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Xu X, Luo Y, He C, Dian Z, Mi H, Yang J, Feng Y, Miao Z, Xia X. Increased Risk of Neurological Disease Following Pediatric Rotavirus Infection: A Two-Center Case-Control Study. J Infect Dis 2023; 227:1313-1321. [PMID: 36520652 PMCID: PMC10226661 DOI: 10.1093/infdis/jiac486] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/14/2022] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Whether pediatric rotavirus infection is associated with extraintestinal complications remains unknown. METHODS We conducted a case-control study to investigate the incidences and risks of rotavirus-associated extraintestinal complications in hospitalized newborns, infants, and children younger than 5 years. RESULTS A total of 1325 young inpatients with rotavirus infection (754 male and 539 newborns) and 1840 controls without rotavirus infection (1035 male and 836 newborns) were included. The incidences of neurological disease were higher among rotavirus individuals compared with controls: newborns, 7.24% (39/539) versus 2.87% (24/836), P < .001; infants and young children, 19.59% (154/786) versus 12.35% (124/1004), P < .001. The associated odd ratios (ORs) for neurological disease frequency following rotavirus infection was 2.64 (95% confidence interval [CI], 1.57-4.44) for newborns and 1.73 (95% CI, 1.34-2.24) for infants and young children, which increased to 2.56 (95% CI, 1.57-4.18) in case-control (1:1) matching analysis and 1.85 (95% CI, 1.41-2.42) in confounder adjustment. Rotavirus infection was associated with other extraintestinal complications, depending on study population and disease severity. Outcome analysis revealed rotavirus infection and its consequences had a significant impact on hospitalization and discharge. CONCLUSIONS Rotavirus exposure was associated with a spectrum of extraintestinal complications, particularly neurological disease. Rotavirus infection and subsequent consequences resulted in poor clinical outcomes.
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Affiliation(s)
- Xiaoyan Xu
- Department of Pediatrics, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan Province, China
| | - Yunjiao Luo
- Department of Infectious Disease, Kunming Children's Hospital, Kunming, Yunnan Province, China
| | - Canlin He
- Neonatal Department, Kunming Children's Hospital, Kunming, Yunnan Province, China
| | - Ziqin Dian
- Clinical Laboratory Department, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan Province, China
| | - Hongying Mi
- Department of Pediatrics, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan Province, China
| | - Jinghui Yang
- Department of Pediatrics, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan Province, China
| | - Yue Feng
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan Province, China
| | - Zhijiang Miao
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan Province, China
| | - Xueshan Xia
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan Province, China
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2
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Vetter V, Gardner RC, Debrus S, Benninghoff B, Pereira P. Established and new rotavirus vaccines: a comprehensive review for healthcare professionals. Hum Vaccin Immunother 2022; 18:1870395. [PMID: 33605839 PMCID: PMC8920198 DOI: 10.1080/21645515.2020.1870395] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/02/2020] [Accepted: 12/28/2020] [Indexed: 01/05/2023] Open
Abstract
Robust scientific evidence related to two rotavirus (RV) vaccines available worldwide demonstrates their significant impact on RV disease burden. Improving RV vaccination coverage may result in better RV disease control. To make RV vaccination accessible to all eligible children worldwide and improve vaccine effectiveness in high-mortality settings, research into new RV vaccines continues. Although current and in-development RV vaccines differ in vaccine design, their common goal is the reduction of RV disease risk in children <5 years old for whom disease burden is the most significant. Given the range of RV vaccines available, informed decision-making is essential regarding the choice of vaccine for immunization. This review aims to describe the landscape of current and new RV vaccines, providing context for the assessment of their similarities and differences. As data for new vaccines are limited, future investigations will be required to evaluate their performance/added value in a real-world setting.
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Affiliation(s)
- Volker Vetter
- Medical Affairs Department, GSK, Wavre, Belgium
- Vaccines R&D – Technical R&D, GSK, Wavre, Belgium
| | - Robert C. Gardner
- Medical Affairs Department, GSK, Wavre, Belgium
- Vaccines R&D – Technical R&D, GSK, Wavre, Belgium
| | - Serge Debrus
- Medical Affairs Department, GSK, Wavre, Belgium
- Vaccines R&D – Technical R&D, GSK, Wavre, Belgium
| | - Bernd Benninghoff
- Medical Affairs Department, GSK, Wavre, Belgium
- Vaccines R&D – Technical R&D, GSK, Wavre, Belgium
| | - Priya Pereira
- Medical Affairs Department, GSK, Wavre, Belgium
- Vaccines R&D – Technical R&D, GSK, Wavre, Belgium
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3
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Hall EW, Tippett A, Fridkin S, Anderson EJ, Lopman B, Benkeser D, Baker JM. Association Between Rotavirus Vaccination and Antibiotic Prescribing Among Commercially Insured US Children, 2007-2018. Open Forum Infect Dis 2022; 9:ofac276. [PMID: 35855006 PMCID: PMC9291383 DOI: 10.1093/ofid/ofac276] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background Vaccines may play a role in controlling the spread of antibiotic resistance. However, it is unknown if rotavirus vaccination affects antibiotic use in the United States (US). Methods Using data from the IBM MarketScan Commercial Database, we conducted a retrospective cohort of US children born between 2007 and 2018 who were continuously enrolled for the first 8 months of life (N = 2 136 136). We followed children through 5 years of age and compared children who completed a full rotavirus vaccination series by 8 months of age to children who had not received any doses of rotavirus vaccination. We evaluated antibiotic prescriptions associated with an acute gastroenteritis (AGE) diagnosis and defined the switching of antibiotics as the prescription of a second, different antibiotic within 28 days. Using a stratified Kaplan-Meier approach, we estimated the cumulative incidence for each study group, adjusted for receipt of pneumococcal conjugate vaccine, provider type, and urban/rural status. Results Overall, 0.8% (n = 17 318) of participants received an antibiotic prescription following an AGE diagnosis. The 5-year adjusted relative cumulative incidence of antibiotic prescription following an AGE diagnosis was 0.793 (95% confidence interval [CI], .761–.827) among children with complete rotavirus vaccination compared to children without rotavirus vaccination. Additionally, children with complete vaccination were less likely to switch antibiotics (0.808 [95% CI, .743–.887]). Rotavirus vaccination has averted an estimated 67 045 (95% CI, 53 729–80 664) antibiotic prescriptions nationally among children born between 2007 and 2018. Conclusions These results demonstrate that rotavirus vaccines reduce antibiotic prescribing for AGE, which could help reduce the growth of antibiotic resistance.
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Affiliation(s)
- Eric W Hall
- School of Public Health, Oregon Health and Science University, Portland, Oregon, USA
| | - Ashley Tippett
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Scott Fridkin
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Evan J Anderson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ben Lopman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - David Benkeser
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Julia M Baker
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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4
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Rivero-Calle I, Gómez-Rial J, Bont L, Gessner BD, Kohn M, Dagan R, Payne DC, Bruni L, Pollard AJ, García-Sastre A, Faustman DL, Osterhaus A, Butler R, Giménez Sánchez F, Álvarez F, Kaforou M, Bello X, Martinón-Torres F. TIPICO X: report of the 10th interactive infectious disease workshop on infectious diseases and vaccines. Hum Vaccin Immunother 2021; 17:759-772. [PMID: 32755474 PMCID: PMC7996078 DOI: 10.1080/21645515.2020.1788301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/20/2020] [Indexed: 11/03/2022] Open
Abstract
TIPICO is an expert meeting and workshop that aims to provide the most recent evidence in the field of infectious diseases and vaccination. The 10th Interactive Infectious Disease TIPICO workshop took place in Santiago de Compostela, Spain, on November 21-22, 2019. Cutting-edge advances in vaccination against respiratory syncytial virus, Streptococcus pneumoniae, rotavirus, human papillomavirus, Neisseria meningitidis, influenza virus, and Salmonella Typhi were discussed. Furthermore, heterologous vaccine effects were updated, including the use of Bacillus Calmette-Guérin (BCG) vaccine as potential treatment for type 1 diabetes. Finally, the workshop also included presentations and discussion on emergent virus and zoonoses, vaccine resilience, building and sustaining confidence in vaccination, approaches to vaccine decision-making, pros and cons of compulsory vaccination, the latest advances in decoding infectious diseases by RNA gene signatures, and the application of big data approaches.
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Affiliation(s)
- Irene Rivero-Calle
- Translational Paediatrics and Infectious Diseases, Department of Paediatrics, Hospital Clínico Universitario De Santiago De Compostela, Santiago De Compostela, Spain
- Genetics, Vaccines and Infections Research Group (GENVIP), Instituto De Investigación Sanitaria De Santiago, Universidad De Santiago De Compostela, Santiago De Compostela, Spain
| | - Jose Gómez-Rial
- Genetics, Vaccines and Infections Research Group (GENVIP), Instituto De Investigación Sanitaria De Santiago, Universidad De Santiago De Compostela, Santiago De Compostela, Spain
| | - Louis Bont
- Wilhelmina’s Children’s Hospital University Medical Center Utrecht, The Netherlands
| | | | - Melvin Kohn
- Vaccines and Infectious Diseases Medical Affairs, Global Medical and Scientific Affairs, Merck & Co. Inc., Kenilworth, NJ, USA
| | - Ron Dagan
- The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Daniel C. Payne
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laia Bruni
- Cancer Epidemiology Research Program, Institut Català d’Oncologia (ICO) - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Andrew J. Pollard
- Oxford Vaccines Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Denise L. Faustman
- The Immunobiology Laboratory, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Albert Osterhaus
- Artemis One Health, Utrecht, The Netherlands
- Research Center Emerging Infections and Zoonoses, Hannover, Germany
| | - Robb Butler
- WHO Regional Office for Europe, Copenhagen, Denmark
| | | | | | - Myrsini Kaforou
- Department of Infectious Disease, Imperial College London, London, UK
| | - Xabier Bello
- Genetics, Vaccines and Infections Research Group (GENVIP), Instituto De Investigación Sanitaria De Santiago, Universidad De Santiago De Compostela, Santiago De Compostela, Spain
| | - Federico Martinón-Torres
- Translational Paediatrics and Infectious Diseases, Department of Paediatrics, Hospital Clínico Universitario De Santiago De Compostela, Santiago De Compostela, Spain
- Genetics, Vaccines and Infections Research Group (GENVIP), Instituto De Investigación Sanitaria De Santiago, Universidad De Santiago De Compostela, Santiago De Compostela, Spain
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5
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Burke RM, Tate JE, Dahl RM, Saydah S, Imperatore G, Gregg EW, Parashar UD. Rotavirus Vaccination and Type 1 Diabetes Risk Among US Children With Commercial Insurance. JAMA Pediatr 2020; 174:383-385. [PMID: 31961393 PMCID: PMC6990735 DOI: 10.1001/jamapediatrics.2019.5513] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This cohort study uses commercial insurance data to examine the association between rotavirus vaccination and type 1 diabetes incidence.
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Affiliation(s)
- Rachel M. Burke
- Division of Viral Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jacqueline E. Tate
- Division of Viral Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rebecca M. Dahl
- Maximus Federal, Contracting Agency to the Division of Viral Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sharon Saydah
- Division of Diabetes Translation, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Giuseppina Imperatore
- Division of Diabetes Translation, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Edward W. Gregg
- Division of Diabetes Translation, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Umesh D. Parashar
- Division of Viral Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
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6
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Parashar UD, Tate JE. The control of diarrhea, the case of a rotavirus vaccine. SALUD PUBLICA DE MEXICO 2019; 62:1-5. [PMID: 31869556 DOI: 10.21149/9943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
[No disponible]
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Affiliation(s)
- Umesh D Parashar
- Viral Gastroenteritis Branch, Division of Viral Diseases, Centers for Disease Control and Prevention. Atlanta GA, USA
| | - Jacqueline E Tate
- Viral Gastroenteritis Branch, Division of Viral Diseases, Centers for Disease Control and Prevention. Atlanta GA, USA
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7
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Hungerford DJ, French N, Iturriza-Gómara M, Read JM, Cunliffe NA, Vivancos R. Reduction in hospitalisations for acute gastroenteritis-associated childhood seizures since introduction of rotavirus vaccination: a time-series and change-point analysis of hospital admissions in England. J Epidemiol Community Health 2019; 73:1020-1025. [PMID: 31511311 PMCID: PMC6877709 DOI: 10.1136/jech-2019-213055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/03/2019] [Accepted: 09/03/2019] [Indexed: 01/17/2023]
Abstract
Introduction The incidence of severe childhood diarrhoea has fallen substantially following the introduction of rotavirus vaccine in the UK in July 2013. Since children with rotavirus infection may experience febrile and afebrile seizures, we evaluated the impact of rotavirus vaccination on seizure hospitalisations in children in England. Methods Using data from Hospital Episode Statistics, we employed interrupted time-series analyses to assess changes in monthly hospital admissions for seizures among children aged <5 years from July 2000 to June 2017. Outcome measures comprised all seizures and febrile seizures, with and without a co-diagnosis of acute gastroenteritis (AGE). Models were adjusted for pneumococcal conjugate vaccine (PCV) introduction. Change-point analysis was used to independently identify step-changes in the time-series. Results Among hospitalised children aged <5 years, the incidence of any seizures and febrile seizures with AGE decreased post-vaccine introduction by 23% (95% CI: 11% to 33%) and 31% (95% CI: 19% to 41%), respectively. For febrile seizures with AGE, a single change-point was identified in July 2013 (95% CI: June 2013 to December 2013). Reductions in seizure incidence were higher during the rotavirus season (49%, 95% CI: 37% to 58%) compared with out-of-season (13%, 95% CI: −4 to 28%) and showed no relation to PCV introduction. There were small reductions in any seizures with any co-diagnosis (4%, 95% CI: 0% to 8%) and in febrile seizures with any co-diagnosis (10%, 95% CI: 2% to 16%). Conclusion Rotavirus vaccination has reduced hospitalisations for seizures associated with AGE in England, providing additional evidence of population-level impact of rotavirus vaccination on seizure incidence in high-income countries.
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Affiliation(s)
- Daniel James Hungerford
- Centre for Global Vaccine Research, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK .,NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, United Kingdom.,NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom.,Field Service, National Infection Service, Public Health England, Liverpool, UK
| | - Neil French
- Centre for Global Vaccine Research, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.,Tropical and Infectious Disease Unit, Royal Liverpool and Broadgreen University Hospitals NHS Trust, members of Liverpool Health Partners, Liverpool, United Kingdom
| | - Miren Iturriza-Gómara
- Centre for Global Vaccine Research, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.,NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, United Kingdom
| | - Jonathan M Read
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, United Kingdom.,NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom.,Centre for Health Informatics, Computing and Statistics, Lancaster University, Faculty of Health and Medicine, Lancaster, UK
| | - Nigel A Cunliffe
- Centre for Global Vaccine Research, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.,Department of Microbiology, Alder Hey Children's NHS Foundation Trust, members of Liverpool Health Partners, Liverpool, United Kingdom
| | - Roberto Vivancos
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, United Kingdom.,NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom.,Field Service, National Infection Service, Public Health England, Liverpool, UK
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8
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Impact of rotavirus vaccination on childhood hospitalizations for seizures: Heterologous or unforeseen direct vaccine effects? Vaccine 2019; 37:3362-3368. [DOI: 10.1016/j.vaccine.2019.04.086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/16/2019] [Accepted: 04/16/2019] [Indexed: 12/25/2022]
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9
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Gómez-Rial J, Sánchez-Batán S, Rivero-Calle I, Pardo-Seco J, Martinón-Martínez JM, Salas A, Martinón-Torres F. Rotavirus infection beyond the gut. Infect Drug Resist 2018; 12:55-64. [PMID: 30636886 PMCID: PMC6307677 DOI: 10.2147/idr.s186404] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The landscape of rotavirus (RV) infection has changed substantially in recent years. Autoimmune triggering has been added to clinical spectrum of this pathology, which is now known to be much broader than diarrhea. The impact of RV vaccines in these other conditions is becoming a growing field of research. The importance of host genetic background in RV susceptibility has been revealed, therefore increasing our understanding of vaccine effectiveness and giving some clues about the limited efficacy of RV vaccines in low-income settings. Also, interaction of RV with intestinal microbiota seems to play a key role in the process of infection vaccine effect. This article reviews current findings on the extraintestinal impact of RV infection and their widening clinical picture, and the recently described mechanisms of host susceptibility to infection and vaccine effectiveness. RV infection is a systemic disease with clinical and pathophysiological implications beyond the gut. We propose an “iceberg” model for this pathology with almost hidden clinical implications away from the gastrointestinal tract and eventually triggering the development of autoimmune diseases. Impact of current vaccines is being influenced by host genetics and gut microbiota interactions and these factors must be taken into account in the development of public health programs.
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Affiliation(s)
- José Gómez-Rial
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago de Compostela (SERGAS), Galicia, Spain, .,Laboratorio de Inmunología, Servicio de Análisis Clínicos, Hospital Clínico Universitario de Santiago de Compostela (SERGAS), Galicia, Spain
| | - Sonia Sánchez-Batán
- Laboratorio de Inmunología, Servicio de Análisis Clínicos, Hospital Clínico Universitario de Santiago de Compostela (SERGAS), Galicia, Spain
| | - Irene Rivero-Calle
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago de Compostela (SERGAS), Galicia, Spain, .,Translational Pediatrics and Infectious Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela (SERGAS), Galicia, Spain,
| | - Jacobo Pardo-Seco
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago de Compostela (SERGAS), Galicia, Spain,
| | - José María Martinón-Martínez
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago de Compostela (SERGAS), Galicia, Spain,
| | - Antonio Salas
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago de Compostela (SERGAS), Galicia, Spain, .,Unidade de Xenética, Departamento de Anatomía Patolóxica e Ciencias Forense, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, Galicia, Spain.,GenPoB Research Group, Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago de Compostela (SERGAS), Galicia, Spain
| | - Federico Martinón-Torres
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago de Compostela (SERGAS), Galicia, Spain, .,Translational Pediatrics and Infectious Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela (SERGAS), Galicia, Spain,
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10
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Biggart R, Finn A, Marlow R. Lack of impact of rotavirus vaccination on childhood seizure hospitalizations in England - An interrupted time series analysis. Vaccine 2018; 36:4589-4592. [PMID: 29937243 DOI: 10.1016/j.vaccine.2018.06.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 06/07/2018] [Accepted: 06/12/2018] [Indexed: 11/18/2022]
Abstract
Observational studies have linked a reduction in childhood seizures (CS) to the introduction of rotavirus vaccination (RV). England is opportunely placed to explore this due to well-defined introduction, high uptake of RV and centralised Hospital Episodes Statistics recording all admissions. We investigated the association between seizures and vaccine use through interrupted time-series analysis of all CS admissions in children <3 years old (ICD-10 codes; G40∗-G41∗, R56.0∗) during 2007-2017. We did not detect a statistically significant association between the introduction of RV and admission with febrile (p = 0.84), afebrile (p = 0.83) or all CS (p = 0.93), even when limited to peak rotavirus seasonality (March). This is the first ecological study in a country that exclusively uses the monovalent vaccine. Although a negative finding, we would argue that if an effect cannot be detected at this population level then it is unlikely to be clinically or economically significant but generates hypotheses of potential non-specific effects.
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Affiliation(s)
| | - Adam Finn
- Population Health Sciences, University of Bristol, UK
| | - Robin Marlow
- Population Health Sciences, University of Bristol, UK
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