Viral Etiology of Acute Gastroenteritis in <2-Year-Old US Children in the Post–Rotavirus Vaccine Era

2018 ◽  
Vol 8 (5) ◽  
pp. 414-421 ◽  
Author(s):  
Ferdaus Hassan ◽  
Neena Kanwar ◽  
Christopher J Harrison ◽  
Natasha B Halasa ◽  
James D Chappell ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Pediatric Population ◽  
Adenovirus Type ◽  
The United States ◽  
Population Based ◽  
Rotavirus Vaccine ◽  
Viral Etiology ◽  
Surveillance Network ◽  
Detection Rates ◽  
Us Children

Abstract Background The rotavirus disease burden has declined substantially since rotavirus vaccine was introduced in the United States in 2006. The aim of this study was to determine the viral etiology of acute gastroenteritis (AGE) in US children aged <2 years. Methods The New Vaccine Surveillance Network (NVSN) of geographically diverse US sites conducts active pediatric population-based surveillance in hospitals and emergency departments. Stool samples were collected from children aged <2 years with symptoms of AGE (n = 330) and age-matched healthy controls (HCs) (n = 272) between January and December 2012. Samples were tested by real-time reverse-transcriptase polymerase chain reaction assays {adenovirus (type 40 and 41), norovirus, parechovirus A, enterovirus, sapovirus, and astrovirus} and an enzyme immunoassay (rotavirus). All samples that tested positive were genotyped. Results Detection rates of pathogens in children with AGE versus those of HCs were, respectively, 23.0% versus 6.6% for norovirus (P < .01), 23.0% versus 16.0% for adenovirus (P = .08), 11.0% versus 16.0% for parechovirus A (P = .09), 11.0% versus 9.0% for enterovirus (P = .34), 7.0% versus 3.0% for sapovirus (P = .07), 3.0% versus 0.3% for astrovirus (P = .01), and 3.0% versus 0.4% for rotavirus (P = .01). A high prevalence of adenovirus was detected at 1 surveillance site (49.0% for children with AGE and 43.0% for HCs). Norovirus GII.4 New Orleans was the most frequently detected (33.0%) norovirus genotype. Codetection of >1 virus was more common in children with AGE (16.0%) than in HCs (10.0%) (P = .03). Conclusions Norovirus, astrovirus, sapovirus, and rotavirus were detected significantly more in children with AGE than in HCs, and norovirus was the leading AGE-causing pathogen in US children aged <2 years during the year 2012.

scholarly journals Multiplex PCR pathogen detection in acute gastroenteritis among hospitalized US children compared to healthy controls during 2011-2016 in the post rotavirus vaccine era

2021 ◽  
Author(s):  
Christopher J Harrison ◽  
Ferdaus Hassan ◽  
Brian Lee ◽  
Julie Boom ◽  
Leila C Sahni ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Kansas City ◽  
Pathogen Detection ◽  
Signs And Symptoms ◽  
Population Based ◽  
Healthy Controls ◽  
Surveillance Network ◽  
Clostridioides Difficile ◽  
Increased Risk ◽  
Us Children

Abstract Background Despite vaccine-induced decreases in US rotavirus (RV) disease, acute gastroenteritis (AGE) remains relatively common. We evaluated AGE pathogen distribution in hospitalized US children in the post-RV-vaccine era. Methods From December 2011 to June 2016, the New Vaccine Surveillance Network (NVSN) conducted prospective, active, population-based surveillance in hospitalized children with AGE. We tested stools from two NVSN sites (Kansas City; Houston) with Luminex x-TAG Gastrointestinal Pathogen Panels (Luminex GPP) and analyzed selected signs and symptoms. Results For 660 pediatric AGE inpatients and 624 age-matched healthy controls (HC), overall organism detection was 51.2% and 20.6% respectively, p &lt;0.001. Among AGE subjects, GPP PCR detected &gt;1 virus in 39% and &gt;1 bacteria in 14% of specimens. Detection frequencies for AGE subjects vs. HC were: norovirus (NoV) 18.5% vs 6.6%, rotavirus (RV) 16.1% vs 9.8%, adenovirus 7.7% vs 1.4%, Shigella 4.8% vs 1.0%, Salmonella 3.1% vs 0.1%, Clostridioides difficile in ≥2-year olds 4.4% vs 2.4%. More co-detections occurred among AGE (37/660, 5.6%) than HC (14/624, 2.2%), p=0.0024. Per logistic regression analysis, ill contacts increased risk for NoV, RV and Shigella, p&lt;0.001. More vomiting episodes occurred with NoV and RV, and more diarrheal episodes with Shigella and Salmonella. Modified Vesikari scores were highest for Shigella and lowest for C. difficile. Conclusion NoV detection was most frequent, however RV remained important in hospitalized AGE in the post-RV-vaccine era. Continued active surveillance is important to document ongoing vaccine effects, pathogen emergence and baseline disease burden for new vaccines.

scholarly journals Estimated Burden of Community-Onset Respiratory Syncytial Virus–Associated Hospitalizations Among Children Aged <2 Years in the United States, 2014–15

2019 ◽  
Vol 9 (5) ◽  
pp. 587-595 ◽  
Author(s):  
Carmen S Arriola ◽  
Lindsay Kim ◽  
Gayle Langley ◽  
Evan J Anderson ◽  
Kyle Openo ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Census Data ◽  
The United States ◽  
Surveillance Network ◽  
Detection Probabilities ◽  
Syncytial Virus ◽  
Us Children ◽  
Us Census ◽  
The Impact ◽  
Community Onset

Abstract Background Respiratory syncytial virus (RSV) is a major cause of hospitalizations in young children. We estimated the burden of community-onset RSV-associated hospitalizations among US children aged &lt;2 years by extrapolating rates of RSV-confirmed hospitalizations in 4 surveillance states and using probabilistic multipliers to adjust for ascertainment biases. Methods From October 2014 through April 2015, clinician-ordered RSV tests identified laboratory-confirmed RSV hospitalizations among children aged &lt;2 years at 4 influenza hospitalization surveillance network sites. Surveillance populations were used to estimate age-specific rates of RSV-associated hospitalization, after adjusting for detection probabilities. We extrapolated these rates using US census data. Results We identified 1554 RSV-associated hospitalizations in children aged &lt;2 years. Of these, 27% were admitted to an intensive care unit, 6% needed mechanical ventilation, and 5 died. Most cases (1047/1554; 67%) had no underlying condition. Adjusted age-specific RSV hospitalization rates per 100 000 population were 1970 (95% confidence interval [CI],1787 to 2177), 897 (95% CI, 761 to 1073), 531 (95% CI, 459 to 624), and 358 (95% CI, 317 to 405) for ages 0–2, 3–5, 6–11, and 12–23 months, respectively. Extrapolating to the US population, an estimated 49 509–59 867 community-onset RSV-associated hospitalizations among children aged &lt;2 years occurred during the 2014–2015 season. Conclusions Our findings highlight the importance of RSV as a cause of hospitalization, especially among children aged &lt;2 months. Our approach to estimating RSV-related hospitalizations could be used to provide a US baseline for assessing the impact of future interventions.

scholarly journals Reduction in Acute Gastroenteritis Hospitalizations among US Children After Introduction of Rotavirus Vaccine: Analysis of Hospital Discharge Data from 18 US States

2010 ◽  
Vol 201 (11) ◽  
pp. 1617-1624 ◽  
Author(s):  
Aaron T. Curns ◽  
Claudia A. Steiner ◽  
Marguerite Barrett ◽  
Katherine Hunter ◽  
Emily Wilson ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Acute Gastroenteritis ◽  
Hospital Discharge Data ◽  
Rotavirus Vaccine ◽  
Discharge Data ◽  
Us States ◽  
Us Children

Continued Evidence of the Impact of Rotavirus Vaccine in Children Less Than 3 Years of Age From the United States New Vaccine Surveillance Network: A Multisite Active Surveillance Program, 2006–2016

2020 ◽  
Author(s):  
Mary Allen Staat ◽  
Daniel C Payne ◽  
Natasha Halasa ◽  
Geoffrey A Weinberg ◽  
Stephanie Donauer ◽  
...  
Keyword(s):  
United States ◽  
Disease Burden ◽  
The United States ◽  
Population Based ◽  
Surveillance Program ◽  
Surveillance Network ◽  
Rotavirus Vaccination ◽  
Ed Visits ◽  
The Impact ◽  
Vaccine Surveillance

Abstract Background Since 2006, the New Vaccine Surveillance Network has conducted active, population-based surveillance for acute gastroenteritis (AGE) hospitalizations and emergency department (ED) visits in 3 United States counties. Trends in the epidemiology and disease burden of rotavirus hospitalizations and ED visits were examined from 2006 to 2016. Methods Children &lt; 3 years of age hospitalized or visiting the ED with AGE were enrolled from January 2006 through June 2016. Bulk stool specimens were collected and tested for rotavirus. Rotavirus-associated hospitalization and ED visit rates were calculated annually with 2006–2007 defined as the prevaccine period and 2008–2016 as the postvaccine period. Rotavirus genotype trends were compared over time. Results Over 11 seasons, 6954 children with AGE were enrolled and submitted a stool specimen (2187 hospitalized and 4767 in the ED). Comparing pre- and postvaccine periods, the proportion of children with rotavirus dramatically declined for hospitalization (49% vs 10%) and ED visits (49% vs 8%). In the postvaccine era, a biennial pattern of rotavirus rates was observed, with a trend toward an older median age. G1P[8] (63%) was the predominant genotype in the prevaccine period with a significantly lower proportion (7%) in the postvaccine period (P &lt; .001). G2P[4] remained stable (8% to 14%) in both periods, whereas G3P[8] and G12P[8] increased in proportion from pre- to postvaccine periods (1% to 25% and 17% to 40%), respectively. Conclusions The epidemiology and disease burden of rotavirus has been altered by rotavirus vaccination with a biennial disease pattern, sustained low rates of rotavirus in children &lt; 3 years of age, and a shift in the residual genotypes from G1P[8] to other genotypes.

scholarly journals Vaccine Effectiveness Against Influenza Hospitalization Among Children in the United States, 2015–2016

2020 ◽  
Author(s):  
Leora R Feldstein ◽  
Constance Ogokeh ◽  
Brian Rha ◽  
Geoffrey A Weinberg ◽  
Mary A Staat ◽  
...  
Keyword(s):  
United States ◽  
Influenza Vaccination ◽  
Respiratory Illness ◽  
The United States ◽  
Vaccine Effectiveness ◽  
Limited Data ◽  
Surveillance Network ◽  
Number Of Children ◽  
Influenza Illness ◽  
Us Children

Abstract Background Annual United States (US) estimates of influenza vaccine effectiveness (VE) in children typically measure protection against outpatient medically attended influenza illness, with limited data evaluating VE against influenza hospitalizations. We estimated VE for preventing laboratory-confirmed influenza hospitalization among US children. Methods We included children aged 6 months–17 years with acute respiratory illness enrolled in the New Vaccine Surveillance Network during the 2015–2016 influenza season. Documented influenza vaccination status was obtained from state immunization information systems, the electronic medical record, and/or provider records. Midturbinate nasal and throat swabs were tested for influenza using molecular assays. We estimated VE as 100% × (1 – odds ratio), comparing the odds of vaccination among subjects testing influenza positive with subjects testing negative, using multivariable logistic regression. Results Of 1653 participants, 36 of 707 (5%) of those fully vaccinated, 18 of 226 (8%) of those partially vaccinated, and 85 of 720 (12%) of unvaccinated children tested positive for influenza. Of those vaccinated, almost 90% were documented to have received inactivated vaccine. The majority (81%) of influenza cases were in children ≤ 8 years of age. Of the 139 influenza-positive cases, 42% were A(H1N1)pdm09, 42% were B viruses, and 14% were A(H3N2). Overall, adjusted VE for fully vaccinated children was 56% (95% confidence interval [CI], 34%–71%) against any influenza-associated hospitalization, 68% (95% CI, 36%–84%) for A(H1N1)pdm09, and 44% (95% CI, –1% to 69%) for B viruses. Conclusions These findings demonstrate the importance of annual influenza vaccination in prevention of severe influenza disease and of reducing the number of children who remain unvaccinated or partially vaccinated against influenza.

scholarly journals Determining the accuracy of the Canadian Hospitals Injury Reporting and Prevention Program for the representation of the rates of mild traumatic brain injuries in Quebec

2019 ◽  
Vol 39 (11) ◽  
pp. 291-297
Author(s):  
Glenn Keays ◽  
Debbie Friedman ◽  
Isabelle Gagnon ◽  
Marianne Beaudin
Keyword(s):  
Prevention Program ◽  
Brain Injuries ◽  
Pediatric Population ◽  
Age Groups ◽  
The United States ◽  
Traumatic Brain Injuries ◽  
Population Based ◽  
Number Of Children ◽  
Mild Traumatic Brain Injuries ◽  
Injury Reporting

Introduction The recent rise in mild traumatic brain injuries (mTBI) in the pediatric population has been documented by many studies in Canada and the United States. The objective of our study was to compare mTBI rates from the Canadian Hospital Injury Reporting and Prevention Program (CHIRPP) in Montréal with population-based rates (Quebec mTBI rates). Methods We calculated CHIRPP’s mTBI rates via two methods: (1) using all CHIRPP injuries as the denominator; and (2) using the number of children aged 0 to 17 years living within 5 km of either of two CHIRPP centres in Montréal as the denominator. We plotted CHIRPP’s mTBI rates against the provincial rates and compared them according to sex and age. Results Whether using all CHIRPP injuries or the number of children aged 0 to 17 years living within 5 km of either CHIRPP centre in Montreal as the denominator, CHIRPP paralleled the fluctuations seen in Quebec’s rates between 2003 and 2016. When stratifying by sex and age, CHIRPP was better at estimating the population-based rates for the youngest (0 to 4 years) and the oldest (13 to 17 years) age groups. Conclusion CHIRPP in Montréal proved a valid tool for estimating the variations in rates of mTBI in the population. This suggests that CHIRPP could also be used to estimate population-based rates of other types of injuries.

scholarly journals Acute gastroenteritis in a pediatric population from Cali, Colombia in the post rotavirus vaccine era

2018 ◽  
Vol 73 ◽  
pp. 52-59 ◽  
Author(s):  
Eduardo López-Medina ◽  
Beatriz Parra ◽  
Diana M. Dávalos ◽  
Pio López ◽  
Eder Villamarín ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Pediatric Population ◽  
Rotavirus Vaccine

scholarly journals Rotavirus Vaccine Is Effective Against Rotavirus Gastroenteritis Resulting in Outpatient Care: Results From the Medically Attended Acute Gastroenteritis (MAAGE) Study

2020 ◽  
Author(s):  
Rachel M Burke ◽  
Holly C Groom ◽  
Allison L Naleway ◽  
Eric M Katz ◽  
Bianca Salas ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Severe Disease ◽  
The United States ◽  
Clinic Visit ◽  
Rotavirus Vaccine ◽  
Case Definitions ◽  
Rotavirus Vaccination ◽  
Mild Disease ◽  
Qrt Pcr ◽  
Negative Case

Abstract Background Rotavirus is a common cause of severe pediatric acute gastroenteritis. Two vaccines are licensed in the United States and have demonstrated high effectiveness against moderate to severe disease. However, fewer data are available on rotavirus vaccine effectiveness (VE) against milder disease. Methods We leveraged active surveillance data from Kaiser Permanente Northwest to calculate rotavirus VE against medically attended rotavirus illness among age-eligible children. We utilized a test-negative case-control design and applied 4 distinct case definitions based on reverse transcription–quantitative real-time PCR (qRT-PCR) assay and enzyme immunoassay (EIA) test results. VE was calculated as 100 × (1 − odds ratio), and models were adjusted for age group. Results The VE analysis population comprised 842 children, 799 (95%) of whom had mild disease requiring at most a clinic visit and 698 (83%) of whom were fully vaccinated against rotavirus. Age-adjusted VE was 70% (95% confidence interval [CI], 37–86%) against disease defined solely by qRT-PCR results, 72% (95% CI, 31–89%) against disease as defined by qRT-PCR with a quantification cycle (Cq) value &lt;27, 73% (95% CI, 32–90%) against disease that was qRT-PCR positive but EIA negative, and 62% (95% CI, –20–88%) against disease defined solely by EIA. Results were similar when restricting to disease resulting in at most an ambulatory clinic or emergency department visit. Conclusions These results support the effectiveness of rotavirus vaccination in protecting US children from mild to moderate and severe disease. Our findings are also useful to show the effectiveness of rotavirus vaccination against qRT-PCR–defined illness.

Time Trends of the Prevalence of Acute Gastroenteritis in the United States: A Population-Based Study

2017 ◽  
Vol 152 (5) ◽  
pp. S810
Author(s):  
Hyunseok Kim ◽  
Thayer Nasereddin ◽  
Adaugo I. Ike ◽  
Michael Demyen ◽  
Sushil Ahlawat
Keyword(s):  
United States ◽  
Acute Gastroenteritis ◽  
Time Trends ◽  
The United States ◽  
Population Based ◽  
Population Based Study
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