ABSTRACT
Rotavirus is the most common cause of severe diarrhea in children under 5 y old in the world. The study aims to explore the relationship between rotavirus vaccination and infection in the outbreak of rotavirus gastroenteritis in a childcare center. Earlier immunization and high vaccination rate should be encouraged.
Rotavirus is the most common cause of severe diarrhea in children under 5 y of age around the world. According to the report of the World Health Organization, in 2008, about 453000 children died of rotavirus gastroenteritis (RVGE), accounting for about 5% of all the dead children. The worldwide rotavirus-associated mortality of children under 5 y old was 86/100000.Citation1 About 90% of the rotavirus deaths come from economically and hygienically underdeveloped countries such as Asia and Africa. China accounts for 8% of the world’s rotavirus diarrhea mortality. In addition, rotavirus outbreaks have been reported in all provinces and cities of China.Citation2 Rotavirus diarrhea not only endangers human life and health but also causes huge economic losses to society and families. Rotavirus vaccines were effective in preventing rotavirus diarrhea, and it was highly effective among children in a rural community setting and provides population-level benefits through indirect protection among adults.Citation3,Citation4
In this study, we carried out an epidemiological investigation on the outbreak of rotavirus in childcare center. To analyze the relationship between rotavirus vaccination and infection, a case-control study was carried out. Vaccination history was documented from vaccine circulation and vaccination management information system of Guangdong Province. Cases were defined as teachers and students in the childcare center with at least one of the following conditions: (1) diarrhea (≥three times/day accompanied by changes in stool properties); (2) diarrhea (<three times/day accompanied by changes in stool properties) and vomiting; (3) vomiting more than twice within 24 h; (4) stool, anal swab, or vomit samples were positive for rotavirus nucleic acid since January 10, 2021. The control group randomly selected healthy children of the same sex and class as the case but without gastrointestinal symptoms. Samples of stool, rectal swab, or vomit were collected to detect intestinal viruses using RT-PCR, including norovirus, adenovirus, astrovirus and rotavirus. Univariate analysis results are summarized in . There was no significant difference in vaccination rate between the case group and the control group (P > .05). The vaccination rates were 21.05% (4/19) and 24.56% (14/57), respectively. The experimental results showed that a total of nine rectal swab samples from children tested positive for Rotavirus (G9P[8]). Similar to our study, an epidemiological study of rotavirus caused diarrhea in children aged <5 y in 26 provinces in China, 2011–2014, showed that the most prevalent genogroup of rotavirus detected was group A and G9P[8] was the most common genotypes of rotavirus group A.Citation5
Table 1. Univariate analysis of distribution of vaccination history between the case and control group
The findings from the Global Rotavirus Surveillance Network showed that after the introduction of rotavirus vaccine, the admission rate of rotavirus-induced acute gastroenteritis in children under 5 y of age continued to decline.Citation6 Our study did not find that rotavirus vaccine has a protective effect on RVGE. The possible reason is that most of the children in the childcare center are children of migrant workers who are from other provinces, resulting in a high proportion of children without vaccination information. Due to the late vaccination time and low vaccination rate, children in China are not fully protected against rotavirus infection.Citation7 At present, there is no specific treatment for RVGE, vaccine is the only effective measure to prevent RVGE. Therefore, earlier immunization and high vaccination rate should be given priority to prevent it.Citation8 In addition, preventive measures include hand washing, improving water supply facilities and improving environmental sanitation should also be advocated.
Author contributions
Concept and design: Ying Lu, Jianyun Lu. Acquisition, analysis, or interpretation of data: Ying Lu, Dahu Wang. Drafting of the manuscript: Ying Lu, Dahu Wang. Experiment: Huaping Xie.
Statistical analysis: Ying Lu. Supervision: Jianyun Lu.
Disclosure of potential conflicts of interest
The authors declare that there are no conflict of interests.
Acknowledgments
We thank all the participants in the study
References
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