Annual rotavirus epidemic patterns in North America: Results of a 5-year retrospective survey of 88 centers in Canada, Mexico, and the United States

Article Abstract:

Rotavirus is the largest single cause of severe diarrhea in children. An estimated of 140 million cases of rotaviral diarrhea occur each year, with nearly 1 million deaths worldwide. The number of cases in the United States totals approximately 3.5 million, 75 to 125 individuals annually die from this disease. Although several vaccines are currently in trial stages, the results have been inconclusive. The present study examined the number of positive laboratory tests for rotavirus in North America. Data was compiled from 75 medical centers within the United States and from government agencies in Canada and Mexico. These findings were correlated over a five-year-period and plotted both for time of occurrence and for geographic location. A total of 34,644 cases of rotavirus were studied. An unusual and cyclical pattern was observed suggesting that a yearly epidemic of rotavirus begins in the fall in Mexico and the Southwest United States. The epidemic spreads easterly across the country to reach a peak in the Northeast and Canadian Maritime Provinces in the spring of the year. This is the first known finding of a repetitive and geographic sequence of a seasonal epidemic-causing virus. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Demographic aspects, Diarrhea, Viral diarrhea

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Evaluation of rhesus rotavirus monovalent and tetravalent reassortant vaccines in US children

Article Abstract:

Both monovalent and tetravalent rhesus rotavirus vaccines may safely and effectively reduce the rate of rotavirus disease in children. Rotavirus infection causes inflammation of the stomach and intestines and diarrhea. Researchers administered three doses of oral vaccines to 898 infants. Of these, 297 received a monovalent rotavirus vaccine, 305 received a tetravalent vaccine, and 296 received a placebo. At the two-year follow-up, the monovalent vaccine was 40% effective and the trivalent vaccine was 57% effective. Both vaccines were more than 70% effective against severe rotavirus infection and reduced the number of medical visits for rotavirus disease by more than 65%. Children in the tetravalent vaccine group were more likely to develop a mild fever than placebo-recipients after one vaccine dose, although the rate of other adverse reactions did not differ according to vaccination group.

Evaluation, Diarrhea in children, Childhood diarrhea, Viral vaccines

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Cost-effectiveness analysis of a rotavirus immunization program for the United States

Article Abstract:

Universal rotavirus vaccination could be cost-effective, especially if the cost of the vaccine could be brought under $10 a dose. Researchers estimated the cost and benefits of a national program to vaccinate all infants against rotavirus at 2, 4, and 6 months. The program would prevent about 1 million cases of diarrhea, avoid 34,000 hospitalizations and 227,000 physician visits in the first 5 years. At $20 per dose, the program would cost $289 million but would save only $182 million in direct medical costs. However, savings to society from lost caregiver earnings would total $296 million. At $9 a dose, direct health care savings would pay for the program.

Economic aspects, Children, Vaccination of children, Vaccination

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