Rotavirus vaccination effectiveness: a case-case study in the EDICS project, Castellón (Spain).

In Spain, in 2006, two oral live-attenuated vaccines against rotavirus disease were licensed for infants up to 6 months. Recent data suggest that vaccine efficacy may vary by region. This makes the real-life postmarketing monitoring of rotavirus vaccination effectiveness an important aspect of rotavirus epidemiologic surveillance. We carried out a case-case study to assess the rotavirus vaccination effectiveness in children from 2 to 35 months of age during the year 2009 in Castellón. As a second- and counterfactual objective to evaluate the possible selection bias and the specificity of the association, we evaluated the "effectiveness" of pneumococcal vaccination against rotavirus diarrhea. Cases were 71 children with confirmed rotavirus gastroenteritis, and controls were 261 children with positive results to any other organism that was not rotavirus. The immunization status of each child, the number of doses and dates of vaccination were assessed by consulting the Regional Immunization Registry. The lowest proportion of vaccinated cases was observed among rotavirus diarrhea (2.8%). The proportion of vaccinated children among the control group was 21.8%. The effectiveness of vaccination with at least one dose of vaccine against rotavirus was 87.7% (45.5-99.7%). If we restrict the analysis to non-hospitalized children, this figure was slightly lower, 83.5% (25.4-96.3%). As expected, pneumococcal vaccination was not protective against rotavirus infection showing the specificity of the association found. The immunization information systems in combination with population-based studies of the incidence of infectious gastroenteritis, such as EDICS offer appropriate conditions for postmarketing monitoring of vaccine effectiveness.

Brotes de gastroenteritis aguda vírica en residencias de ancianos. Sistema de detección por umbral de prevalencia (SIDUP) / Outbreaks of acute viral gastroenteritis in geriatric homes. Threshold detection system for prevalence (SiDUP)

Se describen las intervenciones llevadas a cabo en una unidadde epidemiología local, durante varios años, relacionadascon la epidemiología de la gastroenteritis por norovirus enresidencias de ancianos de Castellón. Desde varios brotesacaecidos en un mismo geriátrico, hasta el estudio de los casosesporádicos que determinan la situación endémica en variasresidencias. Este trabajo se centra en el análisis de esa situaciónendémica de síntomas digestivos en periodos de silencioepidémico y la propuesta de un método sencillo para detectarel inicio de brotes de GEA de transmisión progresiva (persona-persona) que hemos denominado Sistema de Detección porUmbral de Prevalencia (SiDUP). Se discute el espectro epidemiológicode la gastroenteritis por norovirus en estas institucionespara personas mayores(AU)

We describe the interventions carried out in a local epidemiologyunit related to the epidemiology of gastroenteritis dueto norovirus in geriatric homes in Castellón (Spain) duringseveral years. These range from various outbreaks in the samegeriatric home to the study of sporadic cases which determinethe endemic situation. This study focuses on the analysis ofthis endemic situation of digestive symptoms in silent epidemicperiods and proposes a simple method to detect the initiationof GEA of progressive transmission (person-person)which we call System of Detection by Prevalence Threshold(SiDUP). The epidemiological spectrum of gastroenteritis dueto norovirus in geriatric homes is discussed(AU)

[Outbreaks of acute viral gastroenteritis in geriatric homes: threshold detection system for prevalence (SiDUP)]. / Brotes de gastroenteritis aguda vírica en residencias de ancianos: Sistema de detección por umbral de prevalencia (SiDUP).

We describe the interventions carried out in a local epidemiology unit related to the epidemiology of gastroenteritis due to norovirus in geriatric homes in Castellón (Spain) during several years. These range from various outbreaks in the same geriatric home to the study of sporadic cases which determine the endemic situation. This study focuses on the analysis of this endemic situation of digestive symptoms in silent epidemic periods and proposes a simple method to detect the initiation of GEA of progressive transmission (person-person) which we call System of Detection by Prevalence Threshold (SiDUP). The epidemiological spectrum of gastroenteritis due to norovirus in geriatric homes is discussed.