Impact of rotavirus vaccination on hospital-acquired rotavirus gastroenteritis in children

• Published in: Pediatrics (Evanston) 2011-02, Vol.127 (2), p.e264-e270
• Main Authors: Anderson, Evan J, Rupp, Angela, Shulman, Stanford T, Wang, Deli, Zheng, Xiaotian, Noskin, Gary A
• Format: Article
• Language: English
• Subjects: Babies; Child; Childrens health; Cross infection; Cross Infection - complications; Cross Infection - epidemiology; Cross Infection - prevention & control; Demographic aspects; Gastroenteritis; Gastroenteritis - complications; Gastroenteritis - epidemiology; Gastroenteritis - prevention & control; Gastroenteritis - virology; Hospitalization - trends; Humans; Immune system; Immunization; Influence; Nosocomial infections; Pediatrics; Prevention; Respiratory syncytial virus; Rotavirus; Rotavirus infections; Rotavirus Infections - complications; Rotavirus Infections - epidemiology; Rotavirus Infections - prevention & control; Rotavirus Vaccines - therapeutic use; Statistics; Vaccination; Viruses
• ISSN: 0031-4005; 1098-4275; 1098-4275
• DOI: 10.1542/peds.2010-1830

Data show that after the implementation of routine rotavirus vaccination for infants in the United States, community-acquired (CA) rotavirus cases declined substantially in the 2007-2008 season. The impact of community-based rotavirus vaccination on the substantial burden of hospital-acquired (HA) rotavirus has not been documented. We assessed CA and HA rotavirus, respiratory syncytial virus, and influenza infections at Children's Memorial Hospital for 5 winter seasons (defined as occurring from September through May) from 2003 to 2008. We also report rotavirus data from the 2008-2009 season. A similar dramatic decline (>60% compared with the median of previous seasons) occurred in the rates of cases of both CA (P < .0001) rotavirus hospitalizations and HA (P < .01) rotavirus infections in the 2007-2008 season compared with previous seasons, whereas the rates of CA and HA influenza and respiratory syncytial virus, respectively, remained stable. Improvements in hand-hygiene compliance did not correlate with a reduction in the transmission rate of rotavirus in the hospital. Both CA and HA rotavirus rates remained much lower in the 2008-2009 than in the 2003-2007 seasons. Community-based rotavirus vaccination is associated with a substantial reduction in the number of children who are admitted with rotavirus. These data also indicate that routine community-based rotavirus infant vaccination protects hospitalized children from acquiring rotavirus. Vaccination efforts should be encouraged as a strategy to affect the substantial burden of HA rotavirus.