Rotavirus Gastroenteritis Infection Among Children Vaccinated and Unvaccinated With Rotavirus Vaccine in Southern China

Fu, Chuanxi; Dong, Zhiqiang; Shen, Jichuan; Yang, Zhicong; Liao, Ying; Hu, Wensui; Pei, Sen; Shaman, Jeffrey

doi:10.1001/jamanetworkopen.2018.1382

Cited by 24 publications

(24 citation statements)

References 37 publications

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“…The World Health Organization (WHO) recommends that the rotavirus vaccine is included in all national immunization programs for infants, particularly in countries with high infant mortality rates . In China, a domestic monovalent rotavirus vaccine (the Lanzhou lamb rotavirus vaccine [LLR]) and a pentavalent rotavirus vaccine (RotaTeq) have been available in the private market since 2000 and 2018, respectively.…”

Section: Discussionmentioning

confidence: 56%

Molecular epidemiology of group A rotavirus in outpatient diarrhea infants and children in Chongqing, China, 2011‐2015

Zeng

Zhao

et al. 2019

Journal of Medical Virology

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Human group A rotavirus (RVA) is the leading cause of acute viral gastroenteritis in children under 5 years old worldwide. The aim of this study was to investigate the genotype distribution of RVA in the Midwest of China. Sentinel‐based surveillance of acute diarrhea was conducted at Children's Hospital of Chongqing Medical University from 2011 to 2015. RVA was tested by using enzyme‐linked immunosorbent assays. The partial VP4 genes and VP7 genes of rotavirus were amplified and sequenced, and genotyping and phylogenetic analyses were performed. Among the 2236 stool specimens collected from children with acute gastroenteritis, 681 (30.46%) were positive for RVA. The majority of children (89.28%) who tested positive for RVA were children aged ≤2 years. The seasonal peak of RVA was in the winter. As for genotype, four strain combinations, G9P[8], G3P[8], G1P[8], and G2P[4] contributed to 75.62% (515/681) of the RVA‐associated diarrhea cases. After a marked increase in G9P[8] (30.77%) in 2013, G9P[8] became the predominant genotype in 2014 and 2015, whilst the prevalence of G1P[8] was decreased to 2.72% in 2015. Unusual G‐P combinations (eg, G1P[4], G9P[4], G4P[6], G3P[4], G2P[8]) were also detected sporadically over the study period. Phylogenetic tree analysis results showed that the VP7 sequences of G9 strains were clustered into two main lineages, and 77.34% of them were clustered into lineage VI, with the highest nucleotide similarity to the strain JS12‐17(China). VP4 gene sequences of P[8] strains were almost P[8]‐lineage 3. Substantial temporal variation in the circulation of various genotypes of rotavirus in Chongqing was observed during 2011‐2015, and highlights the need for continuous surveillance of RVA infection for better understanding and control of RVA infection.

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Section: Discussionmentioning

confidence: 56%

Molecular epidemiology of group A rotavirus in outpatient diarrhea infants and children in Chongqing, China, 2011‐2015

Zeng

Zhao

et al. 2019

Journal of Medical Virology

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“…the rotavirus vaccine might contribute to the decline of RVA and the rising of other viral pathogens such as norovirus [25]. Moreover, studies conducted in Southern China has confirmed a negative correlation between RVA prevalence and vaccination coverage [26].…”

Section: Discussionmentioning

confidence: 94%

“…Interestingly, all circulating strains appeared to be a mismatch with G10P[15] identified in LLR vaccine [ 24 ]. Studies had revealed that LLR could only offer around 30% protection against the circulating strains [ 26 ]. Furthermore, even the newly launched RotaTeq vaccine lacks a G9 genotype in spite of offering a better vaccine efficacy than LLR [ 9 ], hence there is still room for optimization in vaccine application.…”

Section: Discussionmentioning

confidence: 99%

Genetic diversity of group A rotavirus in acute gastroenteritis outpatients in Shanghai from 2017 to 2018

et al. 2020

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Background: Group A Rotavirus (RVA), despite being an important pathogen in hospitalized children, is less studied in pediatric outpatients, and even rarely investigated in adults. This study aims to understand the genetic diversity of RVA in outpatients across all age groups in Shanghai, and thus providing a molecular basis for vaccine implementation and evaluation. Methods: Stool samples were first screened by Real-time Reverse Transcription Polymerase Chain Reaction (rRT-PCR). RVA genotyping was performed through the amplification of partial VP7 and VP4 gene. Strains of interest were further sequenced and analyzed using MEGA 6.0. Results: Four thousand nine hundred one samples were collected, from which 7.61% (373 cases) were screened positive for RVA. RVA prevalence was higher in children (9.30%) than in adults (7.21%) (χ 2 = 4.72, P < 0.05). 9.38% RVA positive cases had taken antibiotics before hospital visit while 49.60% had been prescribed antibiotics afterwards. RVA displayed a strong seasonality in both adults and children with a shared commonality in genotype repertoire, where G9P[8] was the most prevalent strain (67.96%) followed by G3P[8] (15.49%) and G1P[8] (12.32%). Meanwhile the first local case of fecal shedding of the G10P[15] vaccine strain was also discovered. Conclusions: While the prevalence of rotavirus is highest during cold seasons, it is revealed for the first time that G9P[8] is the predominant genotype in both adults and pediatric outpatients. Clinically, higher occurrence of nausea or vomiting was observed in RVA positive cases. Antibiotic overuse was implicated in both non-clinical and clinical settings. The finding emphasizes the importance of RVA genotyping in surveillance as it provides the basis for new vaccine application as well as a baseline for future vaccine efficacy evaluation.

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“…The Lanzhou lamb rotavirus vaccine (LLR) is a live, attenuated oral vaccine based on a lamb rotavirus strain (G10P[15]) first isolated in 1985, and is licensed exclusively in China [59,60]. LLR has been available in China since 2000, and more than 60 million doses have been distributed [61]; however, the vaccine is not part of the country's national immunization program, and consequently, coverage is relatively low [62]. Further, coverage is highly variable by geography.…”

Section: Nationally Licensed Vaccinesmentioning

confidence: 99%

Current and new rotavirus vaccines

Burke

Tate

Kirkwood

et al. 2019

Current Opinion in Infectious Diseases

130

158

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Purpose of reviewAs of 2019, four rotavirus vaccines have been prequalified by the WHO for use worldwide. This review highlights current knowledge regarding rotavirus vaccines available, and provides a brief summary of the rotavirus vaccine pipeline.Recent findingsData generated from use of currently available products supports their effectiveness and impact in diverse settings. Rotavirus vaccines have a favorable risk–benefit profile, but previous associations of rotavirus vaccination with intussusception necessitate continued monitoring for this rare but serious adverse event. Implementation of rotavirus vaccines was jeopardized in late 2018 and 2019 by a shortage of vaccine supply. Fortunately, with the prequalification of two additional vaccines in 2018, countries have increased choice in products with different characteristics, pricing, and implementation strategies. Other vaccines currently in development may open up further immunization strategies, such as neonatal vaccination schedules or parenteral administration.SummaryRotavirus vaccines have demonstrated impact in reducing diarrheal morbidity and mortality worldwide. As countries begin to introduce the newly prequalified vaccines, additional data will become available on the safety and effectiveness of those products. Products in the pipeline have distinct profiles and could be an essential part of the expansion of rotavirus vaccine use worldwide.

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Rotavirus Gastroenteritis Infection Among Children Vaccinated and Unvaccinated With Rotavirus Vaccine in Southern China

Cited by 24 publications

References 37 publications

Molecular epidemiology of group A rotavirus in outpatient diarrhea infants and children in Chongqing, China, 2011‐2015

Molecular epidemiology of group A rotavirus in outpatient diarrhea infants and children in Chongqing, China, 2011‐2015

Genetic diversity of group A rotavirus in acute gastroenteritis outpatients in Shanghai from 2017 to 2018

Current and new rotavirus vaccines

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