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Clippings
Theme: Rotavirus
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Sriparna Basu
Email:
[email protected]
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Estimates of Rotavirus Mortality in Under-five Children. (Clin
Infect Dis. 2016;62:S96-105)
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This article is a systematic review of all published papers – and WHO
rotavirus surveillance network data – to estimate global, regional, and
national rotavirus mortality in under-five children over a period
of 14 years (2000-2013). A multiple linear regression model showed that
globally, the predicted annual rotavirus detection rate declined from
42.5% (95% CI 37.4-47.5%) in 2000 to 37.3% (95% CI 34.2-40.5%) in 2013,
and the number of rotavirus deaths declined from 528000 (range,
465000-591000) in 2000 to 215000 (range, 197000-233000) in 2013. An
estimated 47100 rotavirus deaths occurred in India in 2013, accounting
for 22% of the global rotavirus deaths. Four countries (India, Nigeria,
Pakistan and Democratic Republic of Congo) accounted for approximately
half (49%) of all estimated rotavirus deaths in 2013.
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Age at First Rotavirus Vaccination and Risk of Intussusception in
Infant. (Drug Saf. 2016 Apr 11. [Epub ahead of print]).
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A five-fold increase in intussusception in the first week after the
first dose, and two-fold after second dose of current rotavirus
vaccines have been reported which may further add to the naturally
occurring increased incidence of intussusception between 3 to 8 months
of age. This public health risk analysis was carried out to model the
impact of age at first rotavirus vaccination and risk of excess intussusception hospitalizations
in infants. The risk of intussusception was lowest (1 in 49,000) if both
first and second doses were given at age <3 months followed by 1 in
41,000 if first dose was given at age <3 months and second dose was
given at 3-5 months of age. Risk was highest (1 in 11,000) if the
infants received both doses after 3 months of age. The authors
recommended administration of first two doses of rotavirus vaccine
before the age of 3 months to minimize the risk of intussusception
following rotavirus vaccination.
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Binding specificity of P[8] VP8* proteins
of rotavirus vaccine strains with histo-blood group antigens.
(Virology. 2016;495:129-135)
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P(VP4) genotype of rotavirus is a protease-sensitive protein that can be
cleaved into VP5* and VP8*. VP8* recognizes histo-blood group antigens
and plays an important role in productive rotavirus infection. In this
study, oligosaccharide and saliva-based binding assays were carried out
to examine the binding specificity of P[8]VP8* protein of two common
rotavirus vaccines, RotaTeq and Rotarix. P[8]VP8*-glutathione S-transferase
proteins of RotaTeq and Rotarix showed obvious binding to saliva samples
for each of the A, B, and O types, indicating that vaccine effectiveness
may correlate with the individuals’ secretor status. It was concluded
that as live-attenuated vaccines have weak vaccine efficiency in
non-secretors, RotaTeq and Rotarix may be of better efficiency in areas
with a high percentage of secretors. Inactivated or subunit vaccines
should be developed for areas with a high percentage of non-secretors.
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Unusual rotavirus genotypes in humans and animals with
acute diarrhea in Northeastern India. (Epidemiol
Infect. 2016 Apr 26:1-10)
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Rotavirus can cause acute infantile diarrhea in both humans and animals.
Close humans-to-animals proximity may lead to cross-species infection
and emergence of novel/unusual strains by genetic reassortment. This
study analyzed 500 diarrheal samples for group A rotaviruses (RVA)
from children (n=290), piglets (n=95) and calves (n=115)
in Northeastern India during 2012-2013. Overall, 28.4% fecal samples
were positive for RVA. Highest number of infection was detected in
piglets (40.1%) followed by children (35.9%) and calves (23.9%). G1P[8]
(25%) and G1P[7] (35%) were the prevailing genotypes in both humans and
animals with single cases of G9P[8], G5P[8] in humans and G1P[13],
G1P[23] and G3P[7] in animals. Cluster analyses of sequences showed
close genetic association of regional strains to their homologous
strains. However, human G5P[8] and porcine G1P[8] strains showed
homology to heterologous hosts of their prototype strains. Continuous
surveillance of infections from diverse hosts in a common setting is
recommended to detect global spread of such unusual strains.
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Can different rotavirus vaccines be used to
complete the vaccination schedule? (Pediatrics.
2016;137:1-10)
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At present we have several licensed rotavirus vaccines with proven
efficacy by using 2 or 3 doses (as per manufacturer’s instructions) in a
given child. In certain situations, it may not be possible to complete
the schedule by using the same vaccine formulation. This randomized,
multicenter, open label study compared the immune responses to the 2
licensed rotavirus vaccines when administered as a mixed schedule
compared with administering a single vaccine formulation alone. 1393
Healthy infants (age 6–14 wk) were randomized to receive rotavirus
vaccines in 1 of 5 different schedules (2 using the same vaccine for all
doses, and 3 using mixed schedules). The group receiving only the
monovalent rotavirus vaccine received 2 doses of vaccine and the other 4
groups received 3 doses of vaccine. One month after the last vaccine
dose, immune responses (rotavirus immunoglobulin A
³20 U/mL) to all the
sequential mixed vaccine schedules were shown to be non-inferior when
compared with the single vaccine reference groups. The proportion of
children seropositive to at least 1 vaccine antigen at 1 month after
vaccination ranged from 77% to 96%, and was not significantly different
among all the study groups. All schedules were well tolerated.
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