The best magazine
Background
Rotavirus (RV) infections are one of the most frequent causes of gastroenteritis in children worldwide with a major impact on mortality in children <2 years living in developing countries. In European countries, mortality attributed to RV infections was estimated to be 1 in 100,000 children <5 years for each year, with a high burden of nosocomial RV gastroenteritis in the pediatric population.
In Austria, about 45,000 episodes of acute RV-associated gastroenteritis (RV-GE) account for approximately 1,400 hospital admissions per 100,000 children. Austria, prompted by cost calculations, was one of the first European countries to recommend vaccination against RV since 2006 and to subsidize an universal mass vaccination (UMV) program in infants aged between 6 weeks and 6 months with Rotateq (Sanofi Pasteur MSD SNC, Lyon, France; market launch September 2006) between July and December 2007 and with Rotarix (GlaxoSmithKline Biologicals, Rixensart, Belgium; market launch May 2006) between January 2008 and December 2009. Both vaccines are directed against the most important serotypes circulating in Austria, G1P (74.0%), G4P (8.0%) and G3P (1.8%) which were found in samples from hospitalized children due to RV-GE in Innsbruck, Tyrol, and Leoben, Styria. A vaccination coverage of 72 to 87% was documented by surveillance data in 2008. The hospitalized cases in RV-affected children aged between 3 and 20 months decreased from August 2007 until December 2008 by 74%. A further reduction of RV-GE and some effects of herd protection in older children who were not covered by the UMV because of age limitations were described for 2009. Both commercially available RV vaccines have a similar efficacy and safety profile and have been found to be cost-effective depending on different perspectives and modeling assumptions in some European and developing countries with a reduction of all-cause diarrhea-related hospitalizations among children <5 years.
From the patho-physiological view, RV causes an intestinal epithelium dysfunction in the small intestine. RV-damaged enterocytes are more capable for bacterial invasion causing secondary bacterial infections. Only few studies exist thus far which focus on secondary blood stream infections (BSI) as one major and life-threatening complication following RV-GE.
The retrospective evaluation by chart analysis (2002–2009) focused on all both clinically diagnosed and microbiologically confirmed RV-GE-associated cases in a large tertiary care children's hospital in Austria. The focus was on RV-GE-associated hospitalizations as the primary outcomes; secondary outcomes were the burdens of nosocomial RV disease and occurrence of secondary BSI as well as direct hospitalization costs for children and their accompanying persons based on the accounts provided by the clearing office of the hospital.
Source: ...