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Rotavirus vaccination may not be sustainable in areas with high prevalence
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In areas that experience high rates of rotavirus transmission and poor responses to oral vaccines, protection by vaccination may be only a temporary solution for children up to their second year of life, according to data published in The Journal of Infectious Diseases.
Additionally, each location with analyzed data on rotavirus infection and disease between 2009 and 2014 demonstrated significantly varying information.
“Before rotavirus vaccines were introduced, despite availability of effective rehydration therapies, rotavirus was estimated to cause nearly half a million deaths annually,” Venkata Raghava Mohan, MD, MPH, from the department of community health at Christian Medical College, Vellore, India, and colleagues wrote. “Where rotavirus vaccines have been introduced into national programs, a dramatic decrease in hospitalizations due to rotavirus has been reported. Reductions in all-cause diarrhea mortality further emphasize the importance of vaccination to prevent severe disease.”
To describe the effect of rotavirus infection in a child’s first 2 years of life in areas that have and have not implemented vaccination programs, the researchers conducted a birth cohort study that included data concerning healthy infants from Bangladesh, Brazil, India, Nepal, Peru, Pakistan, South Africa and Tanzania. According to the researchers, these areas exhibit a high prevalence of childhood diarrhea and malnutrition.
Children were surveilled monthly beginning at 17 days of age up to 24 months, and diarrheal stools were collected. Sociodemographic, feeding and illness information was also gathered at specific intervals (6, 12, 18 and 24 months for sociodemographic; twice weekly for illness and feeding information). Samples collected from participants were tested using enzyme immunoassays for both rotavirus and sera for anti-rotavirus immunoglobins.
Rotavirus was discovered in 5.5% of stool samples (408/7,440) collected from 1,737 children. Of the children from which these samples were collected, 19.8% (344) had previously had rotavirus gastroenteritis. Household overcrowding and high pathogen loads were noted risk factors for contracting rotavirus.
If a child had three prior infections, a protection against subsequent infection was noted at 74% for areas that did not use vaccination. A higher incidence rate of rotavirus was observed in Peru within the second year of life, even though high vaccination coverage was distinguished.
“Overall, this study demonstrates the value of using standardized protocols to assess infectious disease heterogeneity across populations,” Mohan and colleagues wrote. “Despite the sites being chosen to be disadvantaged communities, the differences in incidence of infection and disease were surprising for a ubiquitous viral pathogen.” — by Katherine Bortz
Disclosure: The researchers report no relevant financial disclosures.
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