood diarrhoea in countries that have implemented routine vaccination to date. Despite this success, in many countries, rotavirus vaccine coverage remains lower than that of other routine childhood vaccines. Several issues may potentially affect vaccine uptake, namely safety concerns related to intussusception with consequent age restrictions on rotavirus vaccination, contamination with porcine circovirus, vaccine-derived reassortant strains and hospitalization in newborn nurseries at time of administration of live oral rotavirus vaccine. In addition to these safety concerns, other factors may also affect uptake, including lower vaccine efficacy in the developing world, potential emergence of strains escaping from vaccine protection resulting in lower overall impact of a vaccination programme and sustainable vaccine financing. Although further work is needed to address some of these concerns, global policy bodies have reaffirmed that the benefits of rotavirus vaccination outweigh the risks, and vaccine use is recommended globally. PMID:27129416

Potential safety issues and other factors that may affect the introduction and uptake of rotavirus vaccines.

Science.gov (United States)

Aliabadi, N; Tate, J E; Parashar, U D

2016-12-01

Rotavirus vaccines have demonstrated significant impact in reducing the burden of morbidity and mortality from childhood diarrhoea in countries that have implemented routine vaccination to date. Despite this success, in many countries, rotavirus vaccine coverage remains lower than that of other routine childhood vaccines. Several issues may potentially affect vaccine uptake, namely safety concerns related to intussusception with consequent age restrictions on rotavirus vaccination, contamination with porcine circovirus, vaccine-derived reassortant strains and hospitalization in newborn nurseries at time of administration of live oral rotavirus vaccine. In addition to these safety concerns, other factors may also affect uptake, including lower vaccine efficacy in the developing world, potential emergence of strains escaping from vaccine protection resulting in lower overall impact of a vaccination programme and sustainable vaccine financing. Although further work is needed to address some of these concerns, global policy bodies have reaffirmed that the benefits of rotavirus vaccination outweigh the risks, and vaccine use is recommended globally. Published by Elsevier Ltd.

Rotavirus vaccine a€“ What are the concerns of the developing countries?

OpenAIRE

SHAH, Nitin K

2010-01-01

It is estimated that 0.6 million children die annually due to rotavirus diarrhea under the age of 5 years world over. 90% of these deaths occur in developing countries. Western data suggests that current rotavirus vaccines have 85-95% efficacy against severe rotavirus gastroenteritis (RVGE). There are concerns while using the same in developing countries. Data from African trial has shown 76% efficacy against severe RVGE. Efficacy in malnourished children has been found to be 73% as against 7...

Comparison of viral RNA electrophoresis and indirect ELISA methods in the diagnosis of human rotavirus infection

International Nuclear Information System (INIS)

Avendano, L.F.; Dubinovsky, S.

1984-01-01

A total of 177 stool samples from Chilean diarrhea patients under two years of age were tested for rotavirus by two methods - the indirect enzyme-linked immunosorbent assay (indirect ELISA) and viral RNA electrophoresis in agarose gels (v RNA EPH). Fifty of the specimens came from patients with acute diarrhea and 127 came from patients with protracted diarrhea. The indirect ELISA testing was performed at the National Institutes of Health in the United States: the electrophoretic testing was carried out in Santiago, Chile by the authors. The electrophoretic method detected rotavirus in 36% of the acute samples and 25% of the samples from protracted cases, while the indirect ELISA method detected rotavirus in higher percentages of samples - 46% and 38%, respectively. These results support the conclusion that v RNA EPH is a less sensitive method for detecting rotavirus than the indirect ELISA. Nevertheless, the former method's high specificity, ease of application, and low cost make it a worthwhile alternative to indirect ELISA. Thus, considering the important role played by rotavirus in infant diarrhea and the need for a diagnostic technique that can be incorporated into the routines of medical center laboratories in developing countries, there is good reason to conclude that v RNA EPH is a useful tool for studying rotavirus diarrhea. (author)

PROTECTIVE ACTIVITY STUDY OF A CANDIDATE VACCINE AGAINST ROTAVIRUS INFECTION BASED ON RECOMBINANT PROTEIN FliCVP6VP8

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I. V. Dukhovlinov

2016-01-01

Full Text Available Rotavirus infection is among leading causes of severe diarrhea which often leads to severe dehydration, especially, in children under 5 years old. In Russia, the incidence of rotavirus infection is constantly increased, due to higher rates of actual rotavirus infection cases and improved diagnostics of the disease. Immunity to rotavirus is unstable, thus causing repeated infections intra vitam. Anti-infectious resistance in reconvalescents is explained by induction of specific IgM, IgG, and, notably, IgA antibodies. Due to absence of market drugs with direct action against rotavirus, a rational vaccination is considered the most effective way to control the disease. Currently available vaccines for prevention of rotavirus infection are based on live attenuated rotavirus strains, human and/or animal origin, which replicate in human gut. Their implementation may result into different complications. Meanwhile, usage of vaccines based on recombinant proteins is aimed to avoid risks associated with introduction of a complete virus into humans. In this paper, we studied protective activity of candidate vaccines against rotavirus.In this work we studied protective activity of a candidate vaccine against rotavirus infection based on recombinant FliCVP6VP8 protein which includes VP6 and VP8, as well as components of Salmonella typhimurium flagellin (FliC as an adjuvant. Different components are joined by flexible bridges. Efficiency of the candidate vaccine was studied in animal model using Balb/c mice. We have shown high level of protection which occurs when the candidate vaccine is administered twice intramuscularly. Complete protection of animals against mouse rotavirus EDC after intramuscular immunization with a candidate vaccine was associated with arising rotavirus-specific IgA and IgG antibodies in serum and intestine of immunized animals. The efficacy of candidate vaccine based on recombinant protein FliCVP6VP8 against rotavirus infection was

Significant correlation between the infant gut microbiome and rotavirus vaccine response in rural Ghana

NARCIS (Netherlands)

Harris, V.C.; Armah, G.; Fuentes, S.; Korpela, K.E.; Parashar, U.; Victor, J.C.; Tate, J.; Weerth, C. de; Giaquinto, C.; Wiersinga, W.J.; Lewis, K.D.C.; Vos, W.M. de

2017-01-01

Background. Rotavirus (RV) is the leading cause of diarrhea-related death in children worldwide and ninety-five percent of RV deaths occur in Africa and Asia where rotavirus vaccines (RVV) have lower efficacy. We hypothesize that differences in intestinal microbiome composition correlate with the

Impact of Rotavirus Vaccination on Hospitalisations in Belgium : Comparing Model Predictions with Observed Data

NARCIS (Netherlands)

Standaert, Baudouin; Gomez, Jorge A.; Raes, Marc; Debrus, Serge; Raul Velazquez, F.; Postma, Maarten J.

2013-01-01

Background: Published economic assessments of rotavirus vaccination typically use modelling, mainly static Markov cohort models with birth cohorts followed up to the age of 5 years. Rotavirus vaccination has now been available for several years in some countries, and data have been collected to

Caracterización genotípica y fenotípica de cepas emergentes de Escherichia coli aisladas de niños con diarrea en Bucaramanga y su área metropolitana, Colombia

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Monica Yurley Arias Guerrero

2016-06-01

Full Text Available Introducción: La enfermedad diarreica aguda (EDA sigue siendo uno de los principales problemas en salud pública en países en desarrollo. Dentro de los agentes infecciosos que causan esta enfermedad se encuentran bacterias, virus y parásitos. Los agentes bacterianos ocupan un segundo lugar destacándose Escherichia coli enteropatógenas entre las más importantes. Actualmente, seis cepas con diferentes mecanismos de patogenicidad están asociados a diarrea  E. coli enteropatógena (ECEP, productora de toxina-shiga (ECTS, enterotoxigénica (ECET, enteroinvasiva (ECEI, enteroagregativa (ECEA y adherente difusa (ECAD, cada una con un set específico de genes de virulencia. No obstante, se han reportado brotes de EDA ocasionados por cepas de E. coli diferentes a los patotipos conocidos, denominadas cepas emergentes. Estos brotes han sido reportados en Alemania, Europa y recientemente en Cartagena Colombia, lo que sugiere que en nuestro medio circulan estas cepas. Por lo cual, es necesario caracterizar estas cepas emergentes. Objetivo: Caracterizar genotípicamente y fenotípicamente dos cepas emergentes de E. coli aisladas de muestras diarreicas en niños menores de cinco años en Bucaramanga, Colombia. Materiales y métodos: De un estudio de casos y controles realizado entre Julio del 2013 y diciembre del 2014 en Bucaramanga y su área metropolitana, Colombia a 860 niños menores de 5 años con diarrea (casos y sin diarrea (controles. Se aislaron a partir de coprocultivos cepas de E. coli mediante pruebas bioquímicas. A estas cepas previamente almacenadas a -80°C se les determino mediante PCR multiplex los patotipos de E. coli, los cuales posteriormente fueron confirmados mediante PCR simple. Muestras positivas para dos patotipos u otra característica fueron clasificadas como cepas emergentes. Finalmente, estas cepas se caracterizaron fenotípica y genotípicamente. Para ello, se llevaron a cabo pruebas como secuenciación de genes de

Molecular and process design for rotavirus-like particle production in Saccharomyces cerevisiae

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Palomares Laura A

2011-05-01

Full Text Available Abstract Background Virus-like particles (VLP have an increasing range of applications including vaccination, drug delivery, diagnostics, gene therapy and nanotechnology. These developments require large quantities of particles that need to be obtained in efficient and economic processes. Production of VLP in yeast is attractive, as it is a low-cost protein producer able to assemble viral structural proteins into VLP. However, to date only single-layered VLP with simple architecture have been produced in this system. In this work, the first steps required for the production of rotavirus-like particles (RLP in S. cerevisiae were implemented and improved, in order to obtain the recombinant protein concentrations required for VLP assembly. Results The genes of the rotavirus structural proteins VP2, VP6 and VP7 were cloned in four Saccharomyces cerevisiae strains using different plasmid and promoter combinations to express one or three proteins in the same cell. Performance of the best constructs was evaluated in batch and fed-batch cultures using a complete synthetic media supplemented with leucine, glutamate and succinate. The strain used had an important effect on recombinant protein concentration, while the type of plasmid, centromeric (YCp or episomal (YEp, did not affect protein yields. Fed-batch culture of the PD.U-267 strain resulted in the highest concentration of rotavirus proteins. Volumetric and specific productivities increased 28.5- and 11-fold, respectively, in comparison with batch cultures. Expression of the three rotavirus proteins was confirmed by immunoblotting and RLP were detected using transmission electron microscopy. Conclusions We present for the first time the use of yeast as a platform to express multilayered rotavirus-like particles. The present study shows that the combined use of molecular and bioprocess tools allowed the production of triple-layered rotavirus RLP. Production of VLP with complex architecture in yeasts

Characterization of viroplasm formation during the early stages of rotavirus infection

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Isa Pavel

2010-11-01

Full Text Available Abstract Background During rotavirus replication cycle, electron-dense cytoplasmic inclusions named viroplasms are formed, and two non-structural proteins, NSP2 and NSP5, have been shown to localize in these membrane-free structures. In these inclusions, replication of dsRNA and packaging of pre-virion particles occur. Despite the importance of viroplasms in the replication cycle of rotavirus, the information regarding their formation, and the possible sites of their nucleation during the early stages of infection is scarce. Here, we analyzed the formation of viroplasms after infection of MA104 cells with the rotavirus strain RRV, using different multiplicities of infection (MOI, and different times post-infection. The possibility that viroplasms formation is nucleated by the entering viral particles was investigated using fluorescently labeled purified rotavirus particles. Results The immunofluorescent detection of viroplasms, using antibodies specific to NSP2 showed that both the number and size of viroplasms increased during infection, and depend on the MOI used. Small-size viroplasms predominated independently of the MOI or time post-infection, although at MOI's of 2.5 and 10 the proportion of larger viroplasms increased. Purified RRV particles were successfully labeled with the Cy5 mono reactive dye, without decrease in virus infectivity, and the labeled viruses were clearly observed by confocal microscope. PAGE gel analysis showed that most viral proteins were labeled; including the intermediate capsid protein VP6. Only 2 out of 117 Cy5-labeled virus particles colocalized with newly formed viroplasms at 4 hours post-infection. Conclusions The results presented in this work suggest that during rotavirus infection the number and size of viroplasm increases in an MOI-dependent manner. The Cy5 in vitro labeled virus particles were not found to colocalize with newly formed viroplasms, suggesting that they are not involved in viroplasm

Protective Effect of Natural Rotavirus Infection in an Indian Birth Cohort

Science.gov (United States)

Gladstone, Beryl P.; Ramani, Sasirekha; Mukhopadhya, Indrani; Muliyil, Jayaprakash; Sarkar, Rajiv; Rehman, Andrea M.; Jaffar, Shabbar; Gomara, Miren Iturriza; Gray, James J.; Brown, David W.G.; Desselberger, Ulrich; Crawford, Sue E.; John, Jacob; Babji, Sudhir; Estes, Mary K.; Kang, Gagandeep

2013-01-01

BACKGROUND More than 500,000 deaths are attributed to rotavirus gastroenteritis annually worldwide, with the highest mortality in India. Two successive, naturally occurring rotavirus infections have been shown to confer complete protection against moderate or severe gastroenteritis during subsequent infections in a birth cohort in Mexico. We studied the protective effect of rotavirus infection on subsequent infection and disease in a birth cohort in India (where the efficacy of oral vaccines in general has been lower than expected). METHODS We recruited children at birth in urban slums in Vellore; they were followed for 3 years after birth, with home visits twice weekly. Stool samples were collected every 2 weeks, as well as on alternate days during diarrheal episodes, and were tested by means of enzyme-linked immunosorbent assay and polymerase-chain-reaction assay. Serum samples were obtained every 6 months and evaluated for seroconversion, defined as an increase in the IgG antibody level by a factor of 4 or in the IgA antibody level by a factor of 3. RESULTS Of 452 recruited children, 373 completed 3 years of follow-up. Rotavirus infection generally occurred early in life, with 56% of children infected by 6 months of age. Levels of reinfection were high, with only approximately 30% of all infections identified being primary. Protection against moderate or severe disease increased with the order of infection but was only 79% after three infections. With G1P[8], the most common viral strain, there was no evidence of homotypic protection. CONCLUSIONS Early infection and frequent reinfection in a locale with high viral diversity resulted in lower protection than has been reported elsewhere, providing a possible explanation why rotavirus vaccines have had lower-than-expected efficacy in Asia and Africa. (Funded by the Wellcome Trust.) PMID:21793745

Comportamiento de la madre en relación con la lactancia materna y la alimentación complementaria del niño menor de quince meses, durante la enfermedad diarreica Maternal behavior concerning breast and complementary feeding of children younger than 15 months during acute diarrheal disease

OpenAIRE

Ethel Marina Mora; Ana Cecilia Correa

1994-01-01

Se realizaron 300 encuestas a madres de niños menores de quince meses, llevados por diarrea a la Sala de Rehidratación Oral del Hospital lnfantil de Medellín (Hospital Universitario San Vicente de Paúl), con el fin de conocer los cambios que las madres realizan en la alimentación de los niños durante la diarrea, la duración de los mismos y las razones por las cuales los realizan. Además se esperaba de. mostrar que las madres con mayor escolaridad tienden a cambiar menos la alimentación y que ...

Detection of rotavirus and other enteropathogens in children hospitalized with acute gastroenteritis in Havana, Cuba.

Science.gov (United States)

Ribas, María de Los Angeles; Tejero, Yahisel; Cordero, Yanislet; de Los Angeles León, María; Rodriguez, Misladys; Perez-Lastre, Jorge; Triana, Thelma; Guerra, Mabel; Ayllón, Lucía; Escalante, Gladys; Hadad, Jorge

2015-08-01

The aim of the study was to diagnose infections with rotavirus and other enteric pathogens in children under five years old with acute gastroenteritis and to identify the most common epidemiological and clinical characteristics of these pathogens. The study was conducted using 110 stool samples from the same number of children under five years old who were inpatients at three paediatric hospitals in Havana, Cuba, between October and December 2011. The samples were tested for rotavirus and other enteric pathogens using traditional and molecular microbiological methods. Pathogens were detected in 85 (77.3 %) of the children. Rotavirus was the most commonly found, appearing in 54.5 % of the children, followed by bacteria (29 %) and parasites (10.9 %). Other viral pathogens detected included adenovirus (6.4 %) and astrovirus (3.6 %). In rotavirus-positives cases, at least one other pathogen was detected, usually a bacterium (26.6 %). More than three episodes of watery diarrhea in 24 hours were observed in 78.3 % of the cases. Dehydration was found in 30 (50 %) rotavirus-positive children, of whom seven (11.6 %) were transferred to an intensive care unit due to complications of metabolic acidosis. Rotavirus was most commonly observed among children under 12 months old (65 %). The highest incidence of infection occurred in children who were under the care of a relative at home (78.3 %), had not been breastfed (65 %), or had been breastfed for less than six months (28.3 %). The genotype combinations most frequently found were G9P8 (28.3 %) and G1P8 (10 %). This study demonstrates the presence of rotavirus and other enteric pathogens as causes of gastroenteritis in hospitalized infants and young children in Cuba.

Rotavirus genotype shifts among Swedish children and adults-Application of a real-time PCR genotyping.

Science.gov (United States)

Andersson, Maria; Lindh, Magnus

2017-11-01

It is well known that human rotavirus group A is the most important cause of severe diarrhoea in infants and young children. Less is known about rotavirus infections in other age groups, and about how rotavirus genotypes change over time in different age groups. Develop a real-time PCR to easily genotype rotavirus strains in order to monitor the pattern of circulating genotypes. In this study, rotavirus strains in clinical samples from children and adults in Western Sweden during 2010-2014 were retrospectively genotyped by using specific amplification of VP 4 and VP 7 genes with a new developed real-rime PCR. A genotype was identified in 97% of 775 rotavirus strains. G1P[8] was the most common genotype representing 34.9%, followed by G2P[4] (28.3%), G9P[8] (11.5%), G3P[8] (8.1%), and G4P[8] (7.9%) The genotype distribution changed over time, from predominance of G1P[8] in 2010-2012 to predominance of G2P[4] in 2013-2014. There were also age-related differences, with G1P[8] being the most common genotype in children under 2 years (47.6%), and G2P[4] the most common in those over 70 years of age (46.1%.). The shift to G2P[4] in 2013-2014 was associated with a change in the age distribution, with a greater number of rotavirus positive cases in elderly than in children. By using a new real-time PCR method for genotyping we found that genotype distribution was age related and changed over time with a decreasing proportion of G1P[8]. Copyright © 2017. Published by Elsevier B.V.

Frecuencia y patotipos de Escherichia coli diarrogénicas en niños peruanos con y sin diarrea Frequency and pathotypes of diarrheagenic Escherichia coli in peruvian children with and without diarrhea

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Theresa J. Ochoa

2011-03-01

Full Text Available Introducción. Las E. coli diarrogénicas (DEC son una de las principales causas de diarrea en niños en países en vías de desarrollo. Sin embargo, no son rutinariamente diagnosticadas en los laboratorios clínicos. Objetivos. Determinar la prevalencia de las DEC en niños peruanos y describir la variabilidad genética de estas cepas. Materiales y métodos. Se utilizaron 8 003 cepas de E. coli previamente aisladas de ocho estudios previos de diarrea en niños, mayormente en zonas periurbanas de Lima. El diagnóstico de las DEC fue a través de un PCR múltiple a tiempo real para los seis grupos de DEC. Se empleó PCR para la determinación de genes adicionales de virulencia. Resultados. La prevalencia promedio global en muestras de diarrea (n=4 243 fue: E. coli enteroagregativa (EAEC 9,9%, enteropatogénica (EPEC 8,5%, enterotoxigénica (ETEC 6,9%, difusamente adherente (DAEC 4,8%, productora de toxina shiga (STEC 0,8% y enteroinvasiva (EIEC 0,6%. La frecuencia relativa de cada patógeno varía según la edad y tipo de estudio. Los principales patotipos en muestras control (n=3 760 fueron EPEC (10,9% y EAEC (10,4%. Se encontró una gran variabilidad en la frecuencia de genes de virulencia para cada patotipo, así como en los mecanismos moleculares de resistencia, sin diferencias significativas entre muestras de diarrea y control. Conclusiones. Las DEC son causa importante de diarrea en niños peruanos. Estos patógenos son altamente heterogéneos. Se requieren estudios adicionales para determinar la prevalencia en zonas rurales del Perú, así como en casos graves de diarrea.Introduction. Diarrheagenic E. coli (DEC are a major cause of diarrhea in children in developing countries. However, they are not part of routine diagnosis in clinical laboratories. Objectives. To determine the DEC prevalence in Peruvian children and to describe the genetic variability of these strains. Materials and methods. A total of 8 003 E. coli strains previously

Increased Rotavirus Prevalence in Diarrheal Outbreak Precipitated by Localized Flooding, Solomon Islands, 2014.

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Jones, Forrest K; Ko, Albert I; Becha, Chris; Joshua, Cynthia; Musto, Jennie; Thomas, Sarah; Ronsse, Axelle; Kirkwood, Carl D; Sio, Alison; Aumua, Audrey; Nilles, Eric J

2016-05-01

Flooding on 1 of the Solomon Islands precipitated a nationwide epidemic of diarrhea that spread to regions unaffected by flooding and caused >6,000 cases and 27 deaths. Rotavirus was identified in 38% of case-patients tested in the city with the most flooding. Outbreak potential related to weather reinforces the need for global rotavirus vaccination.

Sequence analysis of the whole genomes of five African human G9 rotavirus strains.

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Nyaga, Martin M; Jere, Khuzwayo C; Peenze, Ina; Mlera, Luwanika; van Dijk, Alberdina A; Seheri, Mapaseka L; Mphahlele, M Jeffrey

2013-06-01

The G9 rotaviruses are amongst the most common global rotavirus strains causing severe childhood diarrhoea. However, the whole genomes of only a few G9 rotaviruses have been fully sequenced and characterised of which only one G9P[6] and one G9P[8] are from Africa. We determined the consensus sequence of the whole genomes of five African human group A G9 rotavirus strains, four G9P[8] strains and one G9P[6] strain collected in Cameroon (central Africa), Kenya (eastern Africa), South Africa and Zimbabwe (southern Africa) in 1999, 2009 and 2010. Strain RVA/Human-wt/ZWE/MRC-DPRU1723/2009/G9P[8] from Zimbabwe, RVA/Human-wt/ZAF/MRC-DPRU4677/2010/G9P[8] from South Africa, RVA/Human-wt/CMR/1424/2009/G9P[8] from Cameroon and RVA/Human-wt/KEN/MRC-DPRU2427/2010/G9P[8] from Kenya were on a Wa-like genetic backbone and were genotyped as G9-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1. Strain RVA/Human-wt/ZAF/MRC-DPRU9317/1999/G9P[6] from South Africa was genotyped as G9-P[6]-I2-R2-C2-M2-A2-N1-T2-E2-H2. Rotavirus A strain MRC-DPRU9317 is the second G9 strain to be reported on a DS-1-like genetic backbone, the other being RVA/Human-wt/ZAF/GR10924/1999/G9P[6]. MRC-DPRU9317 was found to be a reassortant between DS-1-like (I2, R2, C2, M2, A2, T2, E2 and H2) and Wa-like (N1) genome segments. All the genome segments of the five strains grouped strictly according to their genotype Wa- or DS-1-like clusters. Within their respective genotypes, the genome segments of the three G9 study strains from southern Africa clustered most closely with rotaviruses from the same geographical origin and with those with the same G and P types. The highest nucleotide identity of genome segments of the study strains from eastern and central Africa regions on a Wa-like backbone was not limited to rotaviruses with G9P[8] genotypes only, they were also closely related to G12P[6], G8P[8], G1P[8] and G11P[25] rotaviruses, indicating a close inter-genotype relationship between the G9 and other rotavirus genotypes

Role of the Enteric Nervous System in the Fluid and Electrolyte Secretion of Rotavirus Diarrhea

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Lundgren, Ove; Peregrin, Attila Timar; Persson, Kjell; Kordasti, Shirin; Uhnoo, Ingrid; Svensson, Lennart

2000-01-01

The mechanism underlying the intestinal fluid loss in rotavirus diarrhea, which often afflicts children in developing countries, is not known. One hypothesis is that the rotavirus evokes intestinal fluid and electrolyte secretion by activation of the nervous system in the intestinal wall, the enteric nervous system (ENS). Four different drugs that inhibit ENS functions were used to obtain experimental evidence for this hypothesis in mice in vitro and in vivo. The involvement of the ENS in rotavirus diarrhea indicates potential sites of action for drugs in the treatment of the disease.

Evaluación nutricional, lactancia, alimentación complementaria y factores socioambietales en niños con diarrea crónica

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Bottarelli, Josela

2012-01-01

Objetivo: evaluar cual es el estado nutricional, el tipo de la lactancia materna, alimentación complementaria y factores socioambientales en niños de 6 a 12 meses de edad que presentan diarrea crónica. Material y métodos: estudio transversal descriptivo, en una muestra de 40 niños lactantes, atendidos en un consultorio de gastroenterología de un Hospital público de la ciudad de Mar del Plata. Se evalúo el estado nutricional a través de los indicadores de crecimiento in...

Incorporation of a rotavirus vaccine into the national immunisation schedule in the United Kingdom: a review.

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Nakagomi, Osamu; Iturriza-Gomara, Miren; Nakagomi, Toyoko; Cunliffe, Nigel A

2013-11-01

Rotavirus, the commonest cause of severe acute gastroenteritis in infants and young children worldwide, imposes a large health and economic burden on the British society, accounting for an estimated 14,300 hospitalisations and 133,000 general practitioner consultations each year among children aged rotavirus vaccine, Rotarix (GlaxoSmithKline Biologicals, Belgium), was introduced into the UK childhood immunisation programme in 2013. This article provides a review of the product profile of the Rotarix vaccine for use in the national immunisation programme in the UK from an expert perspective. This single G1P[8] strain-based human rotavirus vaccine has demonstrated high efficacy in preventing severe rotavirus gastroenteritis in the first 3 years of life in middle- and high-income countries. In countries that have adopted rotavirus vaccine in childhood immunisation programmes, indirect benefits (herd protection) have been observed among older, unvaccinated children and adults. When the first dose is administered between 6 and 14 weeks of age and the last dose by 24 weeks of age, Rotarix carries a small risk of intussusception within the week of vaccination. However, this small risk may at most result in a negligible population attributable risk at the end of the first year of life. Overall, the rotavirus immunisation programme is expected to provide substantial health benefits to the UK population.

Effects of Lactobacillus rhamnosus GG on the maturation and differentiation of dendritic cells in rotavirus-infected mice.

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Jiang, Y; Ye, L; Cui, Y; Yang, G; Yang, W; Wang, J; Hu, J; Gu, W; Shi, C; Huang, H; Wang, C

2017-08-24

Rotavirus-related diarrhoea is considered one of the most important diseases in field animal production. In addition to the classic vaccine strategy, a number of studies have utilised probiotics, such as Lactobacillus rhamnosus GG (LGG), to prevent rotavirus-induced diarrhoea. Although it has been partially revealed that Toll-like receptors (TLRs) are involved in the LGG-mediated protection against rotavirus infection, the details of the underlying immunologic mechanisms remain largely unknown. In this study, three-to-four-week-old female BALB/c mice were divided into three groups and orally administered phosphate buffered saline (PBS), PBS plus rotavirus or LGG plus rotavirus, respectively. The differentiation and maturation of dendritic cells (DCs) were then determined by FACS, the expression levels of TLR-3 and nuclear factor kappa beta (NF-κB) were evaluated using real time PCR, and the production of inflammatory cytokines in mesenteric lymph nodes (MLNs) were determined by ELISA. The results demonstrated that rotavirus infection significantly increased the percentage of CD11c + CD11b + CD8a - DCs and decreased the percentage of CD11c + CD11b - CD8a + DCs in MLNs. By contrast, the presence of LGG significantly decreased the percentage of CD11c + CD11b + CD8a - DCs and increased the percentage of CD11c + CD11b - CD8a + DCs, which indicates that the differentiation of DCs is involved in the protective effects of LGG. Rotavirus infection also resulted in the increased expression of surface markers such as CD40, CD80 and MHC-II in DCs, and the administration of LGG significantly increased the expression level further. The mRNA levels of TLR-3 and NF-κB in the intestine and MLNs were also significantly increased in the presence of rotavirus, which was further increased in the presence of LGG. The production of inflammatory cytokines was also determined, and the results showed that rotavirus caused the increased production of interleukin (IL)-12 and tumour necrosis

Evaluación del efecto del agonista cannabinoide WIN 55,212-2 en el tratamiento de los efectos secundarios producidos por el fármaco antineoplásico 5-fluorouracilo en rata

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Muñoz Huertas, María

2016-01-01

Los efectos secundarios producidos por la quimioterapia anticancerosa suponen un problema para el que se han propuesto los cannabinoides como tratamiento (a pesar de su principal limitación, los efectos centrales). El antineoplásico 5-Fluorouracilo (5-FU) produce en los pacientes náuseas, vómitos, diarrea, neuropatía periférica y, posiblemente, dolor visceral. Se evaluó si el agonista cannabinoide WIN 55, 212-2 (WIN), a dosis no psicoactivas, puede ser efectivo para tratar dichos efectos secu...

The Comparition of the Efficacy of Two Different Probiotics in Rotavirus Gastroenteritis in Children

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Özlem Erdoğan

2012-01-01

Full Text Available Objectives. The aim of the study is to compare the clinical effectiveness of the probiotics—Saccharomyces boulardii and Bifidobacterium lactis—in children who had been diagnosed with rotavirus gastroenteritis. Materials and methods. Seventy five patients aged between 5 months–5 years diagnosed as rotavirus gastroenteritis were included in the study. The patients diagnosed as rotavirus gastroenteritis by latex agglutination test in stool were divided into 3 groups of twenty-five patients each: First group was given oral rehydration therapy and rapid refeeding with a normal diet with Saccharomyces boulardii (spp. I-745, second group was given oral rehydration therapy and rapid refeeding with a normal diet with Bifidobacterium lactis (spp. B94, culture number:∘118529 and third group received only oral rehydration therapy and rapid refeeding with a normal diet. Results. The duration of diarrhea was shorter in the group given oral rehydration therapy and rapid refeeding with a normal diet with Bifidobacterium lactis and Saccharomyces boulardii than the group given only oral rehydration therapy and rapid refeeding with a normal diet. Conclusion. Bifidobacterium lactis has a complemental role in the treatment of rotavirus gatroenteritis and other probiotics may also have a beneficial effect in rotavirus gastroenteritis compared with the therapy included only oral rehydration therapy and rapid refeeding with a normal diet.

Synthesizing evidences for policy translation: a public health discourse on rotavirus vaccine in India.

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Panda, Samiran; Das, Aritra; Samanta, Saheli

2014-08-11

The debate on the relevance of rotavirus vaccine to immunization program in India, where 27 million children are born every year, rages on. We synthesized the issues raised during these debates and reviewed the current literature to identify themes that could inform public health policy decision. The paradigm we used integrated disease burden data, host and environmental factors, vaccine efficacy, immunization program issues, and economic considerations. Our synthesis reveals that substantive country specific information on disease burden and economic impact of rotavirus illness in India is constrained by lack of public discussion and qualitative studies on mothers' perceptions of the vaccine in concern. The need to improve the performance of current immunization program against six major vaccine preventable diseases (tuberculosis, diphtheria, tetanus, pertussis, polio, and measles) is often cited as a priority over introduction of rotavirus vaccine. Health in India being a state subject, we emphasize that the states which are in a position to reap the benefit of rotavirus vaccine, due to their good immunization program performance, should not be restrained from doing so. Meanwhile, the poorly performing states should step up their vaccination program and increase immunization coverage. Scientific, ethical and societal concerns captured through multiple sources indicate that the introduction of rotavirus vaccine would be a good investment for India. Copyright © 2014. Published by Elsevier Ltd.

Rotavirus 2/6 Viruslike Particles Administered Intranasally with Cholera Toxin, Escherichia coli Heat-Labile Toxin (LT), and LT-R192G Induce Protection from Rotavirus Challenge

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O’Neal, Christine M.; Clements, John D.; Estes, Mary K.; Conner, Margaret E.

1998-01-01

We have shown that rotavirus 2/6 viruslike particles composed of proteins VP2 and VP6 (2/6-VLPs) administered to mice intranasally with cholera toxin (CT) induced protection from rotavirus challenge, as measured by virus shedding. Since it is unclear if CT will be approved for human use, we evaluated the adjuvanticity of Escherichia coli heat-labile toxin (LT) and LT-R192G. Mice were inoculated intranasally with 10 μg of 2/6-VLPs combined with CT, LT, or LT-R192G. All three adjuvants induced ...

A Point Mutation in the Rhesus Rotavirus VP4 Protein Generated through a Rotavirus Reverse Genetics System Attenuates Biliary Atresia in the Murine Model.

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Mohanty, Sujit K; Donnelly, Bryan; Dupree, Phylicia; Lobeck, Inna; Mowery, Sarah; Meller, Jaroslaw; McNeal, Monica; Tiao, Greg

2017-08-01

Rotavirus infection is one of the most common causes of diarrheal illness in humans. In neonatal mice, rhesus rotavirus (RRV) can induce biliary atresia (BA), a disease resulting in inflammatory obstruction of the extrahepatic biliary tract and intrahepatic bile ducts. We previously showed that the amino acid arginine (R) within the sequence SRL (amino acids 445 to 447) in the RRV VP4 protein is required for viral binding and entry into biliary epithelial cells. To determine if this single amino acid (R) influences the pathogenicity of the virus, we generated a recombinant virus with a single amino acid mutation at this site through a reverse genetics system. We demonstrated that the RRV mutant (RRV VP4-R446G ) produced less symptomatology and replicated to lower titers both in vivo and in vitro than those seen with wild-type RRV, with reduced binding in cholangiocytes. Our results demonstrate that a single amino acid change in the RRV VP4 gene influences cholangiocyte tropism and reduces pathogenicity in mice. IMPORTANCE Rotavirus is the leading cause of diarrhea in humans. Rhesus rotavirus (RRV) can also lead to biliary atresia (a neonatal human disease) in mice. We developed a reverse genetics system to create a mutant of RRV (RRV VP4-R446G ) with a single amino acid change in the VP4 protein compared to that of wild-type RRV. In vitro , the mutant virus had reduced binding and infectivity in cholangiocytes. In vivo , it produced fewer symptoms and lower mortality in neonatal mice, resulting in an attenuated form of biliary atresia. Copyright © 2017 American Society for Microbiology.

Detection and molecular characterization of group A rotavirus from hospitalized children in Rio de Janeiro, Brazil, 2004

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Filipe Anibal Carvalho-Costa

2006-05-01

Full Text Available Rotavirus is a major cause of infantile acute diarrhea, causing about 440,000 deaths per year, mainly in developing countries. The World Health Organization has been recommending the assessment of rotavirus burden and strain characterization as part of the strategies of immunization programs against this pathogen. In this context, a prospective study was made on a sample of 134 children with acute diarrhea and severe dehydration admitted to venous fluid therapy in two state hospitals in Rio de Janeiro, Brazil, from February to September 2004. Rotavirus where detected by polyacrylamide gel electrophoresis (PAGE and by an enzyme-linked immunoassay to rotavirus and adenovirus (EIARA in 48% of the children. Positive samples for group A rotavirus (n = 65 were analyzed by reverse transcription/heminested multiplex polymerase chain reaction to determine the frequency of G and [P] genotypes and, from these, 64 samples could be typed. The most frequent G genotype was G1 (58% followed by G9 (40%. One mixed infection (G1/G9 was detected. The only [P] genotype identified was [8]. In order to estimate the rotavirus infection frequency in children who acquired diarrhea as hospital infection in those hospitals, we studied 24 patients, detecting the pathogen in 41% of them. This data suggest that genotype G9 is an important genotype in Rio de Janeiro, with implications to the future strategies of vaccination against rotavirus, reinforcing the need of continuous monitoring of circulating strains of the pathogen, in a surveillance context.

The Hidden Health and Economic Burden of Rotavirus Gastroenteritis in Malaysia: An Estimation Using Multiple Data Sources.

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Loganathan, Tharani; Ng, Chiu-Wan; Lee, Way-Seah; Jit, Mark

2016-06-01

Rotavirus gastroenteritis (RVGE) results in substantial mortality and morbidity worldwide. However, an accurate estimation of the health and economic burden of RVGE in Malaysia covering public, private and home treatment is lacking. Data from multiple sources were used to estimate diarrheal mortality and morbidity according to health service utilization. The proportion of this burden attributable to rotavirus was estimated from a community-based study and a meta-analysis we conducted of primary hospital-based studies. Rotavirus incidence was determined by multiplying acute gastroenteritis incidence with estimates of the proportion of gastroenteritis attributable to rotavirus. The economic burden of rotavirus disease was estimated from the health systems and societal perspective. Annually, rotavirus results in 27 deaths, 31,000 hospitalizations, 41,000 outpatient visits and 145,000 episodes of home-treated gastroenteritis in Malaysia. We estimate an annual rotavirus incidence of 1 death per 100,000 children and 12 hospitalizations, 16 outpatient clinic visits and 57 home-treated episodes per 1000 children under-5 years. Annually, RVGE is estimated to cost US$ 34 million to the healthcare provider and US$ 50 million to society. Productivity loss contributes almost a third of costs to society. Publicly, privately and home-treated episodes consist of 52%, 27% and 21%, respectively, of the total societal costs. RVGE represents a considerable health and economic burden in Malaysia. Much of the burden lies in privately or home-treated episodes and is poorly captured in previous studies. This study provides vital information for future evaluation of cost-effectiveness, which are necessary for policy-making regarding universal vaccination.

Epidemiology and transmission of rotavirus infections and diarrhoea in St. Lucia, West Indies.

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Henry, F J; Bartholomew, R K

1990-12-01

To determine the epidemiology and risk factors of rotavirus infections in St. Lucia, 229 children in three valleys with varying levels of sanitation were studied for 2 years. A four-fold rise in complement fixation antibody to rotavirus antigen was used in paired samples as evidence of recent infection. Results showed that forty-eight per cent of infants experienced at least one infection during a two-year period, and 17% of children were reinfected. Infections occurred within the first months of life and peaked between 6 and 23 months of age. The peak infection coincided with the dry season in each age group. Children breast-feeding had fewer infections. Although crowding within the home was significantly associated with repeated infection, the incidence of infection was not affected by the degree of sanitation. Other studies in the region, using recently developed techniques, concur with these findings which advance our understanding of the epidemiological importance of rotavirus in St. Lucia. Although these studies provide insights into the risk factors for rotavirus infections, other studies are required to determine whether investments should be focused on improved sanitation or immunization or both.

Longitudinal Observation on Rotavirus Infection in Children Aged under 5 Years Old Hospitalized in 2 Hospitals of Ukraine in 2006–2015

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L.I. Chernyshova

2016-10-01

Full Text Available Background. More than 50,000 cases of acute gastroenteritis are registered in children in Ukraine annually. Statistical data concerning rotavirus infection are not correct due to poor capacities of rotavirus laboratory diagnostics in medical units. The aim of the study was to estimate rotavirus infection burden, to analyze and describe rotavirus infection in children aged under 5 years old who were hospitalized into two infectious hospitals (Kyiv and Odessa within 2006–2015 period. Material and Methods. Investigation was carried according to a standard protocol, adopted by WHO. The disease severity was estimated by score scale for clinical manifestations of rotavirus gastroenteritis assessment of Vesikari. Results. At the period from December 2006 to December 2015 20,932 children aged under 5 years old were observed. Those children admitted to hospitals of infectious diseases in Kyiv and Odessa for acute gastroenteritis and met studies inclusive criteria. From them 18,384 (87.33 % children were investigated for rotavirus, i.e. wide majority of all children admitted to hospitals with gastroenteritis. The cause of their hospitalization was rotavirus infection in almost half of all children. It was mentioned that in some periods hospitalization rate for rotavirus as a cause of gastroenteritis was up to 70 % of all cases. In Ukraine incidence of rotavirus diarrhea in hospitalized children up to 5 years old was the highest one among 6 countries of the European region included into Global Rotavirus Surveillance Network. In Ukraine it was 41 % and the region mean value was 24 %. Within the total period of observation half of all hospitalizations caused by rotavirus occurred in children of first two years of life. All time the main viruses causing infection in both hospitals were of 4 genotypes: G1P[8], G2P[4], G3P[8], G4P[8]. Genotype G9P[8] possessed a significant position in Kyiv, but there were years, when it was not identified neither in Kyiv

Socio-demographic, Clinical and Laboratory Features of Rotavirus Gastroenteritis in Children Treated in Pediatric Clinic

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Azemi, Mehmedali; Berisha, Majlinda; Ismaili-Jaha, Vlora; Kolgeci, Selim; Avdiu, Muharrem; Jakupi, Xhevat; Hoxha, Rina; Hoxha-Kamberi, Teuta