RESUMO
BACKGROUND: Histo-blood group antigen (HBGA) status may affect vaccine efficacy due to rotavirus strains binding to HBGAs in a P genotype-dependent manner. This study aimed to determine if HBGA status affected vaccine take of the G3P[6] neonatal vaccine RV3-BB. METHODS: DNA was extracted from stool samples collected in a subset (n = 164) of the RV3-BB phase IIb trial in Indonesian infants. FUT2 and FUT3 genes were amplified and sequenced, with any single-nucleotide polymorphisms analyzed to infer Lewis and secretor status. Measures of positive cumulative vaccine take were defined as serum immune response (immunoglobulin A or serum-neutralizing antibody) and/or stool excretion of RV3-BB virus. Participants were stratified by HBGA status and measures of vaccine take. RESULTS: In 147 of 164 participants, Lewis and secretor phenotype were determined. Positive vaccine take was recorded for 144 (97.9%) of 147 participants with the combined phenotype determined. Cumulative vaccine take was not significantly associated with secretor status (relative risk, 1.00 [95% CI, .94-1.06]; P = .97) or Lewis phenotype (relative risk, 1.03 [95% CI, .94-1.14]; P = .33), nor was a difference observed when analyzed by each component of vaccine take. CONCLUSIONS: The RV3-BB vaccine produced positive cumulative vaccine take, irrespective of HBGA status in Indonesian infants.
Assuntos
Antígenos de Grupos Sanguíneos , Infecções por Rotavirus , Vacinas contra Rotavirus , Rotavirus , Lactente , Recém-Nascido , Humanos , Vacinas contra Rotavirus/genética , Indonésia , GenótipoRESUMO
BACKGROUND: 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. METHODS: 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. RESULTS: 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 (P<0.001), 51% (95% CI, 7 to 76) in the infant-schedule group (P=0.03), and 63% (95% CI, 34 to 80) in the neonatal-schedule and infant-schedule groups combined (combined vaccine group) (P<0.001). Similar results were observed in the intention-to-treat analysis (1649 participants); the vaccine efficacy was 68% (95% CI, 35 to 86) in the neonatal-schedule group (P=0.001), 52% (95% CI, 11 to 76) in the infant-schedule group (P=0.02), and 60% (95% CI, 31 to 76) in the combined vaccine group (P<0.001). Vaccine response, as evidenced by serum immune response or shedding of RV3-BB in the stool, occurred in 78 of 83 participants (94%) in the neonatal-schedule group and in 83 of 84 participants (99%) in the infant-schedule group. The incidence of adverse events was similar across the groups. No episodes of intussusception occurred within the 21-day risk period after administration of any dose of vaccine or placebo, and one episode of intussusception occurred 114 days after the third dose of vaccine in the infant-schedule group. CONCLUSIONS: RV3-BB was efficacious in preventing severe rotavirus gastroenteritis when administered according to a neonatal or an infant schedule in Indonesia. (Funded by the Bill and Melinda Gates Foundation and others; Australian New Zealand Clinical Trials Registry number, ACTRN12612001282875 .).
Assuntos
Gastroenterite/prevenção & controle , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus/imunologia , Administração Oral , Método Duplo-Cego , Fezes/virologia , Feminino , Gastroenterite/epidemiologia , Gastroenterite/virologia , Humanos , Esquemas de Imunização , Indonésia , Lactente , Recém-Nascido , Análise de Intenção de Tratamento , Masculino , Rotavirus/isolamento & purificação , Vacinas contra Rotavirus/administração & dosagem , Vacinas contra Rotavirus/efeitos adversos , Resultado do TratamentoRESUMO
Background: Introduction of rotavirus vaccines into national immunization programs (NIPs) could result in strain selection due to vaccine-induced selective pressure. This study describes the distribution and diversity of rotavirus genotypes before and after rotavirus vaccine introduction into the Australian NIP. State-based vaccine selection facilitated a unique comparison of diversity in RotaTeq and Rotarix vaccine states. Methods: From 1995 to 2015, the Australian Rotavirus Surveillance Program conducted genotypic analysis on 13051 rotavirus-positive samples from children <5 years of age, hospitalized with acute gastroenteritis. Rotavirus G and P genotypes were determined using serological and heminested multiplex reverse-transcription polymerase chain reaction assays. Results: G1P[8] was the dominant genotype nationally in the prevaccine era (1995-2006). Following vaccine introduction (2007-2015), greater genotype diversity was observed with fluctuating genotype dominance. Genotype distribution varied based on the vaccine implemented, with G12P[8] dominant in states using RotaTeq, and equine-like G3P[8] and G2P[4] dominant in states and territories using Rotarix. Conclusions: The increased diversity and differences in genotype dominance observed in states using RotaTeq (G12P[8]), and in states and territories using Rotarix (equine-like G3P[8] and G2P[4]), suggest that these vaccines exert different immunological pressures that influence the diversity of rotavirus strains circulating in Australia.
Assuntos
Variação Genética , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/virologia , Vacinas contra Rotavirus/administração & dosagem , Rotavirus/classificação , Rotavirus/isolamento & purificação , Austrália/epidemiologia , Pré-Escolar , Monitoramento Epidemiológico , Feminino , Genótipo , Técnicas de Genotipagem , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Reação em Cadeia da Polimerase Multiplex , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Rotavirus/genética , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus/imunologia , Sorotipagem , Vacinas Atenuadas/administração & dosagem , Vacinas Atenuadas/imunologiaRESUMO
Abstract: This report from the Australian Rotavirus Surveillance Program describes the circulating rotavirus genotypes identified in children and adults during the period 1 January to 31 December 2022. After two years of a lower number of stool samples received as a result of the coronavirus disease 2019 (COVID-19) pandemic, this reporting period saw the highest number of samples received since the 2017 surveillance period, with samples received from all states and territories. During this period, 1,379 faecal specimens had been referred for rotavirus G- and P- genotype analysis, of which 1,276 were confirmed as rotavirus positive. In total, 1,119/1,276 were identified as wildtype rotavirus, 155/1,276 identified as the Rotarix vaccine strain and 2/1,276 that could not be confirmed as vaccine or wildtype due to sequencing failure. Whilst G12P[8] was the dominant genotype nationally among wildtype samples (28.2%; 315/1,119), multiple genotypes were identified at similar frequencies including G9P[4] (22.3%; 249/1,119) and G2P[4] (20.3%; 227/1,119). Geographical differences in genotype distribution were observed, largely driven by outbreaks reported in some jurisdictions. Outbreaks and increased reports of rotavirus disease were reported in the Northern Territory, Queensland, and New South Wales. A small number of unusual genotypes, potentially zoonotic in nature, were identified, including: G8P[14]; G10[14]; caninelike G3P[3]; G6P[9]; and G11P[25]. Ongoing rotavirus surveillance is crucial to identify changes in genotypic patterns and to provide diagnostic laboratories with quality assurance by reporting incidences of wildtype, vaccine-like, or false positive rotavirus results.
Assuntos
Fezes , Genótipo , Infecções por Rotavirus , Vacinas contra Rotavirus , Rotavirus , Humanos , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/virologia , Rotavirus/genética , Austrália/epidemiologia , Fezes/virologia , Pré-Escolar , Lactente , Criança , Adulto , COVID-19/epidemiologia , COVID-19/virologia , SARS-CoV-2/genética , Adolescente , Feminino , Masculino , Surtos de Doenças , Vacinas Atenuadas , Recém-Nascido , Relatórios Anuais como Assunto , Monitoramento Epidemiológico , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Histo-blood group antigens (HBGAs) may influence immune responses to rotavirus vaccination. METHODS: HBGA phenotyping was determined by detection of antigens A, B, H and Lewis a and b in saliva using enzyme-linked immunosorbent assay. Secretor status was confirmed by lectin antigen assay if A, B and H antigens were negative or borderline (OD ± 0.1 of threshold of detection). PCR-RFLP analysis was used to identify the FUT2 'G428A' mutation in a subset. Rotavirus seropositivity was defined as serum anti-rotavirus IgA ≥ 20 AU/mL. RESULTS: Of 156 children, 119 (76â¯%) were secretors, 129 (83â¯%) were Lewis antigen positive, and 105 (67â¯%) were rotavirus IgA seropositive. Eighty-seven of 119 (73â¯%) secretors were rotavirus seropositive, versus 4/9 (44â¯%) weak secretors and 13/27 (48â¯%) non-secretors. CONCLUSIONS: Most Australian Aboriginal children were secretor and Lewis antigen positive. Non-secretor children were less likely to be seropositive to rotavirus antibodies following vaccination, but this phenotype was less common. HBGA status is unlikely to fully explain underperformance of rotavirus vaccines among Australian Aboriginal children.
Assuntos
Antígenos de Grupos Sanguíneos , Infecções por Rotavirus , Vacinas contra Rotavirus , Humanos , Anticorpos Antivirais , Austrália/epidemiologia , Antígenos de Grupos Sanguíneos/genética , Genótipo , Imunoglobulina A , Antígenos do Grupo Sanguíneo de Lewis/genética , Infecções por Rotavirus/prevenção & controle , Vacinação , Povos Aborígenes Australianos e Ilhéus do Estreito de Torres , Vacinas contra Rotavirus/imunologiaRESUMO
Abstract: This report from the Australian Rotavirus Surveillance Program describes the circulating rotavirus genotypes identified in children and adults during the period 1 January to 31 December 2021. During this period, 521 faecal specimens had been referred for rotavirus G- and P- genotype analysis, of which 474 were confirmed as rotavirus positive. Of these, 336/474 were wildtype rotavirus strains and 138/474 were identified as vaccine-like. Of the 336 wildtype samples, 87.5% (n = 294/336) were identified as G8P[8], and were detected in five of the six jurisdictions that provided samples for the reporting period. Two rotavirus outbreaks, located in the Northern Territory and Western Australia, were also attributed to G8P[8]. As with the 2020 reporting period, a low number of stool samples were received for this reporting period as a result of the COVID-19 pandemic. However, an unexpectedly high proportion of samples with unusual genotypes were identified which were potentially zoonotic in nature, including feline G3, P[9], bovine-like G8, P[14], and porcine-like G4, G6, P[1], and P[6]. Ongoing rotavirus surveillance is crucial to identify changes in genotypic patterns and to provide diagnostic laboratories with quality assurance by reporting incidences of wildtype, vaccine-like, or false positive rotavirus results.
Assuntos
COVID-19 , Gastroenterite , Infecções por Rotavirus , Rotavirus , Animais , Bovinos , Gatos , Humanos , Suínos , Rotavirus/genética , Infecções por Rotavirus/epidemiologia , Pandemias , Gastroenterite/epidemiologia , COVID-19/epidemiologia , Northern Territory/epidemiologiaRESUMO
ABSTRACT: This report from the Australian Rotavirus Surveillance Network describes the circulating rotavirus genotypes identified in children and adults during the period 1 January - 31 December 2020. During this period, 229 faecal specimens were referred for rotavirus G- and P- genotype analysis, including 189 samples that were confirmed as rotavirus positive. Of these, 98/189 were wildtype rotavirus strains and 86/189 were identified as vaccine-like. A further five samples could not be determined as wildtype or vaccine-like due to poor sequence reads. Genotype analysis of the 98 wildtype rotavirus samples from both children and adults demonstrated that G3P[8] was the dominant genotype identified for the third consecutive year, identified in 27.6% of samples, followed by G2P[4] in 20.4% of samples. Forty-six percent of rotavirus positive samples received were identified as vaccine-like, highlighting the need to add caution in interpreting rotavirus positive results in children aged 0-8 months. This surveillance period was significantly impacted by the coronavirus disease 2019 ( COVID-19 ) pandemic. The reduction in rotavirus notifications reflected reduced healthcare-seeking behaviour and a decrease in community spread, with 'community lockdowns', school and day-care centre closure and improved compliance with hand hygiene. Fewer stool samples were collected throughout Australia during this period. There was a reluctance to store samples at collaborating laboratories and uncertainties regarding the safety and feasibility of the transport of samples to the central laboratory during the closure of state and territory borders. Systems have now been adapted to manage and send biological samples safely and confidently. Ongoing rotavirus surveillance is crucial to identify changes in genotypic patterns and to provide diagnostic laboratories quality assurance by reporting incidences of wildtype, vaccine-like, or false positive rotavirus results.
Assuntos
COVID-19 , Gastroenterite , Infecções por Rotavirus , Vacinas contra Rotavirus , Rotavirus , Adulto , Austrália/epidemiologia , Criança , Controle de Doenças Transmissíveis , Humanos , Vigilância da População , Rotavirus/genética , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/prevenção & controle , SARS-CoV-2RESUMO
BACKGROUND: Rotavirus is the most common cause of severe gastroenteritis among children. We conducted hospital-based surveillance to estimate the burden of hospitalizations for rotavirus among children aged <5 years and to describe strain distribution patterns during the 2-year study period. METHODS: Children aged <5 years with diarrhea were prospectively enrolled and evaluated by trained pediatricians at representative hospitals in Mongolia and Sri Lanka. Fecal specimens were tested by rotavirus antigen detection enzyme immunoassay. Specimens that tested positive for rotavirus were further characterized to determine the genotype of strains by reverse-transcriptase polymerase chain reaction. RESULTS: From 1 March 2005 through 28 February 2007, a total of 1277 hospitalized children with diarrhea were enrolled in Mongolia, and 1916 were enrolled in Sri Lanka. Of the 1152 children in Mongolia who had samples tested, 458 (40%) had results positive for rotavirus, and in Sri Lanka, 428 (24%) of 1806 children with samples tested had positive results. G3P[8] was the most common genotype among rotavirus strains in Mongolia (68%) and Sri Lanka (15%). CONCLUSIONS: Rotavirus causes 40% and 24% of hospitalizations for diarrhea among children in Mongolia and Sri Lanka, respectively. Each study site will continue surveillance of rotavirus, and additional laboratory testing will be performed to provide additional information on the distribution of rotavirus strains by G and P genotype.
Assuntos
Diarreia/epidemiologia , Infecções por Rotavirus/epidemiologia , Pré-Escolar , Genótipo , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Mongólia/epidemiologia , Rotavirus/classificação , Infecções por Rotavirus/virologia , Sri Lanka/epidemiologia , Fatores de TempoRESUMO
BACKGROUND: The RV3-BB human neonatal rotavirus vaccine was developed to provide protection from severe rotavirus disease from birth. The aim of this study was to investigate the potential for mutual interference in the immunogenicity of oral polio vaccine (OPV) and RV3-BB. METHODS: A randomized, placebo-controlled trial involving 1649 participants was conducted from January 2013 to July 2016 in Central Java and Yogyakarta, Indonesia. Participants received three doses of oral RV3-BB, with the first dose given at 0-5â¯days (neonatal schedule) or ~8â¯weeks (infant schedule), or placebo. Two sub-studies assessed the immunogenicity of RV3-BB when co-administered with either trivalent OPV (OPV group, nâ¯=â¯282) or inactivated polio vaccine (IPV group, nâ¯=â¯333). Serum samples were tested for antibodies to poliovirus strains 1, 2 and 3 by neutralization assays following doses 1 and 4 of OPV. RESULTS: Sero-protective rates to poliovirus type 1, 2 or 3 were similar (range 0.96-1.00) after four doses of OPV co-administered with RV3-BB compared with placebo. Serum IgA responses to RV3-BB were similar when co-administered with either OPV or IPV (difference in proportions OPV vs IPV: sIgA responses; neonatal schedule 0.01, 95% CI -0.12 to 0.14; pâ¯=â¯0.847; infant schedule -0.10, 95% CI -0.21 to -0.001; pâ¯=â¯0.046: sIgA GMT ratio: neonatal schedule 1.23, 95% CI 0.71-2.14, pâ¯=â¯0.463 or infant schedule 1.20, 95% CI 0.74-1.96, pâ¯=â¯0.448). CONCLUSIONS: The co-administration of OPV with RV3-BB rotavirus vaccine in a birth dose strategy did not reduce the immunogenicity of either vaccine. These findings support the use of a neonatal RV3-BB vaccine where either OPV or IPV is used in the routine vaccination schedule.
Assuntos
Anticorpos Antivirais/sangue , Imunogenicidade da Vacina/imunologia , Vacina Antipólio de Vírus Inativado/administração & dosagem , Vacina Antipólio Oral/administração & dosagem , Vacinas contra Rotavirus/administração & dosagem , Feminino , Humanos , Esquemas de Imunização , Imunoglobulina A/sangue , Lactente , Recém-Nascido , Masculino , Poliomielite/prevenção & controle , Poliovirus/imunologia , Vacina Antipólio de Vírus Inativado/imunologia , Vacina Antipólio Oral/imunologia , Rotavirus/imunologia , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus/imunologiaRESUMO
Serum rotavirus IgA responses are an imperfect non-mechanistic correlate of protection, and the lack of an accurate serological marker is a challenge to the development of new rotavirus vaccines. Serological responses to rotavirus NSP2 occur following wild-type infection; however, it is unknown if serological responses to NSP2 occur following administration of rotavirus vaccines. The phase IIa immunogenicity trial of RV3-BB provided an opportunity to investigate the serological responses to NSP2 following vaccination. Healthy, full-term babies (n = 96) were previously recruited as part of a phase IIa safety and immunogenicity trial in Dunedin, New Zealand between January 2012 and April 2014. Participants received three doses of oral RV3-BB vaccine with the first dose given at 0-5 days after birth (neonatal schedule), or the first dose given at about 8 weeks after birth (infant schedule), or to receive placebo (placebo schedule). Serum IgA and IgG antibody responses to total RV3-BB and NSP2 protein (RV3-BB) were assessed using ELISA. Despite significant serum IgA response against total RV3-BB, we were unable to demonstrate a significant serological response to NSP2 in participants receiving RV3-BB when compared to placebo. Heterotypic antibodies against multiple NSP2 genotypes were detected following RV3-BB vaccination. Our data demonstrates that while serological responses to NSP2 were detectable in a subset of participants, it is a less useful marker when compared to total rotavirus serum IgA response.
Assuntos
Imunogenicidade da Vacina , Proteínas de Ligação a RNA/imunologia , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus/imunologia , Rotavirus/imunologia , Proteínas não Estruturais Virais/imunologia , Administração Oral , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Biomarcadores/análise , Genótipo , Humanos , Esquemas de Imunização , Lactente , Recém-Nascido , Nova Zelândia , Proteínas de Ligação a RNA/genética , Rotavirus/genética , Infecções por Rotavirus/imunologia , Infecções por Rotavirus/virologia , Vacinas contra Rotavirus/administração & dosagem , Testes Sorológicos/métodos , Vacinas Atenuadas/administração & dosagem , Vacinas Atenuadas/imunologia , Proteínas não Estruturais Virais/genéticaRESUMO
BACKGROUND: The RV3-BB human neonatal rotavirus vaccine aims to provide protection from severe rotavirus disease from birth. The aim of the current study was to characterise the rotavirus strains causing gastroenteritis during the Indonesian Phase IIb efficacy trial. METHODS: A randomized, double-blind placebo-controlled trial involving 1649 participants was conducted from January 2013 to July 2016 in Central Java and Yogyakarta, Indonesia. Participants received three doses of oral RV3-BB vaccine with the first dose given at 0-5â¯days after birth (neonatal schedule), or the first dose given atâ¯â¼8â¯weeks after birth (infant schedule), or placebo (placebo schedule). Stool samples from episodes of gastroenteritis were tested for rotavirus using EIA testing, positive samples were genotyped by RT-PCR. Full genome sequencing was performed on two representative rotavirus strains. RESULTS: There were 1110 episodes of acute gastroenteritis of any severity, 105 episodes were confirmed as rotavirus gastroenteritis by EIA testing. The most common genotype identified was G3P[8] (90/105), the majority (52/56) of severe (Vesikari scoreâ¯≥11) rotavirus gastroenteritis episodes were due to the G3P[8] strain. Full genome analysis of two representative G3P[8] samples demonstrated the strain was an inter-genogroup reassortant, containing an equine-like G3 VP7, P[8] VP4 and a genogroup 2 backbone I2-R2-C2-M2-A2-N2-T2-E2-H2. The complete genome of the Indonesian equine-like G3P[8] strain demonstrated highest genetic identity to G3P[8] strains circulating in Hungary and Spain. CONCLUSIONS: The dominant circulating strain during the Indonesian Phase IIb efficacy trial of the RV3-BB vaccine was an equine-like G3P[8] strain. The equine-like G3P[8] strain is an emerging cause of severe gastroenteritis in Indonesia and in other regions.
Assuntos
Gastroenterite/virologia , Vírus Reordenados/isolamento & purificação , Infecções por Rotavirus/virologia , Vacinas contra Rotavirus/uso terapêutico , Rotavirus/isolamento & purificação , Administração Oral , Método Duplo-Cego , Fezes/virologia , Feminino , Gastroenterite/epidemiologia , Genoma Viral , Genótipo , Humanos , Indonésia , Recém-Nascido , Masculino , Filogenia , Vírus Reordenados/classificação , Rotavirus/classificação , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/prevenção & controleRESUMO
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.
Assuntos
Fezes/virologia , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus/administração & dosagem , Rotavirus/isolamento & purificação , Replicação Viral , Eliminação de Partículas Virais , Administração Oral , Anticorpos Antivirais/sangue , Antígenos Virais/genética , Proteínas do Capsídeo/genética , Método Duplo-Cego , Feminino , Humanos , Esquemas de Imunização , Imunogenicidade da Vacina , Recém-Nascido , Intestinos/virologia , Masculino , Nova Zelândia/epidemiologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Rotavirus/genética , Rotavirus/imunologia , Rotavirus/fisiologia , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/virologia , Vacinas contra Rotavirus/efeitos adversos , Vacinação/efeitos adversos , Vacinas Atenuadas/administração & dosagem , Vacinas Atenuadas/efeitos adversos , Carga ViralRESUMO
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.
Assuntos
Gastroenterite/prevenção & controle , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus/imunologia , Países em Desenvolvimento , Gastroenterite/epidemiologia , Humanos , Infecções por Rotavirus/epidemiologia , Resultado do TratamentoRESUMO
Identity (ID) badges and lanyards worn by pediatric health care workers (HCWs) have been shown to be potential vectors of nosocomial bacterial infections. This cross-sectional study determined the contamination of ID badges and lanyards worn by pediatric HCWs with common respiratory and gastrointestinal viruses. The results showed that ID badges and lanyards are not significantly contaminated with common respiratory or gastrointestinal viruses and are unlikely to be a significant vector for nosocomial infection.
Assuntos
Microbiologia Ambiental , Vírus/classificação , Vírus/isolamento & purificação , Estudos Transversais , Feminino , Pessoal de Saúde , Hospitais Pediátricos , Humanos , Masculino , Estudantes de MedicinaRESUMO
Outbreaks of rotavirus diarrhea cause a large disease burden in the Alice Springs region of the Northern Territory, Australia. The introduction of the rotavirus vaccine Rotarix® has been associated with an increase in detection of G2P[4] strains in many countries. However, G2P[4] emergence has also been observed in vaccine-naive countries, suggesting a general global increase in the circulation of G2P[4] strains. A G2P[4] rotavirus outbreak occurred in 2009, 28 months after the introduction of the Rotarix® vaccine and 43 children were hospitalized. Pre-vaccine introduction, G2P[4] strains were observed associated with large outbreaks in 1999 and 2004. To determine the genetic relationship between these strains whole genome sequence analysis was conducted on representative strains from each of the G2P[4] outbreaks, in 1999, 2004 and 2009. Phylogenetic analysis revealed the majority of genes from 2009 outbreak strain clustered with contemporary global strains, while the VP7 gene clustered with contemporary and older strains and was antigenically distinct to the majority of contemporary global G2P[4] strains; suggesting the strain was an intragenogroup reassortant. The 1999 and 2009 strains appear to share similar evolutionary origins, and both had a high degree of genetic identity to previously identified Australian and global strains. Conversely, the 2004 outbreak strain was more divergent in comparison to Australian and global strains. The 1999 and 2004 outbreaks likely occurred due to the accumulation of immunologically naïve children in the population following low levels of G2P[4] rotavirus disease in the community in the years prior to each outbreak. The 2009 outbreak was associated with moderate vaccine coverage in the population and vaccine efficacy against the strain was low. The circulation of this unusual strain in the population combined with low vaccine coverage and diminished vaccine efficacy likely contributed to the outbreak occurring in this population.
Assuntos
Gastroenterite/epidemiologia , Infecções por Rotavirus/epidemiologia , Rotavirus/classificação , Rotavirus/genética , Sequência de Aminoácidos , Pré-Escolar , Surtos de Doenças , Evolução Molecular , Feminino , Gastroenterite/história , Gastroenterite/virologia , Genes Virais , Genoma Viral , Genótipo , História do Século XX , História do Século XXI , Humanos , Lactente , Recém-Nascido , Masculino , Dados de Sequência Molecular , Northern Territory/epidemiologia , Filogenia , Infecções por Rotavirus/história , Infecções por Rotavirus/virologia , Alinhamento de Sequência , Análise de Sequência de DNARESUMO
This study documents rotavirus strains causing severe disease in Australian children during the pre-vaccine era. During the period 1997-2007, rotavirus strains from national multi-centre hospital-based surveillance in Australia were analysed for G and P types. G1P[8] was the dominant genotype identified during the 11-year study, with intermittent peaks associated with genotypes G2P[4], G3P[8] and G9P[8]. The results provide baseline information of the G and P genotypes causing disease in Australian children, and highlight the unpredictable changes in genotype incidence that can occur on both a local and national level. To be optimally effective, rotavirus vaccines must prevent disease caused by all common rotavirus genotypes.
Assuntos
Diarreia/epidemiologia , Vigilância da População , Infecções por Rotavirus/epidemiologia , Rotavirus/genética , Distribuição por Idade , Austrália/epidemiologia , Criança Hospitalizada/estatística & dados numéricos , Pré-Escolar , Diarreia/virologia , Genótipo , Humanos , Lactente , Epidemiologia MolecularRESUMO
Globally rotavirus is the most common cause of severe gastroenteritis in children. From March 2005 through February 2007, a prospective hospital-based surveillance study was conducted at a national hospital in Phnom Penh, Cambodia, to estimate the burden of rotavirus hospitalizations among children aged <5 years old and to determine strain patterns. Children with diarrhoea underwent standard clinical evaluations. Parents were interviewed for demographic and family information. Faecal specimens were tested for rotavirus by enzyme immunoassay (EIA) and positive specimens were further characterized. Of 2817 hospitalized children with diarrhoea, 56% (n=1278) were positive for rotavirus antigen. The G1P[8] strain was the most common genotype (53%) followed by G2P[4] (10%). The findings suggest a need for improved prevention and control programs for rotavirus diarrhoea in Cambodia.
Assuntos
Diarreia/epidemiologia , Vigilância da População , Infecções por Rotavirus/epidemiologia , Distribuição por Idade , Antígenos Virais/isolamento & purificação , Camboja/epidemiologia , Criança Hospitalizada/estatística & dados numéricos , Pré-Escolar , Efeitos Psicossociais da Doença , Diarreia/virologia , Genótipo , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Lactente , Estudos Prospectivos , Rotavirus/genéticaRESUMO
Rotavirus is one of the most common causes of severe life-threatening diarrhoea in children leading to hospitalization especially in developing countries. At Mahosot Hospital in Vientiane, Lao PDR, children with diarrhoea underwent standard clinical evaluation and faecal specimen collection to estimate the burden of rotavirus hospitalizations and to determine rotavirus strain patterns among children aged less than 5 years old. From March 2005 to February 2007, a total of 1158 stool specimens were collected from children aged less than 5 years old hospitalized with acute diarrhoea. Rotavirus was identified in 624 (54%) of these patients. The G1P[8] strain was the most common genotype (35%), followed by G9P[8] (25%). These surveillance data suggest that improved prevention and control programs for rotavirus as well as other causes of diarrhoea are needed in Lao PDR.
Assuntos
Diarreia/epidemiologia , Vigilância da População , Infecções por Rotavirus/epidemiologia , Distribuição por Idade , Criança Hospitalizada/estatística & dados numéricos , Pré-Escolar , Diarreia/virologia , Genótipo , Humanos , Lactente , Laos/epidemiologia , Rotavirus/genética , Estações do AnoRESUMO
The National Rotavirus Reference Centre, together with collaborating laboratories Australia-wide, conducts a laboratory based rotavirus surveillance program. This report describes the serotypes of rotavirus strains responsible for the hospitalisation of children with acute gastroenteritis during the period 1 July 2006 to 30 June 2007. One thousand and two faecal samples from across Australia were examined using a combined approach of monoclonal antibody immunoassays, reverse transcription-polymerase chain reaction and polyacrylamide gel analysis. Serotype G1 was the dominant serotype nationally, representing 36.7% of all strains, followed by serotype G9 (31.1%), and serotype G3 (23.3%). Serotype G2 represented less than 5% of strains, while no serotype G4 strains were identified. All G1, G3 and G9 strains assayed for P genotype contained the P[8] genotype, bar one G1 strain, which possessed a P[6]. Uncommon rotavirus genotypes, G8 (n = 1) and G12 (n = 2) were identified in children with acute gastroenteritis during this study period.
Assuntos
Diarreia Infantil/epidemiologia , Vigilância da População , Infecções por Rotavirus/epidemiologia , Rotavirus/isolamento & purificação , Distribuição por Idade , Relatórios Anuais como Assunto , Austrália/epidemiologia , Pré-Escolar , Controle de Doenças Transmissíveis , Diarreia Infantil/virologia , Notificação de Doenças , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Programas Nacionais de Saúde , Prevalência , Rotavirus/classificação , Infecções por Rotavirus/virologia , SorotipagemRESUMO
The National Rotavirus Reference Centre together with collaborating laboratories Australia-wide has conducted rotavirus surveillance since June 1999. This report describes the serotypes of rotavirus strains responsible for the hospitalisation of children with acute gastroenteritis during the period 1 July 2005 to 30 June 2006. Eight hundred and forty-eight faecal samples from across Australia were examined using monoclonal antibody immunoassays, reverse transcription-polymerase chain reaction and polyacrylamide gel analysis. Serotype G1 was the dominant serotype nationally, representing 40.2 per cent of all strains, followed by serotype G4 (22.6%), serotype G9 (15.1%) and serotype G3 (14.7%). Genotype G12 strains were identified for the first time in Australia. As in previous years, there was substantial geographic variation in the prevalence of rotavirus serotypes.