Incidence of rotavirus gastroenteritis hospitalizations and genotypes,before and five years after introducing universal immunization in Israel |
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| Affiliation: | 1. Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel;2. Department of Pediatrics, Hillel Yaffe Medical Center, Hadera, Israel;3. Department of Pediatrics, Laniado Medical Center, Netanya, Israel;4. Department of Pediatrics, Carmel Medical Center, Haifa, Israel;5. Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel;6. Central Virology Laboratory, Ministry of Health, Tel Hashomer, Israel;1. Hospital La Fe, Valencia, Spain;2. Vaccine Research Department of FISABIO, Valencia, Spain;1. Institute of Infection and Global Health, University of Liverpool, Liverpool, UK;2. Field Epidemiology Services, Public Health England, Liverpool, UK;3. CHICAS Group, Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK;4. Department of Microbiology, Alder Hey Children''s NHS Foundation Trust, Liverpool, UK;5. Virus Reference Department, Public Health England, Colindale, London, UK;1. Centre for Epidemiology and Evidence, NSW Ministry of Health, North Sydney, NSW 2060, Australia;2. Centre for Epidemiology and Evidence, NSW Ministry of Health, Locked Mail Bag 961, North Sydney, NSW 2059 Australia;3. School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia;4. The Telethon Kids Institute, Subiaco, 6008 WA, Australia;5. Public Health Unit, South Eastern Sydney Local Health District, Randwick, NSW 2031, Australia;6. National Centre for Immunisation Research and Surveillance (NCIRS), Westmead, NSW 2145, Australia;7. Discipline of Paediatrics and Child Health, University of Sydney, NSW 2006, Australia;1. Field Epidemiology Training Program/São Paulo State (EPISUS-SP), Secretaria de Estado da Saúde de São Paulo, Avenida Dr Arnaldo, 35, 6th floor, São Paulo, SP 01246-000, Brazil;2. Division of Immunization, São Paulo State Health Department, Avenida Dr Arnaldo, 35, 6th floor, São Paulo, SP 01246-000, Brazil;3. Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Diseases Control and Prevention, 1600 Clifton Rd, MS A-34, Atlanta, GA 30333, United States;4. Centers for Diseases Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, United States;5. Departamento de Medicina Social, Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Mota Jr., 61, 6th floor, São Paulo, SP 01221-020, Brazil;6. Division of Viral Diseases, Centers for Diseases Control and Prevention, 1600 Clifton Rd, MS A-34, Atlanta, GA 30333, United States;1. Hospital Clínico Universitario de Valladolid, Valladolid, Spain;2. Johns Hopkins University, Baltimore, MD, United States;3. Centro de Salud Pilarica, Valladolid, Spain;1. Department of Preventive Medicine & Public Health, Medical Immunology and Microbiology, Rey Juan Carlos University, Madrid, Spain;2. Medical and Scientific Department, Sanofi Pasteur, Madrid, Spain |
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| Abstract: | BackgroundUncertainty exists about the sustainability of the reduction in rotavirus gastroenteritis (RVGE) following the introduction of rotavirus vaccines into national immunization programs, and on its potential impact on circulating genotypes. RotaTeq was introduced into the Israeli national immunization program in December 2010, and vaccination coverage is around 80%.AimsTo examine the change in incidence of RVGE hospitalization and rotavirus genotypes, during the five years after introduction of RotaTeq into the Israeli national immunization program.MethodsData were obtained prospectively on hospitalization of children aged 0–59 months due to acute gastroenteritis (N = 7346) from three hospitals in northern Israel. Stool samples were tested for rotavirus by immunochromatography. Rotavirus was genotyped (N = 506) by RT-PCR and/or sequencing.ResultsThe average incidence of RVGE hospitalization declined by 61.0% (95% CI 49.0–73.4%), from 5.6 per 1000 (95% CI 5.0–6.2) in the pre-universal immunization period (2008–2010) to 2.2 per 1000 (95% CI 1.8–2.5) during the universal immunization period (2012–2015), but yearly fluctuations were still observed.The most common genotypes in the pre-universal immunization period were G1P[8] (35.3%) followed by G2P[4] (15.5%), G3P[8] (8.8%), G4P[8] (4.3%) and G9P[8] (4.3%), and 19.5% were mixed infections. The dominance of G1P[8] continued into the universal immunization period (48.6%), followed by G3P[8] (21.5%), G9P[8] (15.9%) and G12P[8] (4.7%), while mixed rotavirus infections were no longer detected.ConclusionsUniversal immunization with RotaTeq in Israel was associated a sustained reduction in RVGE hospitalization. It is unclear whether changes in the circulating rotavirus genotypes are due to vaccine-induced selective pressure. Assessment of the long-term impact of rotavirus vaccination on the incidence of rotavirus gastroenteritis and continued strain surveillance is warranted. |
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| Keywords: | Universal rotavirus vaccination RotaTeq Long-term impact Genotypes Israel |
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